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                        OF NOTE...
                        News to Use

Special Medical Edition (41-50)                       December 1, 1993
Earl Appleby, Jr., Editor                             CURE, Ltd.

                         Alternative Medicine

Wang-Pong Chen demonstrated the ancient art of Qi Gong in the main
auditorium of the National Institutes of Health's hospital, the
Clinical Center, "a place that in some cosmologies is the center of
the medical universe." The 32-year-old Chinese healer held a one-and-
a-quarter-inch thick quartzite rock in his right hand. Crouching,
shouting, and stamping his foot, he jabbed at it with two fingers of
his left hand without appearing to strike it. Accompanied by a few
shards and considerable dust, the top of the rock flew some four feet.
Among the three hundred witnesses was molecular geneticist Roscoe
Brady, chief of the developmental and metabolic branch of the National
Institute of Neurological Orders and Stroke. Asked if the Qi Gong
master had shattered the stone without making contact, he replied,
"From where I sat, it appeared as if he did," adding, "As a scientist,
the first thing you want to know is: How does he do it? If it is
really true, how is it that he concentrates these forces?" (A Hands-
Off Approach to Healing, David Brown, Washington Post, 9/3/93)

                               Arch Who?

For most of the United States, mid-August signals the start of allergy
season with the onset of ragweed pollination. A single ragweed plant
produces a million pollen grains a day. Pollen has been found 400
miles out at sea. (Ragweed Is Back, Peter Mac Pherson, WPH, 9/7/93)

                           Biotech Bulletin

A Food and Drug Administration (FDA) advisory panel's recommendation
for approval of Genentech Inc.'s genetically-engineered Pulmozyme, the
first drug therapy for cystic fibrosis to appear in nearly three
decades should boost morale in the emerging biotechnology industry,
where stocks have been hit hard by disappointing clinical trials and
the uncertainties surrounding health care reform. (Biotech's
Regulatory Relief Act, Daniel Southerland, Washington Post, 8/10/93)

                            Breath of Life

Breath in Danger II, a new report from the American Lung Association,
estimates that 66% of Americans live in areas that fail to meet
current standards of air quality. (How Good Is the Air Americans
Breathe? Washington Post Health, 7/13/93)

                            Courting Disaster

A Montgomery County, MD judge freezes the assets of Rockville
accountant Thomas Karam and his wife in connection with a $15-million
civil lawsuit by Fairfax Anesthesiology Associates Inc. who charge
that Karam moved some $13 million of its money, repaying all but $2.5
million--a charge Karam's attorney Richard Hibey says his client
"adamantly" denies. (Doctors Sue Accountant in Case of Missing Funds,
William Powers, Washington Post, 9/3/93)

                               Dateline World

"An outpouring of financial help for Elena Kobzeva, a 14-year-old
Russian girl who has waged a three-year battle against leukemia, will
enable her to have a bone marrow transplant that is her only hope for
life, Children's Hospital said yesterday. 'She's going to have it. The
money's there, and we're ready to see her,' a hospital spokeswoman
said....The hospital required a $90,000 deposit on the $115,000
procedure before admitting the girl, based on its rules that
foreigners must pay cash up front." (Lifesaving Transplant Funded by
Strangers, Phil McCombs, Washington Post, 11/18/93)

                            Diabetes Data

According to the results of a ten-year trial by the National Institute
of Diabetes and Digestive and Kidney Diseases, much of the blindness,
kidney damage, and amputations often encountered by insulin-dependent
diabetics can be delayed and even prevented by stricter use of
standard methods to control blood-sugar levels. (Diabetics Can Avoid
Complications with Stricter Regimen, Study Says, Sally Squires,
Washington Post, 6/14/93)

                        Doctor, Doctor

"I simply had to respond to the letter from the medical transcriber
who was going bonkers trying to translate tapes dictated by doctors
who eat while they're talking. I do a great deal of transcribing for
doctors, and I wish eating were the only thing I had to listen to
besides the dictation. I have heard gum chewing and popping, apples
being crunched, a kid practicing the clarinet in the background, and
airplanes droning. Some of the doctors dictate while they are at ball
games, attending weddings, or playing poker." --Blushing in San
Bernardino. (Slob Doctors Are at Their Worst on Tape, Landers,
Martinsburg Journal, 6/28/93)

"Dr. Josephine Newell remembers crawling her way up an icy ravine with
her doctor's bag in her left hand and her broken right hand buttoned
into her coat. She eventually made it through the storm--which left
her car in the creek and her wrist broken--to reach her heart
patient's home. That was 30 years ago and the retired country doctor
knows her once-thriving profession as an endangered species. 'I don't
think you'll find many of us left,' says Newell, 68, who practiced in
Bailey, NC, population 548. 'Doctors who would make house calls are
dying, if not gone.'" (Booster Shot for Country Doctors, Nikki Maute,
USA Today, 7/1/93) ABLEnews Editor's Note: For another treatment of
Dr. Newell's story see the June 21 issue of MedNotes. Some 25 years ago
a group of North Carolina professional women decided to open a museum.
"There were more doctors than lawyers and postal workers among us so we
decided to go medical instead of legal." --Dr. Josephine Newell,
co-founder, Country Doctor Museum, Bailey, NC.

"A doctor can never be involved in approving interrogation [of
prisoners]. A doctor can only report on the medical condition."
--Miriam Zangen, chairwoman, Israeli Medical Association. "Civil
rights lawyer Tamar Peleg said that among medical documents given her
by a prison in the occupied West Bank was a 'Medical Fitness Form'
saying her client could be bound, hooded, and made to stand for long
periods." (Israeli Group Warns Doctors Against Approving
Interrogation, Washington Post, 7/1/93)

"Approaching its 100th anniversary, the university that became a model
for modern medical school education has refined its curriculum, to
soften the traditional steamroller approach and produce doctors ready
for the 21st century...Rather than cram heads full of facts in copious
lectures, the school wants to foster a lifetime of learning so doctors
can adopt to technological innovations, shifting economics, community
concerns, and medical advances." CURE Comment: Pedagogical techniques
can always be improved, although it should be noted that at least one
medical student on a PBS documentary series reporting on a similar
technique complained about the dearth of information provided students
by professors. What concerns CURE is the replacement of factual
instruction with political indoctrination rationalized as community
and, revealingly, economic concerns. (John Hopkins Giving Medical
Students Breathing Room, Sunday A.M., July 11, 1993)

"I have been offended by your recent articles concerning doctors'
incomes. Most grievous have been those comparing doctors' salaries to
the 'average person'...Who is the average person? Is it someone with a
high school diploma or an undergraduate degree? Is it someone with
four years of graduate training, followed by three or four more years
of specialty training?...Does the undefined average person pay
malpractice insurance? Does she or he have employees and skyrocketing
overhead expenses?" --Khristine Kuck, Sioux Falls, SD. (Can't Compare
Docs, 'Average Person,' Kuck, letter-editor, USA Today, 7/12/93)

