Showing 1 - 10 of 213 annotations tagged with the keyword "Medical Research"

Summary:

The Death of Innocents offers an unbelievable but true tale that fulfills the promise of its tagline: Murder, medicine, and high-stakes science. Following prosecutor Bill Fitzpatrick in Onondaga County, New York, journalists Richard Firstman and Jamie Talan unravel the tale of Sudden Infant Death Syndrome, otherwise known as SIDS, in upstate New York in the 1970s. They first reveal the details of the case of Stephen Van Der Sluys, a father convicted of murdering his child for insurance money, establishing that parents don’t always have the best interests of their children at heart; this then lays the groundwork for the story of the successful prosecution of a mother whose children’s deaths had been considered as the basis for the theory of prolonged apnea as the cause of recurrent SIDS. With the prodding of Fitzpatrick, the prosecutor in nearby Tioga County then investigated and called in a slew of local and state investigators and national experts. Waneta Hoyt confessed to and was convicted of the murders, upending the research based on the prolonged sleep apnea theory, millions of dollars of NIH-funded research, and the careers of several research scientists. Although nurses and other pediatricians questioned Waneta’s maternal attachment and even suggested that the deaths were not natural, their voices went unheard. Politicians like Walter Mondale and Ronald Reagan jumped onto a bandwagon led by parents angry that the federal government had not done more to find out why their babies had died without explanation. National conferences on SIDS were held where theories were expounded based on published cases starring the “H” children. And commercial interests entered the stage as apnea monitors, which had never been used at home, became an unproven (and lucrative) recommendation for parents to prevent SIDS.  

In addition to Waneta and Tim Hoyt and their five children (who ranged in age from 1 to 28 months) who were murdered between 1965-1971,  there is a cast of characters out of a Hollywood script. The leading player is Alfred Steinschneider, MD, PhD, a pediatrician and researcher at Upstate Medical University in Syracuse, New York. Others include Drs. Michael Baden, Milton Halpern, Janice Ophoven and Marie Valdes-Dapena. Pediatric luminaries such as Abe Bergman, Jerold Lucey, Frank Oski, and even T. Berry Brazelton played roles.

The book takes us through the story using court and medical records, interviews, television and audio recordings, conference notes, publications and other publically available information, some of which the authors painstakingly retrieved and obtained through the Freedom of Information Act. We hear the sad story of Waneta and Tim, from high school sweethearts to life partners in rural poverty, and of their family members who tried to help but were often rebuffed. The story takes us to early pregnancy and early death, with inadequate evaluations, lack of autopsies or of more than cursory investigation, and wishes to not upset the Hoyts or their community with insinuations of murder. We hear about the years after the deaths, with the Hoyts’ attempts at adoption, mental health treatment and eventually their confession to heinous acts. We also hear about Steinschneider’s rise, fall and eventual ostracism by the medical community.

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Editing Humanity

Davies, Kevin

Last Updated: Jun-28-2022
Annotated by:
Coulehan, Jack

Primary Category: Literature / Nonfiction

Genre: History of Medicine

Summary:

Editing Humanity explores the history, biology, sociology, and ethical import of CRISPR (“clustered regularly interspaced short palindromic repeats”), the major new DNA technology indicated in the book’s subtitle, “The CRISPR Revolution and the New Era of Genome Editing.”  Using CRISPR, researchers can manipulate the DNA of animals, plants and microorganisms with extremely high precision. In particular, scientists now have the potential to customize the human genome.  

What is CRISPR? To quote Davies, “CRISPR is a small subsection of the bacterial genome that stores snippets of captured viral code for future reference, each viral fragment (or spacer) neatly separated by an identical repetitive DNA sequence.” (p. 23) When the cell is reattacked by a virus, an RNA copy of that virus’ stored “signature” forms a DNA-splitting complex that destroys the incoming virus. In 2012, Jennifer Doudna, of the University of California, Berkeley, and Emmanuelle Charpentier, of the Max Planck Institute, Berlin, demonstrated that CRISPR could be engineered to edit any gene. One could, for example, replace a disease-causing mutation in any DNA segment with the healthy variant, thus preventing genetic disease.  