"First, Boston Celtics basketball star Reggie Lewis collapsed in a
playoff game last spring. Next, one group of doctors told him he had a
life-threatening heart condition. Other doctors, said, no, it just
seemed to be a tendency to faint, controllable by medication, and he
could probably play. Last week, Lewis decided to get out on a
basketball floor and died." (When Your Doctors Disagree, Victor Cohn,
op ed, Washington Post Health, 8/3/93)

"The standard doctor's office visit is not so standard, a study of 59
primary care physicians in northern New England found. Trained
actresses posing as 55-year-old patients overdue for most recommended
medical tests and at risk for lung, breast, and colorectal cancer
requested a routine checkup but what they received varied widely in
time, cost, and content...The time devoted to the office visit ranged
from five minutes to an hour. The fees ranged from zero..to $108." (A
Routine Checkup? Depends on the Doctor, Don Colburn, WP Health, 8/10/93)

"Our role [as physicians]...is to heal when we can, and to comfort
always, but it has never been to kill." --Jimmie C. Holland, MD,
chief of psychiatric service, Memorial Sloan-Kettering Cancer Center,
New York, NY. "Regardless of whether patients use [Dr. Jack]
Kevorkian's machine or [Dr. Timothy] Quill's compassionate
prescription for sedatives, they are dead by premeditated intention.
In either case, physicians, who are the necesary instruments of the
patient's death, are as such a moral accomplice as if they had
administered the dose themselves." --Edmund Pelligrino, MD, director,
Center for the Advanced Study if Ethics, Georgetown University,
Washington, DC. (Assisted Suicide, Dan Colburn, WP Health, 9/14/93)

"Ken Yuasa admits he used healthy Chinese for practice surgery during
World War II, removed parts of their brains, and even shot prisoners
in order to demonstrate how to remove bullets. As a Japanese army
doctor, Yuasa said, he tested the effectiveness of anesthetics on two
healthy farmers and practiced a tracheotomy. His colleagues cut their
arms, legs, and intestines into pieces, and then stitched them back
together again. After the surgery practice, the doctors killed their
'patients,' strangling one with a belt when he survived the injection
of an anesthetic into a vein...Hundreds of other doctors and nurses
conducted similar experiments in Shanxi Province alone, he said. 'Most
never have recognized their crime because it was 'justice.'"...Yuasa
said...the Japanese conducted mass medical experiments on thousands of
captive, otherwise healthy subjects. Most notorious is Unit 731,
which...killed at least 3,000 Chinese, Russians, Koreans, and
Mongolians in top-secret experiments that involved injections of
various germs, such as anthrax, typhus, and dysentery; human
vivisection; and shrapnel-induced gangrene. Many of those who survived
the experiments were executed later so they would not talk." (Doctor
of Death, Mari Yamaguchi, Washington Times, 9/18/93)

Among the 34 states with the death penalty, only Maryland uses the gas
chamber exclusively. Virginia uses an electric chair, while the
District of Columbia has no death penalty. Maryland's gubernatorial
commission says a lethal injection option will bring Maryland in line
with other states, and Gov. William Donald Shaefer's spokesman Page
Boinest says he supports lethal injections as more "cost-efficient."
Gary Bair, the commission's chairman, agrees it is "less expensive."
But Diann Rust-Tierney, director of the Capital Punishment Project of
the American Civil Liberties Union, says execution by injection
"raises some thorny ethical questions for members of the medical
profession, since it involves medical technology." CURE Comment:
Traditionally the AMA has found physician participation as executioner
unethical. CURE opposes capital punishment by lethal injection because
it blurs the role of doctor and executioner. (Maryland Panel Urges
Lethal Injection, Richard Tapscott, Washington Post, 10/6/93)

"I am an advocate of Dr. Richard Selzer's concept of the 'diagnostic
embrace' [between doctor and patient], as are, I believe, most of my
colleagues. There is a concern that the embrace may, by governmental
tampering, become the dispassionate hug of second cousins at a family
picnic." --Howard Levine, MD, Bethesda, MD. (Doctor-Patient Rapport,
Levine, letter-editor, Washington Post Health, 10/12/93)

"Pres. Clinton's health care reform plan is creating anxiety among
many area medical students and educators, who fear that its emphasis
on family medicine and competitive pricing would limit doctors' career
choices and threaten both the role and funding of teaching
hospitals... Medical students and residents said they are concerned
that they may not get to pursue their chosen fields or earn enough
money to repay their medical school loans--some as high as $130,000--
and support families at the same time. And educators say forcing
teaching hospitals to compete for patients--at the same Medicare
reimbursement rate as other hospitals, instead of the higher rate they
now receive--could drive away patients at the expense of students'
educations." (Clinton Makes Them Wince at Medical School, Brooke
Masters, Washington Post, 10/18/93)

                                   Eye Say

Implanted in the corneas of nearsighted people the Intrastomal Corneal
Ring, a flat, plastic ring a third of an inch in diameter, marks the
latest experiment in the treatment of myopia which affects 20 million
Americans. But while Dr. Jay Pepose, professor of ophthalmology at
Washington University School of Medicine, agrees "it may become a
useful technique to offer patients," he reminds us that "forms of
refractive surgery that now exist, like radial keratotomy...have gone
through a much longer period of evaluation." (Tiny Plastic Rings May
Bring New Focus to the Nearsighted, Martinsburg Journal, 9/21/93)

                               FDA Files

"An inevitable rite of childhood--getting chicken pox--could soon be
history if federal health officials approve a vaccine to protect
against the viral disease...But for scientists, the vaccine under
review by the Food and Drug Administration [FDA] has raised some
serious questions--including whether chicken pox, ususally more an
annoyance than a menace, is worth vaccinating against in the first
place."

An independent federal advisory panel for the FDA will review clinical
test data on Respivir. The drug, manufactured by the biotech firm
MedImmune fights a virus that causes infant pneumonia. (MedImmune Drug
to Get FDA Review in September, Daniel Southerland, WP, 8/24/93)

This year alone 14 drugs manufactured by Warner-Lambert have been
recalled by the FDA. They include Centrax, used to control anxiety,
Norlestrin, an oral contraceptive, Norlustate, used to control uterine
bleeding, Pyridium, an anesthetic used in urinary tract infections,
Tedral, used to treat bronchial asthma, and at least one form of
Dilantin, used in treating epilepsy. "It just looks like this company
has a plethora of problems. The question is why it took so long for
the FDA to do anything." --Sidney Wolfe, executive director, Public
Citizen Health Research Group. (No Shortages Seen in Drug Maker
Revamping, Sally Squires, Washington Post Health, 8/24/93)

"A fifth volunteer died...from an experimental drug (Fialuridine or
FIAU) touted as a miracle cure for hepatitis B...as scientists
unraveled the mystery of what went gravely wrong in a clinical
trial....'Something terrible happened and we missed it,' Dr. Jay
Hoofnagle said in an emotional interview describing the horror of
realizing that the drug was killing people months after they stopped
taking it. "The dreadful thing is waiting to see what will happen," he
said, his voice trembling, before learning of the latest death. 'I
just hope we're over the worse.'" (Fifth Dies From Liver Drug Testing,
MJ, 9/1/93)

After MedImmune Inc. announces that the Food and Drug Administration
(FDA) is postponing its review of the Gaithersburg, MD biotechnology
company's application to market Respivir to combat infant pneumonia,
its stock plunges 19% in heavy trading. (Med Immune Stock Tumbles on
FDA Delay, Daniel Southerland, Washington Post, 9/3/93)

"More than four years ago, a scare over possible cyanide poisoning of
grapes imported from Chile stumped the Food and Drug Administration...
Though agency investigators found cyanide in two grapes plucked from
among tens of thousands sitting on a Philadelphia dock, they could
never say whether the contamination took place in Chile, on a boat en
route to the United States, on the docks, or perhaps at the FDA's own
lab...Grocery shelves were cleared. Tons of fruit spoiled as the FDA
imposed an embargo...Chilean growers lost an estimated $240 million.
In the end, there was little evidence that the threat was real, but
substantial evidence that the agency charged with policing thousands
of consumer goods and much of the nation's food supply was not
equipped to do the job." (New Tools Make FDA Tougher in Tracking
Threats to Public Safety, Howard Schneider, Washington Post, 10/18/93)

The Food and Drug Administration (FDA)'s Endocrinologic and Metabolic
Drugs Advisory Committee recommends FDA approval of Nutropin,
Genetech's recombinant human growth hormone, which may help children
with kidney failure keep growing. (FDA OKs Growth Drug to Help Kids,
Morning Herald, 10/25/93)

Admitting that scientists missed warning signals in three earlier
experiments with fialuridine, the hepatitis B vaccine implicated in
the deaths of five subjects, FDA Commissioner David Kessler announces
the agency will revise its rules for clinical drug trials. (Deaths in
Drug Trials Prompt FDA Reforms, Washington Times, 11/16/93)

                           Food for Thought

"Some of the 30,000 doctors, nurses, and researchers at the American
Heart Association's annual meeting talk healthy diets out of ones side
of their mouth, and put burgers and fries in the other. At lunch they
clogged their arteries with meals high in cholesterol, fat, and
sodium, all of which contribute to heart disease. 'It was convenient
and quick,' Dr. Paul Colavita said as he gulped down a Big Bacon
Classic Burger and Biggie Fries at a Wendy's near the convention site
the Georgia World Congress Center. But doesn't it set a bad example
for doctors to be seen eating such fatty meals? 'Not me, because I
took my name tag off.' Colavita said." (Do As I Say, Not as I Do:
Heart Doctors Load Up on Junk Food, Martinsburg Journal, 11/10/93)

                              Heart Beat

Ron Humphreys, 51, is the first graduate of Washington County (MD)
Hospital's Cardiac Rehabilitation Program, which provides a monitored
environment in which patients who have had a heart attack, angina, or
bypass surgery can strengthen their hearts. (Cardiac Comeback, Julie
Greene, Morning Herald, 8/26/93)

Some forms of high density lipoproteins (HDL)--the so-called "good"
cholesterol--thought to prevent heart disease may cause it,
researchers at the University of California, Los Angeles (UCLA)
report. (Heart Disease Protein Nixed, NCR, 8/29/93)

While the American College of Sports Medicine recommends stress tests
for healthy but sedentary men over 40 and women over 50 wishing to
being such strenuous exercise as jogging 20 minutes or more, Paul
Thompson, director of preventive cardiology at the University of
Pittsburgh, does not believe stress tests effectively predict who will
die while exercising. (Stress Test Before Exercise May Not Find Heart
Problems. Washington Post Health, 10/5/93)

Despite doctors' orders, most patients with automatic implantable
cardioverter defibrillators (AICD) to prevent cardiac arrest still
drive, a South Carolina study reports. (Patients with Implants Ignore
Driver Warning, Don Colburn, Washington Post Health, 10/12/93)

"Based on a large body of evidence, we believe [low] socio-economic
status should be added to the list of potential risk factors for
cardiac disease." -American Heart Association study, which found a
strong link between poverty and increased mortality from heart and
blood vessel diseases, including atherosclerosis, or build up of fatty
deposits along the inside of artery walls. (How Status Affects Risk of
Heart Disease, Stroke, Don Colburn, Washington Post Health, 10/19/93)

Using ultrasound scans, doctors at Boston's New England Medical Center
have created the first three-dimensional holograms of the living human
heart. Viewing the heart from above or the sides reveals details that
cannot be seen head on. Researchers report the images could help
physicians diagnose heart problems and determine how to treat them.
(Holograms May Help Find Heart Ailments, MJ, 11/10/93)

                            Heart Stoppers

83-year-old Edna Connor of Queens, NY dies in hospital of a massive
overdose of morphine which the New York City's Chief Medical Examiner
rules was "intentionally administered intravenously in a homicide" or
what the New York Times calls an apparent "mercy killing." (Overdose,
Communique, 7/23/93)

"The better response to patients in pain is not to kill them, but to
make sure that the medicine and technology currently available to
control pain is used more widely and competently." (Why We Shouldn't
Legalize Assisted Suicide, Part II, Burke Balch, JD, and David Waters,
NRL News, 9/30)

"Physicians planning to withdraw support must therefore make choices,
and their decisions may influence the rapidity, painlessness, and
dignity of patients' deaths." --Nicholas Christakis, MD; David Asch,
MD; University of Pennsylvania, and colleagues. CURE Comment: A lethal
injection is rapid but of questionable legality at present. Starving a
patient to death is hardly painless, euthanasia never dignified.
(Halting Life Support: One Question Is How, Don Colburn, WPH, 10/5/93)