The author, Kevin Davies is a geneticist and science writer whose previous books include Cracking the Genome and DNA: The Story of the Genetic Revolution.  In Editing Humanity, he discusses an array of actual and potential applications of CRISPR technology, including human disease prevention by altering susceptibility of animal vectors, improving farm productivity, and even resurrecting extinct species. However, the most powerful and controversial topic is genetic manipulation of the human embryo. Davies devotes several chapters to the cautionary tale of the young Chinese scientist He Jiankui who engineered the world’s first gene-edited babies, and the scandal and disgrace that followed. (He was convicted in China of “illegal medical practice” and sentenced to prison.)

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Wild Boy

Dawson, Jill

Last Updated: Jun-15-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Young doctor Jean-Marc Itard is serving in the Paris home for deaf-mute children. When a “wild boy” without speech is found near a village in Aveyron, France, Itard accepts the challenge of educating him. Many senior colleagues, including Philippe Pinel, opine that it will be impossible, even when Itard determines that the boy is not deaf. The lad, now named Victor, seems to be about ten years old, but his small size owing to malnutrition may be deceptive; he quickly reaches puberty. Helped by the care and empathy of the home’s housekeeper, Madame Guérin, and Julie, her daughter, Victor learns to perform several domestic tasks but manages to speak only a few words.

 His situation is a mystery. Caregivers marvel at how he had been able to survive alone in the woods for several years. They wonder if he ran away from an abusive home, or if he was deliberately abandoned because of his disability. A crisis emerges when a woman appears claiming to be his relative. Itard eventually abandons the effort to educate Victor, but he is allowed to continue living with the Guérins.

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The Inkblots

Searls, Damion

Last Updated: Jun-14-2022
Annotated by:
Madsen, Danielle

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

Damion Searls’ The Inkblots: Hermann Rorschach, His Iconic Test, and the Power of Seeing is a comprehensive history of Rorschach’s life and an overview of the use and influence of his psychiatric test over the past century.

Rorschach grew up in Switzerland, the son of a widowed middle school art teacher who would die while Rorschach was a teenager after suffering from years from neurological disease caused by lead paint exposure. Rorschach debates whether to study drawing and become a teacher or attend medical school and pursue a career in neurology. The book follows his career across three countries after choosing to do the latter, until he becomes a practicing psychiatrist at a rural Swiss institution. It traces his psychiatric influences—Bleuler and then Jung as professors while at the University of Zurich and Freud via their influence—as well as his artistic ones—Ernst Haeckel, the pre-modernist galleries of Zurich, then Russian Futurism. It also provides an overview of the field of psychiatry at the time: schizophrenia was considered an unremittable condition named dementia praecox, psychiatric institutions included patients with tertiary syphilis, and increasing neurologic knowledge and psychiatric techniques improved diagnostics but not treatments.

The earliest inkblots of Rorschach’s are temporary creations made with a local schoolteacher and administered to patients and pupils, formulated as one of dozens of strategies to gain insight into people. Rorschach’s patients see much in these inkblots, but the schoolboys little, and the experiment is abandoned. He returns to the idea a decade later, with greater stress placed on the image. He requires that they look organic rather than made, imply movement, and have multiple foreground/background interpretations. After creating a set of ten products, he starts to categorize results. He codes whether the answers are seen in the whole image or a detail; whether they are based on form, color, or movement; whether the figures seen in the image are well- or poorly-defined; and how many and what category of answers are seen. The coded results enable Rorschach to give accurate blind diagnoses and he begins to gain traction in psychiatric community. However, he dies before his inkblots become popular.

The book follows the test as it travels to America and gains acclaim with psychologists. It is used in clinic and hospitals and becomes a standard part of psychology training. The inkblots are part of military personnel assessments and scientific studies. They are referenced in criminal trials and family court. They are applied in anthropology and education. They show up on movie posters and in fashion shows and become a household name. As it details these broad applications, the book explains the battle over how the test should be given and whether analysis of the results should be open-ended interpretation or a standardized scoring method. It also details society’s constantly shifting belief as to whether psychological testing is a valid diagnostic tool.  