                               Helping Hands

"When you're sick, and frightened and scratching and coughing and
hurting and telling yourself the lump has got to be cancer because it
can't possibly be anything else, and you've lost your job and don't
have any insurance so you can't afford to go to the doctor. and you
understandably start getting pretty desperate about all this, there's
a place you can go called the Washington Free Clinic. There are real
doctors and nurses there who are volunteering their services and who
will give you the same excellent treatment and analysis you'd receive
in one of those nice little brick houses in Bethesda where private
doctors keep their offices, and if you don't speak English it doesn't
matter because the clinic will put an interpreter right in the
examining room with you and the doc. And when you walk out of the room
you may well think...that an angel of mercy has touched your life."
(Where Healing Comes Without a Price Tag, Phil McCombs, WP, 10/28/93)

                              HOSPITALity

"America's hospitals are wasting vast sums of money on paper-pushing
and billing." --Steffie Woolhander, Harvard Medical School, whose
study, reported in the New England Journal of Medicine (NEJM), finds
that twice the proportion of health care costs go to administration
and billing costs in the United States as in Canada. Stuart Altman,
chairman of the Prospective Payments Assessment Commission, that
advises Congress on health care costs, calls the study's $50 billion
estimate "absurd," and Kenneth Thorpe, deputy assistant secretary,
Department of Health and Human Services also expressed doubt at the
figure, estimating the rate at 15 to 16%. (Hospital Administration
Costs Put at 25%, Spencer Rich, Washington Post, 8/6/93)

"A landmark agreement which helps to build public awareness of the
behaviors, practices, and attitudes that either cause or prevent
advancement of minorities and women to leadership and management
positions." -Robert Reich, Secretary of Labor, on Fairfax Hospital's
settlement in which 52 women will receive $425,586 in back pay and the
44 still employed by the hospital will receive raises totalling
$178,357. (Fairfax Hospital to Pay $640,000 in Sex Bias Study,
Patricia Davis, Washington Post, 10/1/93)

                             Mal-Practice

"I've never found any victim who has been seriously injured who
believes that their damages should be limited to some arbitrary figure
of $250,000. I know the complaint from doctors; they only have one
Mercedes." --Philip Corboy, personal-injury attorney, Chicago, IL.
(Lawyers Say No to Limits on Malpractice, Martinsburg Journal, 8/9/93)

Medicare has been cheated out of $14 million by a ring of doctors and
health care companies issuing phoney billings for nutritional
supplement and feeding tubes. "The recruiters would go to community
centers and apartment buildings where large numbers of senior citizens
were present to solicit new patients," the indictment charges. "The
recruiters would tell the senior citizens they were eligible to
receive 'milk' free of charge from the government." (Billing Fraud Got
Millions from Medicare, Martinsburg Journal, 8/10/93)

From 1990 to 1992, the number of fraud cases investigated by insurers
rose more than 75%, according to the Health Insurance Association of
America (HIAA), which reports that health care providers are twice as
likely to be involved as patients. (Investigating Health Care Fraud,
Washington Post Health, 9/7/93)

A research team of physicians, attorneys, economists and statisticians
reviewed 31,000 medical records of patients discharged in 1984 from
New York state hospitals, applying their findings to the 2.6 million
patients discharged that year, they estimated that medical treatment
had injured close to 100,000 patients, nearly a third of them through
the negligent acts of doctors, nurses, and other health care
providers. Half of the 14,000 patients who died of injuries inflicted
in hospitals were victims of negligence. According to Dr. Howard
Hiatt, a professor of medicine at Harvard Medical School, who directed
the research, medical malpractice kills 700,000 Americans a year--
twice the number who die in automobile accidents. (When Should a
Doctor Pay for a Mistake?, Earl Ubell, Parade Magazine, 9/12/93)

"Call the Louisiana State Board of Examiners and ask about
obstetrician-gynecologist Rodney William Brown and the answer is that
he has an office in New Orleans, holds an unrestricted medical
license, and is considered to be in 'good standing.' What callers are
not told is that the 54-year-old physician has been the subject of
serious disciplinary action in two states. Last March, he surrendered
his California medical license after he was charged with gross
negligence and incompetence...Nor are callers usually told that
despite his 'good standing,' Brown is under investigation by the
Louisiana medical board. This is not the first time the Louisiana
medical board has investigated Brown." (What You Can't Know About Your
Doctor, Sandra Boodman, Washington Post Health, 9/14/93)

"Thank you for your article, 'What Patients Can't Know About Their
Doctors' [Cover, September 14]. You highlighted a problem at the core
of our health care crisis: the lack of physician accountability. When
doctors of proven incompetency are enabled to hide out in our
hospitals and clinics, when the Department of Health and Human
Services, the American Medical Association  and other medical
societies, state boards and hospital administrations protect
incompetent doctors from us and not the other way around, not only is
the well-being of Americans endangered but the well-being of our
entire health care system." --Janice Byer, Clifton, MD. (Getting
Information on Bad Doctors, Byer, letter-editor, WP Health, 10/5/93)

"Your special report was one of the best in-depth stories you've done.
Bad doctors add to the cost of medical insurance when huge malpractice
payments are awarded; they burden any consumer who must spend extra
time and money to remedy the problems caused by bad advice or
service." --D.L. Foster, Martinsburg, WV. (Getting Information on Bad
Doctors, Foster, letter-editor, Washington Post Health, 10/5/93)

"I read with curiosity 'How to Treat Your Doctor' [How & Why,
September 14]. If anything, doctors should learn how to treat their
patients. I am a 23-year-old health-conscious woman who has changed
doctors three times this year. One physician almost cause me to have a
nervous breakdown. I requested to be tested for the HIV virus and was
told by the doctor that someone would call me in three days with the
results. By the fourth day, I was anxious. On the fifth day, I called
the office and was told the results were negative." --Jaunice Cromer,
Lanham, MD. (Lessons for Doctors, Cromer, let-ed, WP Health, 10/5/93)

A.M. Ozbey's  September 28 letter was noteworthy in that he neglected
to mention the real victims of malpractice. The victims are not the
physicians. The victims are the patients who receive substandard care.
When health care professionals begin to focus on this reality, rather
than on lawyers, they will be on the path to solving the malpractice
problem. Retraining and disciplining negligent physicians is only part
of the solution. Adequate compensation and protection of patients
should be paramount. --James Taglieri, Washington, DC (Malpractice
Victims, Taglieri, letter-editor, Washington Post, 10/14/93)

Conventional wisdom among physicians notwithstanding, poor patients
are not more likely to sue doctors for poor practice. According to
Harvard researchers, the poor and near-poor are only about 10% as apt
to sue for malpractice, even when they are victims of serious,
ngeligent injuries, since they have less access to legal
representation. Older patients are also less likely to file
malpractice suits. CURE Comment: By eliminating or restricting
contingency fees, malpractice tort reformers would compound the
discrimination poor victims of medical negligence face by virually
eliminating their slight access to competent legal counsel. (Poor Are
Less Likely to Sue Their Doctors, Sandra Boodman, WP Health, 10/26/93)

"I admit that it was improper to engage in a sexual relationship with
any patient." --Neil Solomon, M.D., Maryland's first secretary of
health, in a statement released by the state Board of Physician
Quality Assurance. Dr. Solomon admitted to initiating sexual relations
with at least eight female patients "for my own sexual gratification."
(Maryland Doctor Admits to Sex Charges, Richard Tapscott, WP, 10/28/93)
Edward Simon, a 77-year-old doctor who practiced family medicine for
more than 50 years in Havre de Grace, surrenders his medical license
in a letter to the Maryland Board of Physician Quarterly Assurance.
The letter lists three charges for which the board was seeking the
suspension of Dr. Simon's license: immoral or unprofessional conduct
in the practice of medicine; solicitation of professional patronage
through an agent or other person, or profiting from the acts of
another person who is represented as an agent of the physician; and
selling, prescribing, giving away, or administering drugs for illegal
or illegitimate medical purposes. The letter cited advanced age and
poor health as reasons for Dr. Simon's decision to surrender his
license and cited his ling-standing practice of treating the indigent
without charge. (Doctor Gives Up License Over Drug Allegations, Mike
Farabaugh, Baltimore Sun, 10/29/93)

                            Medicine Chest

Betaseron, a genetically engineered drug containing beta interferon, a
protein that helps regulate the immune system, is the first drug that
"appears to treat multiple sclerosis." (Betaseron for MS Closer to
[FDA] Approval, Sally Squires, Washington Post Health, 6/22/93)

"Pharmaceuticals are not only expensive, they are also often dangerous
to women's health. Large sectors of American women have been tranquil-
ized for decades with Miltown, Valium, Librium, and Thorazine. Now
lots of new drugs have been added. Prozac, hormones, and other anti-
depressants are being heavily promoted as mood sweeteners for women."
--Joan Lester, executive director, Equity Institute, Emeryville, CA.
(Women a Big Market for 'Legal' Drug Pushers, USA Today, 6/29/93)

"The latest drug to be tried against the AIDS virus has a
controversial past. It's thalidomide--best known as the morning-
sickness drug that caused severe birth defects in the 1950s and
1960s." (Drug From the Past, USA Today, 7/1/93)

Artemisin, an ancient Chinese remedy for fever, it the world's
treatment of choice for multi-drug resistant malaria, but it is not
licensed in the US. It is derived from an easily grown weed related to
the herb anise. (An Ancient Assault on Malaria, Sandy Rovner,
Washington Post Health, 7/13/93)

"Editorial voices across the Nation have been raised in oppostion to
proposals for government regulation of pharmaceutical prices. We
believe voluntary price restraints are a better solution. In fact, 17
companies representing 65% of the US prescription drug market have
already individually pledged to keep prices at or below the rate of
inflation. For more information call the Pharmaceutical Manufacturers
Association at 1-800-538-2692." (The Word Is Out that Federal
Regulation of Prescription Drug Prices Is the Wrong Medicine, PMA, ad,
Washington Post, 7/26/93)

"Having dusted itself off after the bribery and fraud scandals of the
1980s, the generic drug industry is preparing for a new battle. The
push to cut health care costs and the pending expiration of patents
for a slew of drugs will expand the market for generic drugs."
(Generic-Drug Makers Prepare for Their Next Battle, Jyoti Thottam,
Wall Street Journal, 8/9/93)

"What we have here is a company in the mode of taking on major drugs,
shaking the tree in the hopes something will fall out." --Steven
Judlowe, attorney for Glaxo Inc., which is defending its patent for
Zantac, the world's best-selling prescription drug, against the
Canadian generic manufacturer Novopharm Ltd. Earlier Novopharm and
other generic maker lost their challenge to Burroughs Wellcome Co.'s
patent for AZT, used in treating AIDS. (Companies Fight Over Rights to
Ulcer Drug, Martinsburg Journal, 8/10/93)

"The Food and Drug Administration's approval...of a drug for epilepsy
ends a 15-year lapse in new medical treatments for this mysterious
neurological condition. Felbamate, the drug that won FDA approval, is
expected to offer a new option for those with hard-to-treat epilepsy,
especially the 2,000 children who suffer from a severe form of the
disorder, known as Lennox-Gastaut syndrome. One key advantage of the
drug is that unlike some of the other medications now available,
felbamate is not a sedative, so it won't make users feel sleepy or
sluggish." ABLEnews Editor's Note: For further information about
epilepsy, contact the Epilepsy Foundation of America at 1-800-EFA-1000
(9AM-6PM, Eastern Standard Time, Monday-Friday). (New Drug for
Epilepsy, Sally Squires, Washington Post Health, 8/10/93)

According to a study reported in the Journal of the American Medical
Association (JAMA), treating mild hypertension with medication, diet,
and exercise works slightly better than treating it with lifestyle and
exercise alone. About 50 million Americans have high blood pressure
and about $8 billion a year is spent treating it. (Medication Found
Helpful in Treating Mild Hypertension, David Brown, WP, 8/11/93)

"Like 2.5 million other Americans, [Lynn] Tiscia, a 38-year-old
Connecticut homemaker and mother of two young boys, suffers from
epilepsy, in her case the result of brain damage sustained in a car
crash...While about half of epilepsy patients have been able to
control their seizures with drugs such as Dilantin, Tegretol, and
phenobarbital, Tiscia was one of the other, less fortunate
half...Until now. Tiscia's life changed dramatically last fall when
her doctors prescribed an experimental drug called felbamate." (Taming
the Brain Storms, Christine Gorman, Time, 8/16/93)

"Dear Ann:...We need to realize that the cost of a bottle of medicine
is not just for those '20 tiny pills' but for the research, testing,
manufacture, and liability insurance premiums. Like a spoiled child
who whines until he gets something he never really wanted, Americans
who complain that drugs are too expensive may get something THEY don't
really want--no more life-saving drugs. Drug companies cannot give
away their products and continue to support the research scientists
who are dedicated to finding cures for as yet untreatable illnesses.
We are all potential victims, so we had better not be so quick to
condemn the 'money-hungry' pharmaceutical companies.' An Indiana
Reader." (Drugs that Save Lives Can Be Worth the Price, Ann Landers,
op-ed, Martinsburg Journal, 9/17/93)

"Fewer than one-half of one percent of the 250,000 higher plants of
the world have been thoroughly analyzed for their chemical composition
and therapeutic benefit. We know so little about these species and
their potential." --Michael Balick, New York Botanical Garden on
project with Pfizer. (Botanical Garden, Drug Company Join Forces in $2
Million Project, Martinsburg Journal, 9/20/93)