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Annotated by:
Dammeyer, Kristen

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

Life According to Sam provides insight into the life of Sampson “Sam” Berns and his family. At the beginning of the film, Sam states, “I want you to know me.” Accordingly, the film alternates between highlighting Sam’s experiences as he navigates life as a teenage boy and his participation in the first ever clinical trial for progeria.  At the start of the film, Sam is a 13-year-old boy in middle school. As with many other boys his age, his interests include Legos, music, and spending time with his friends, or his “bros” as he affectionately calls them.  

But Sam was diagnosed with progeria just prior to his second birthday. Progeria is a rare disease that affects approximately 250 children worldwide, caused by a genetic mutation which codes for the formation of an abnormal toxic protein, protegrin, that builds up in organs over time. It is a premature aging syndrome that causes progressive cardiovascular decline and for which there is no cure. The average age of death for these children is 13, and they die primarily of heart attacks and strokes.  

At the time of Sam’s birth his mother Leslie was a pediatric intern and his father, Scott, a pediatric emergency medicine physician. After his diagnosis, the family devoted themselves to progeria, an orphan disease which at the time had no identified genetic etiology, no foundation, no research, and no treatment. With the help of Leslie’s sister Audrey, the family started The Progeria Research Foundation, which raised over $1.25 million dollars, funded the discovery of the gene for progeria, and began the first clinical trials to test treatment for the disease. 

In the film, Leslie spearheads the first ever clinical trial for the treatment of progeria. The drug, lonafarnib, had demonstrated efficacy in mice and was FDA approved for a clinical trial including 28 children from 16 countries. The children would receive the medication for 2.5 years and return to Boston Children’s Hospital three times per year for a battery of tests. At the end of the trial, Leslie goes through the arduous process of writing up the results and submitting the trial for publication in hopes of making the drug more widely available for children with progeria. In the end, the trial results are published and the results for individual patients are released. While the medication falls short of being a cure, there are glimpses of hope in patients whose disease progression has been slowed or even reversed.

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The King's Anatomist

Blumenfeld, Ron

Last Updated: Jan-03-2022
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Brussels mathematician Jan van den Bossche, (fictional), single, and fifty years old, is devasted to learn of the death of his lifelong friend, the brilliant (and very real) anatomist Andreas Vesalius.  Companions since childhood, shorter, sturdy Vesalius was the outgoing exuberant leader of the duo, snubbing authority, taking risks, and seizing every opportunity to explore the anatomical structure of animals and humans. He constantly dragged the quiet, shy Jan in his exploits.  

News of Vesalius’s death sends Jan in two directions. First, he wanders back through many memories: their lives and travels together to Paris, Leiden, Padua, Spain; the rise of Vesalius’s fame in anatomy, medicine, and surgery; and his odd departure from academe to serve foreign crowned heads in France and Spain. Second, it propels him forward on a journey to his friend’s grave on the Greek island of Zante (now Zakynthos), in an effort to comprehend why the notorious skeptic would have embarked on a religious pilgrimage in the first place. Jan realizes that he can forgive Vesalius almost everything, including the theft by marriage of his beloved Alice. But he is incapable of pardoning the bewildering manner of his death.

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This is Your Mind on Plants

Pollan, Michael

Last Updated: Oct-21-2021
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: Investigative Journalism

Summary:

Michael Pollan is curious about human consciousness and how humans alter it using a variety of molecular compounds. This curiosity took him first to three mind-altering psychedelic drugs: psilocybin, lysergic acid diethylamide (LSD), and 5-MeO-DMT (“The Toad”). He reported his findings and personal experiences in a 2018 book, How to Change Your Mind. His curiosity yet untamed, Pollan expands his project to three mind-altering compounds found in plants: opium, caffeine, and mescaline in his latest book.

Pollan’s investigation is born of his vocation as a gardener “fascinated by our attraction to these powerful plants as well as by the equally powerful taboos and fraught feelings with which we surround them.” He’s further attracted to them for the way in which when “we take these plants into our bodies and let them change our minds, we are engaging with nature in one of the most profound ways possible” (p. 3). The sources he chooses are the opium poppy for opium; coffee and tea for caffeine; and peyote and San Pedro cacti for mescaline. 

Opium, caffeine, and mescaline represent the range of mind-altering properties available from plants of interest to Pollan. In opium he saw a sedative, in caffeine a stimulant, and in mescaline a hallucinogen, or as he characterizes them, the “downer, the upper, and the outer,” respectively (p. 4). Their effects on consciousness do not feature dissolution of the ego, as is the case with psychedelics, and indeed, they can solidify ego. Seemingly most important to his selection, however, was that,

Taken together, these three plant drugs cover much of the spectrum of the human experience of psychoactive substances, from the everyday use of caffeine, the most popular psychoactive drug on the planet; to the ceremonial use of mescaline by Indigenous peoples; to the age-old use of opiates to relieve pain. (p. 4)
The book comprises an introduction and a chapter each covering opium, caffeine, and mescaline. The introduction describes his dual interest in the ancient human drive to fool with consciousness, and in plants that produce mind-altering substances as evolutionary features. Pollan also touches on how civilizations, ancient and current, aid and combat the use of these substances, at times simultaneously. In the chapter on opium, Pollan updates his April, 1997 Harper’s Magazine article about his experience growing opium poppies as the war on drugs peaked in the mid-1990s; in this version he reconstitutes the section he left out for fear of arrest and conviction that has since abated. In the next two chapters, Pollan separately reports on how caffeine and mescaline affected his consciousness. Because he was already a heavy caffeine user, Pollan had to give up coffee and tea if he was to discern its mind-altering effects, but for mescaline’s mind-altering effects, he had to find a source, a setting, and a guide through the maze the Covid-19 pandemic created.

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Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

This engaging and informative book describes the latest scientific understanding of the brain, primarily in humans, but also in other animals. The author, a leading brain researcher, writes clearly and often with humor. 

As Barrett explores the deep history of brains, she emphasizes that as much as some humans may prize thinking, the brain’s central task is not thinking but monitoring and guiding—day and night—the many systems of the body. Brains of all creatures manage a “budget” for various factors such as water, salt, glucose, blood gases, etc., to create an on-going fitness against any future threats.

Our brains and bodies are interlinked, interactive, and unified, not the “triune” brain Carl Sagan popularized in 1977. All animal brains have similar neurons, and all mammals share a “single manufacturing plan” for brain development after birth. Babies’ brains develop according to their genes and in response to their environment, especially to their caregivers. Human brains have flexible networks much like the global air-travel system and can vary from person to person and, individually, over time because of brain plasticity.           

Our individual brains influence—even create—our perceptions and relate to brains of other people through family, language, gesture, culture, and more. Barrett concludes, “Social reality is a superpower that emerges from an ensemble of human brains. It gives us the possibility to chart our own destiny and even influence the evolution of our species” (p. 123). 

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5B

Haggis, Paul; Krauss, Dan

Last Updated: Apr-17-2020
Annotated by:
Teagarden, J. Russell

Primary Category: Performing Arts / Film, TV, Video

Genre: Film

Summary:

5B is a documentary about the special unit created at San Francisco General Hospital (Ward 5B) in 1983 to take care of people with AIDS. Three years later, it moved to the larger Ward 5A, where it remained in operation until 2003 after the introduction of treatments effective enough to drastically reduce the demand for hospitalization and standards of care for AIDS patients were in place throughout the hospital. The documentary covers the medical, social, and political considerations surrounding the opening of Ward 5B, and the AIDS epidemic during that time.

The story is told from various perspectives through interviews with key figures in its development and operation, and archival footage of the ward and AIDS activism in the community. The most prominent among the key figures is Cliff Morrison, a clinical nurse specialist who spearheaded the idea for the unit and then managed it. Several other nurses who served in staff and supervisory positions are featured. Participating physicians include Paul Volberding, an oncologist at the time who became pivotal in the development of effective HIV treatments, and  Julie Gerberding, a physician treating patients on the unit who later became the Director of the Centers for Disease Control (CDC). Lorraine Day, the chief of orthopedic surgery at the hospital when the unit opened is heard often as an opposing voice. Hank Plante, a local television news reporter also appears frequently to offer his perspectives on many of the social and political issues swirling around the unit. Among other participants are AIDS activists, volunteers, and family members of patients on the unit.

Several storylines frame the documentary including how nurses drove the unit’s inception and then were instrumental in running it. “Nurses were in charge,” said Volberding, admiringly. Interwoven throughout the film are the experiences of the patients and individual nurses, including one nurse who was infected with HIV from a needle stick. “Those nurses were the real heroes,” said one activist.  