Illnesses in which interferon seems to be making a difference include
multiple sclerosis, hepatitis B and C, Karposi's sarcoma, genital
warts, chronic granulomatous disease, cervical cancer, bladder cancer,
tuberculosis, and kidney cancer. (Interferon Shows Renewed Promise,
Sally Squires, Washington Post Health, 10/12/93)

"The letters look like any other constituent  mail that streams into
the office of Rep. Ron Wyden (D-OR) each day. Only in these letters,
the prepared text is crossed out and replaced with a more personalized
message: 'This junk mail came to me from those drug companies. Pretty
phony and self-serving. You should be aware of the source if you
receive any.'" (Drug Industry Seeds the 'Grass Roots,' Jack Anderson
and Michael Binstein, Washington Post, 10/21/93)

If Medco Containment Services Inc.'s shareholders approve the
company's merger with Merck & Co., America's largest pharmaceutical
manufacturer will be able to persuade physicians to prescribe its
products through the large mail-order dispenser. Accordingly,
consumers and health care reformers have a stake in the vote at
tomorrow's special meeting. (High-Pressure Tactics Raise Doctor's
Pressure,  Philip Alper, MD, Wall Street Journal, 11/17/93)

                               NIH News

"Few posts are more important to the nation's health--and to the
health of scientific research--than director of NIH. Since 1887, when
it was the one-room Laboratory of Hygiene, NIH has grown into a vast
biomedical research conglomerate with a 300-acre campus in Bethesda
and an annual budget that tops $10 billion. The research conducted
through the 24 institutes, centers, and visions that make up NIH and
its 1,700 research institutions worldwide affects every branch of
medicine from heart disease and cancer to mental health and gene
technology. NIH employs 19,00 people, 4,500 of whom hold professional
or research doctorate degrees...[Harold] Varmus would be the first
Nobel Laureate to head NIH." (A Hands-On Researcher for NIH, John
Schwartz, Washington Post, 8/9/93)

According to statistics compiled by the NIH chapter of Blacks in
Government, the average salary for white employees at the National
Institutes of Health (NIH) is $44,615; for black males, $34,191, and
for black females, $29,502. (Blacks Describe How Bias Hurt Their
Careers at NIH, Veronica Jennings, Washington Post, 8/10/93)

"I was in housekeeping for 11 years as a temporary, with no benefits.
When I started speaking out in 1986, that's when the problems
started." --Paula Bufford, telling a National Institutes of Health
(NIH) Task Force that she received negative performance ratings and
was denied overtime after complaining about being passed over for a
permanent position. (Retaliation Was the Rule, NIH Workers Tell Panel,
Veronica Jennings, Washington Post, 8/11/93)

"The first meeting of the People Against Fraud and Abuse of Power in
Public Institutions was held at the Northwest Washington home of
neurologist Maureen Polsby...(who) left the National Institutes for
Health [NIH] after a bitter and raucous quarrel over sexual harassment
and research theft. 'It's unwieldy,' she says of the group's name,
'and there's no acronym, but I wanted to be sure to include everyone
who has been hurt.'" (Tales of Mistreatment at NIH, Mary McGrory, op
ed, Washington Post, 8/17/93)

                            Public Health

"When the Korean War ended, veterans returned home with an
overwhelming desire to leave the conflict behind and resume their
lives. But for more than 3,000 of them, including UN troops from 16
nations, the war was not over yet. They returned with vivid
recollections of a brush with death--not from the enemy's hand but
from the viral disease Korean hemorrhagic fever (later dubbed Hantaan
virus after a river in Korea)...Hantaan is only one of several dozen
viral diseases (AIDS, influenza, St. Louis encephalitis, dengue,
Ebola, etc.) that have appeared or dramatically expanded their global
range during the last few decades...As Nobel laureate Joshua
Lederberg, PhD, professor at the Rockefeller University in New York
City, warns: 'Our only real competition for dominion of the planet
remain the viruses.'" (The Enemy Within, Stephen Morse, PhD, and
Robert Brown, Modern Maturity, 6-7/93)

When 11-year-old Kelly Ahrendt complained of pain in her left arm, a
doctor diagnosed it as a sprain. Days later the Sullivan County, NY
girl died. Now health officials and Kelly's family are trying to
determine how she became the first US fatality from rabies this year.
(Death Alerts Eastern US to Rabies Epidemic, MJ, 8/13/93)

Public health officials proclaimed victory over infections in the
1950s, but in the 1990s infectious diseases--such as the mystery "flu"
of the American Southwest, Lyme disease, prominent in the East and
Midwest, and human immunodeficiency virus (HIV), which strikes
everywhere, are moving center stage on the public health scene.
(Infectious Diseases Take Toll Years After Medical 'Victory,' Mike
Woods, Washington Times, 8/13/93)

"It is very plausible that this infection is more widespread than we
originally thought and has been causing human illness for some time."
--Dr. Jay Butler, medical epidemiologist, Centers for Disease Control
and Prevention (CDC), on the Southwest mystery "flu," whose known
death toll stands at 20. (Navajo Flu's Scope Wider Than Thought,
Washington Times, 8/13/93)

"Philadelphia--The first deaths came in July, but the pattern wasn't
clear for another month. Black vomit, yellow skin, frequent
nosebleeds, and delirium were the symptoms. On August 19, 1793, Dr.
Benjamin Rush, a signer of the Declaration of Independence and one of
the leading physicians in what was then the nation's capita, finally
diagnosed this plague: It was yellow fever. 'You cannot imagine the
situation of this City...,' Isaac Heston, a 23-year-old law clerk,
wrote to his brother a month later. 'They are a Dieing on our right
hand & our left.' Soon he, too, was gone. Rush's medicine chest and
Heston's idiosyncratic spelling are among the relics of an epidemic
that took some 5,000 lives, 10 percent of the city's population before
the November frosts. This was the young nation's first major epidemic,
and it led to the creation of public health departments and procedures
for moving the federal government in times of crisis." (Epidemic Stung
Young nation, Ted Duncombe, Washington Times, 8/18/93)

"I hope we can bring to bear on the environments of the inner city
more health promotion and disease prevention, not just areas of
infectious disease where certainly AIDS is a major concern, but also
violence and substance abuse." --David Satcher, director, Centers for
Disease Control and Prevention (CDC). (CDC's New Director Plans Shift
in Focus for Agency, Sandy Rovner, Washington Post Health, 8/24/93)

According to the Centers for Disease Control and Prevention (CDC),
teenage girls, ages 15-19, have the nation's highest rate of infection
by gonorrhea, a rate 22 times higher than women 30 and older. The
second highest? Teenage boys. Gonorrhea can lead to infertility as
well as heart and joint problems, while increasing chances of HIV
infection. (The Bad News, Time, 8/30/93)

"Many people think that the more doctors you have, the lower the
price. That's a sort of economist's view of the world. I believe we
have too many." --Philip Lee, MD, Assistant Secretary for Health, HEW
(1965), HHS (1993). Lee lionizes group practice as the "single most
important innovation" in American health care delivery. Whether it's
called integrated multispecialty systems or staff model HMOs or
capitated prepaid plans, "we see this as the basis for a more rational
allocation of medical resources," the veteran health bureaucrat
concludes. (Unfinished Business, Don Coburn, WPH, 9/7/93)

The first six months of 1990 saw 14,000 measles cases. There have ben
175 cases reported for first six months of 1993. "We have seen measles
virtually disappear in the United States in 1993." -William Atkinson,
Centers for Disease Control and Prevention. (Measles Cases in US Drop
Dramatically, Washington Post, 10/29/93)

While the Environmental Protection Agency's proposal to require paper
mills to decrease chlorine used in paper bleaching has been dubbed a
"halfway measure" by Jessica Landman of the Natural Resources Defense
Council, industry spokesmen say it will cost the industry $10 billion,
30 mills, and 19,000 jobs. "The US pulp and paper industry is among
the nation's most competitive in global markets, but cannot remain so
for long if forced to divert billions of dollars...to expenditures on
environmental technology that yields insignificant environmental
benefits," claims Red Cavaney, president of the American Forest and
Paper Association. Assistant Administrator Robert Perciasepe says the
EPA had asked for more data on the industry's proposal. (EPA Targets
Paper Industry to Reduce Dioxin, Martinsburg Journal, 11/2/93)

                            Research Review

"Lobbying seems to have become an inseparable part of American
culture. Long recognized for both its merits and its excesses, and
vehemently attacked in recent political campaigns, it is nonetheless
here to stay. Activism became a force in the biomedical world in the
1980s with the unprecedented efforts of the AIDS groups. The results
were remarkable. The federal Public Health Service AIDS budget for
fiscal year 1993 is about $2.1 billion more than the non-AIDS portion
of the National Cancer Institute budget of $1.8 billion. The research
dollars invested per death from AIDS in 1989 alone ($66,792) were
almost 30 times the dollars spent for cancer ($2,520) and
approximately 200 times the figure for heart disease ($299)."
(Lobbying for Research $$, Anna Marie Shalka, WPH, 6/22/93)

"A peak through the microscope inside [the Fort Detrick, MD] research
lab might reveal a young tadpole without eyes or one with one eye.
Others have two tails, enlarged heads, or blisters and bubbles on
their bodies. It's a microscopic freak show inside this Army
laboratory that is studying how chemicals and other pollutants in
water affect the development of aquatic life. Instead of relying on
expensive, longer-term studies of laboratory rats or other mammals,
these scientists are putting tiny frog embryos...in water tainted with
pollutants...'Most toxicologists have been use to working with warm,
fuzzy rabbits, mice, and rats. There is the animal rights issue and
also, it's extremely expensive to run mammalian tests,'" says Robert
Finch, a research toxicologist at the US Army Biomedical Research and
Development Laboratory. CURE Comment: We only wish the bio-war
researchers behind Detrick's locked doors would show as much concern
for the human rights of unwitting human guinea pigs as for the animal
rights of "warm, fuzzy" rats. We deplore the use of "freak" to
describe anomalies as too readily extended to humans with disabilities
as in, indeed, the "freak show." (Frederick Lab Probes Pollution,
Martinsburg Journal, 7/11/93)

"What this shows is that APOE-4 increases the risk and lowers the age
at which you get the disease." --A.D. Roses, MD, Duke University,
where researchers have linked apolipoprotein-E, type 4, a gene that
helps process cholesterol with the most common form of Alzheimer's--
late-onset. (Researchers Link Gene to Alzheimer's, WT, 8/13/93)

Studying factors involved in recurrent canker sores, gum disease, and
other oral diseases in the early 1980s, Dr. Richard Glass, University
of Oklahoma, found that patients improved simply by using a new
toothbrush each mont. If they changed their toothbrushes weekly, they
improved even more. (Replacing Your Toothbrush Can Root Out Nasty
Bugs, Mike Woods, Washington Times, 8/18/93)

"Gene therapy can prevent muscle destruction and preserve muscle
function in muscular dystrophy," says the Muscular Dystrophy
Association, describing the findings of research conducted by Jeffrey
Chamberlain, University of Michigan and colleagues. Mice genetically
altered to develop a form of muscular dystrophy turned out normal if
their cells also carried a miniature, artificial version of the gene
that was originally defective. The problem of delivering the
corrective gene into all the muscles cells of a person with muscular
dystrophy, however, remains formidable. (Gene Therapy Is Found to
Correct Muscular Dystrophy in Mice, Boyce Rensberger, WP, 8/19/93)

"It is the area's biggest zoological collection, but you can't see a
single one of its animals. The American Type Culture Collection, in
Rockville [MD], is home to nearly 15,000 bacteria, 25,000 fungi and
yeasts, 1,000 protozoa, and thousands of other living or near-living
things. The microscopic collection, which is stored in three
utilitarian buildings is as obscure as its name." (Rockville Center Is
Infested with Germs--That Go for Research, David Brown, WP, 8/24/93)

Researchers at the University of California at Berkeley report in
Science magazine their discovery of "a protein that instructs an
embryo to create a layer of tissue that eventually folds inward to
form the brain and spinal cord." In time, the protein may lead to
treatments enabling persons with degenerative nerve diseases such as
Parkinson's or Alzheimer's, in which nerve cells die off, to grow new
ones. (Scientists Report Finding Key Protein in Embryo Development,
Washington Times, 10/2/93)

According to a study led by David Trentham, head of the rheumatology
division at Boston's Beth Israel Hospital, drinking a solution of
protein made from chicken bones may be an easy and effective way of
easing the crippling pain of rheumatoid arthritis. (Chicken Protein
Found to Ease Arthritis Pain, Washington Post Health, 10/5/93)

"It's just what the space doctors ordered...: calcium, iodine, sulfur,
and amino acids ingested by and injected into Columbia's astronauts to
monitor body changes in weightlessness....The shuttle scientists drank
water laced with oxygen isotopes, nitrogen, and calcium on this first
full day of their planned two-week medical research mission....The
crew members also gave each other shots of chemicals that were traced
through their bodies to measure changes in blood volume, kidneys,
bones, and muscles. Blood, urine, and saliva samples were collected.
In another test, the astronauts monitored their heartbeats with an
ultrasound device developed by one of the crew's two physicians, David
Wolf. They also exercised on a stationary cycle and collected the
droppings of some of the 48 laboratory rats on board." (Shuttle Is An
Orbiting Medical Lab, Martinsburg Journal, 10/20/93)