The unit and those who worked there also encountered opposition from inside the hospital. The nurses of this unit practiced in ways they considered safe but not in such a manner that would preclude them from touching patients or require that they don so much protective gear they become unseeable. Nurses and other clinicians from other parts of the hospital objected and did not want to be compelled to adopt practices they thought endangered them on the occasions they took care of AIDS patients. The film follows this story through union grievances and public debates to their conclusion, which sided with the unit nurses and their advocates.

The story is told against a backdrop of gay rights activism in the 1970s that led to AIDS activism with its influence on how the unit operated. Also getting attention is the fear AIDS struck in society and the resulting social backlash at a time of federal government insouciance. This fear continued up to the time the federal government recognized the epidemic and began taking action, relieving some of the tension but never eliminating it. The documentary ends with key participants reflecting on their experiences with the unit; most were proud, some bitter, and a few a little of both.

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The Little King

Rushdie, Salman

Last Updated: Dec-19-2019

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Dr. R. K. Smile, MD, founder of Smile Pharmaceuticals, Inc. (SPI), enjoys a sudden lurch into fortune and celebrity. Dubbed the ‘Little King’ by his Atlanta-based Indian community, Dr. Smile is a towering medical authority, philanderer and philanthropist, known to be both generous and avaricious. His pinnacle pharmaceutical coup, the patent that has earned him billionaire status, is InSmile™, a sublingual fentanyl spray designed for terminally ill cancer patients. Dr. Smile’s entrepreneurial vim, however, hardly stems from benevolent medical research, but rather an ‘excellent business model’ that he observed on a visit to India during which a Bombay ‘urchin’ handed him a business card that read, ‘Are you alcoholic? We can help. Call this number for liquor home delivery.’ The blunt practicality of building a market around sating addiction strikes the doctor as entirely sensible. Often wistful about India’s ‘old days,’ Dr. Smile fondly recounts the insouciance of neighborhood dispensary hawkers, their willingness to ‘hand out drugs without a doctor’s chit.’ Though admitting that ‘it was bad for [their] customers’ health but good for the health of the business,’ Dr. Smile yearns to replicate a similar culture of delinquent pharmacology, an unregulated market capable of profiting from supply-and-demand forces but indifferent to the wellbeing of its patrons. 

In the meantime, Dr. Smile’s wife, Mrs. Happy Smile, a simpering and daft socialite, envisions grand branding prospects that will globalize the Smile name through ostentatious publicity—inscribed name placards at the ‘Opera, art gallery, university, hospital […] your name will be so, so big.’ She refers to the worldwide reputation of the OxyContin family, the proliferation of the family’s name and esteemed place among prestigious cultural institutions: ‘So, so many wings they have,’ she says, ‘Metropolitan Museum wing named after them, Louvre wing also, London Royal Academy wing also. A bird with so, so many wings can fly so, so high.’ 

InSmile™ sales drive Dr. Smile’s burgeoning drug trade, as his prescription becomes preferred to conventional OxyContin highs due to its ‘instant gratification’ in the form of an oral spray. While SPI fulfills special house-calls for American celebrities and customers in ‘gated communities from Minneapolis to Beverly Hills,’ it also ships millions of opioid products to places such as Kermit and Mount Gay, West Virginia—communities, outside fictional contexts, that bear real-world vestiges of the opioid epidemic (West Virginia has the highest rate of drug overdose in the United States). Through a lecture series scheme, Dr. Smile bribes respected doctors to publicize and prescribe the medication, further entrenching the dangerous drug in medical circles.

As the SPI empire collapses following a SWAT-led arrest of his wife, Dr. Smile muses indignantly on his reputation and the ingratitude of his clients. Tugged again by nostalgia for the old country, he justifies his drug trafficking by likening it to quotidian misdemeanors, instances when one could circumvent the inconveniences of India’s law by knowing how to pull the venal strings of corrupt systems—like cutting a long ticket queue at the rail station, he says, by paying a little extra at a backyard office; or bribing government officers to stamp customs papers required to ship restricted antiques abroad—‘We know what is the oil that greases the wheels.’ With this deleterious mindset, combining nostalgia and entrepreneurial greed, Dr. Smile’s future is uncertain, but he is resolved to return—after all, he says, ‘I have lawyers.’

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