According to a report by the Institute of Medicine, the $625 million,
14-year Women's Health Initiative, the largest federally funded study
of women's health issues, is too expensive, will take too long, is not
likely to answer the questions it was designed to address, and ought
to be redesigned. (Federal Women's Health Study Faulted, John
Schwartz, Washington Post, 11/2/93)

"There's great excitement at the prospects for this research. These
are studies you have to call convincing. They're clearly likely to
have human applications." -James Gavin, president, American Diabetes
Association, on findings published in Nature by two independent
research teams studying mouse diabetes: one led by Daniel Kaufman, a
molecular biologist at the University of California at Los Angeles,
and the other by Hugh McDevitt, of Stanford University. (2 Groups Cite
Gains Against Diabetes, Boyce Rensberger, Washington Post, 11/4/93)

Studies find estrogen therapy may lower a woman's risk of Alzheimer's
disease and even reduce symptoms in women who develop the disease.
(Estrogen Doses May Lower Women's Alzheimer's Risk, MJ, 11/10/93)

                            Surgical Survey

"I am a news photographer. Often I trudge to assignments, bearing
three cameras, a bag holding a flash, film and extra lenses, an
aluminum ladder, and a heavy tripod. I climb over fences, jump of
walls, crawl around on my hands and knees or run at top speed while
juggling gear. And I hold my camera upright with elbows fixed for long
periods of time waiting for the perfect shot. My problems began during
one such run-stop-twirl-and-shoot workout when a camera collided with
my right 'funny bone'...I had what doctors call cubital tunnel
syndrome and carpal tunnel syndrome in which the nerves in my right
arm were compressed. Without surgery, doctors told me, eventually I
would not be able to use my arm...As I was wheeled into the operating
room, my fear spilled out. 'Just remember,' I told him, 'when you're
cutting on my arm, you're cutting on my career.'" (Elbow-Bending
Surgery, Margaret Thomas, Washington Post Health, 6/22/93)

"While the urge to improve their looks brings many patients to see
plastic surgeons, the doctors actually spend more time fixing
injuries, such as scars, burns, dog bites, or birth defects. Such
cases account for more than 60% of the average practice, with repairs
outnumbering enhancements 1.1 million to 395,000." (Therapeutic vs.
Cosmetic Surgery, Washington Post Health, 8/3/93)

                            TB or Not to Be

"One reason we want to screen the migrants is they're so mobile."
--Gonzalo Graupera, 23, a first-year medical student at John Hopkins
University, who is working at the Shenandoah Community Health Center
in Martinsburg, WV under the American Medical Student Association's
intern program. (Graupera Organizes Local TB Screenings, Meg
Partington, Martinsburg Journal, 8/1/93)

"The capacity of the human species to absorb suffering and then ignore
its lessons is staggering. Tuberculosis, a disease that goes back to
antiquity, is thought to have killed more than a billion people in
just the past two centuries. It was only brought to its knees five
decades ago, yet today it is largely forgotten and totally outside the
experience of nearly everybody under the age of 50 in the developed
world. British physician Frank Ryan awakens us from our forgetfulness
in 'The Forgotten Plague: How the Battle Against Tuberculosis Was Won-
-And Lost.' In a perverse twist of fate, this now rare bacterium...is
making a comeback." (Dreaded Disease Returning to Kill, JD Robinson,
MD, book review, Washington Times, 8/10/93)

"The world procrastinated on AIDS. Don't let the same thing happen
with tuberculosis." -Richard Bumgarner, deputy director, World Health
Organization's TB program. (WHO Seeks Cash to Fight TB, WT, 11/16/93)

                                                            The Whole Tooth

"Last year a quarter of all orthodontic patients were adults, a nearly
fourfold increase over 20 years ago. An estimated 15% to 20% were in
my boat. Call it Jaws II; somehow the keyboard-straight ivories we won
the hard way in our teens didn't stay on track into adulthood. Chalk
it up to a combination of bad genes and lost retainers. Now we're gong
through the whole wrenching rigmarole again." (Brace Yourself for a
Prized Smile, Patricia Orsini, Baltimore Sun, 11/1/93)

                                Word of Life

"During the past year, I have visited about 1,000 patients undergoing
open-heart surgery. Some had two, three, or four bypasses. Others had
valves of the heart replaced with mechanical or pig valves. In each
case, the patient's chest was laid open, the life-sustaining procedure
performed, and then the chest was stitched together in cross tiers
like a railroad track. Or, as patients liked to boast, they had joined
'the zipper club.'...A chaplain is welcomed by these heart patients
simply because he is someone familiar and not one of the white
uniforms from a land unknown. The welcome smile leads easily to the
spiritual side of a chaplain's work. The words of prayer are familiar
and easily understood....Quite a few patients have an inner healing as
they mend in body. With time to think as they recuperate, they
rearrange their priorities. Most express the idea very simply by
saying they will be nicer or gentler or more appreciative once they
get back home." --Fr. Bonaventure Stefan, OFM Cap, co-chaplain, St.
Francis Medical Center, Pittsburgh, PA,. (Making the Rounds With a
Hospital Chaplain, Fr. Stefan, Our Sunday Visitor, 10/31/93)

                        Wish We'd Said That...

     It is as presumptuous and ethically inappropriate for
     doctors to presuppose that their professional expertise
     qualifies them to know what kind of life is worth
     prolonging as it would be for meteorologists to suppose
     their professional expertise qualifies them to know what
     kind of destination is worth a long drive in the rain.
                                         (Felicia Ackerman)

     One day a patient came to the doctor and asked what he owed.
     The doctor said he did not have any record. Then the man
     told what he had done for him a long time ago when he
     visited for his wife's long illness. The doctor said this
     was way back when he burned the old books and he told the
     man to just forget it. The man insisted that he could not
     pay when he needed his service but now I have the money to
     pay you. He insisted that he pay for it. He said that he
     would not be happy unless he had had his bill. After the
     doctor asked him how many visits he had made where he lived
     then the doctor billed half. The man looked at him and sent
     him twice what he asked. Both ended happy. (Frederick
     Newbraugh, on "The Old Doctors"...and the old patients)

     We're afraid to have our hands tied. You're obligated and
     expected to rein in costs...But you feel you are doing that
     at the expense of your patient. (Joseph Vinetz, third-year
      medical student, John Hopkins University)

                           ...Glad We Didn't

     A quicker death shows more respect for life than a protracted one.
                                                      (Ronald Dworkin)

                        A Word From Our Sponsor

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Special Editions include Abled, AIDS, Cancer, Family, Health Care,
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