Youth and Age

 

I dedicate this to my children who think I may have lost a step or two on the basketball court.  JC

The old crow is getting slow.
The young crow is not.
Of what the young crow does not know
The old crow knows a lot.

At knowing things the old crow
Is still the young crow’s master.
What does the slow old crow not know?
-How to go faster.

The young crow flies above, below,
And rings around the slow old crow.
What does the fast young crow not know?
-Where to go.

John Ciardi

Ciardi made a book called Limericks Too Gross with Isaac Asimov in which they say that a limerick must be just a little dirty.

For a long time, Ciardi had a 5-minute show  on  National Public Radio about words and meanings.  On one show he explained how his Italian name had evolved from the German Gebhardt–he was descended from the Germans who invaded northern Italy.

RJN

 

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I admire lithe young ladies
(especially their thighs)
striding by my winter window,
seriously postponing age and death                                                                                        or what may be.
And I’m so glad that I’m alive
this day and upstairs there’s
a warm and wise old woman,
seriously postponing me.

RJN

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Youth and Age

by George (Lord) Byron
THERE'S not a joy the world can give like that it takes away 
When the glow of early thought declines in feeling's dull decay; 
'Tis not on youth's smooth cheek the blush alone which fades so fast  
But the tender bloom of heart is gone ere youth itself be past.
 

Then the few whose spirits float above the wreck of happiness  
Are driven o'er the shoals of guilt or ocean of excess: 
The magnet of their course is gone or only points in vain 
The shore to which their shiver'd sail shall never stretch again.
 

Then the mortal coldness of the soul like death itself comes down; 
It cannot feel for others' woes it dare not dream its own;  
That heavy chill has frozen o'er the fountain of our tears  
And though the eye may sparkle still 'tis where the ice appears.
 

Though wit may flash from fluent lips and mirth distract the breast  
Through midnight hours that yield no more their former hope of rest  
'Tis but as ivy-leaves around the ruin'd turret wreathe 15 
All green and wildly fresh without but worn and gray beneath.
 

Oh could I feel as I have felt or be what I have been  
Or weep as I could once have wept o'er many a vanish'd scene  
As springs in deserts found seem sweet all brackish though they be  
So midst the wither'd waste of life those tears would flow to me!

George Lord Byron

 

Danger at the Ballpark

 

 

Image result for photo speeding baseball

Pitchers are throwing the ball 90 – 100 miles per hour now. A 90-mph fastball can leave the bat at 110 mph. source

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Anyone who pays some attention to baseball knows that it’s dangerous to get near a game.  That’s why batters wear helmets and pads.  And it’s one reason spectators pay attention to every pitch and protect themselves. Also they want the ball. Also the sharp pieces of broken bats fly into the crowd.

While I was driving past Louisville once, I heard on the radio a man from the Louisville Slugger company who said major league players use 80 bats in a season.

These dangers are greatest in the lower, very expensive seats, though we’ve seen  foul balls come toward us on the upper deck.

I feel sorry for anyone hurt anywhere, maybe especially kids; but I feel no support for lawsuits demanding damages from the team owners.

Why do people take small children and even infants into an area swarming with people, then into a park with 40,000 people, some drinking beer and/or margaritas, busy with hot dogs, tacos, and nachos ?  My authoritative belief  is that most kids under 9 or 10 can’t or don’t want to focus on the process of the game or to be alert to dangers of various kinds, including  hygiene in the busy washrooms.  Is that changing table clean?  The kids can learn the game from television as well or better than in the park.  Always with parental help, of course.

When a hot line drive heads into the stands, will you always see it coming?  You’d better.

You can’t expect to collect on an injury that is your own damn fault.

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From the Trib:

Spectators hurt by baseballs face long odds in court
State law shields teams from litigation

By Steve Schmadeke and Elvia Malagon,  Chicago Tribune 10.14.17
Juanita DeJesus never saw the ball coming.
DeJesus was sitting along the first base line at a 2009 minor-league baseball game in Gary when an infield fly struck her in the face just as she looked up to spot the ball. The impact broke several bones in her face and resulted in permanent blindness in her left eye.
Her injuries were strikingly similar to those recently suffered by John “Jay” Loos, a Schaumburg man who filed a negligence lawsuit against the Chicago Cubs this week after also being blinded in his left eye when he was hit by a foul ball while sitting in a seat down the first base line in the outfield at Wrigley Field in late August.
“I had no idea that you were subjected to such missiles and the rate of speed that a ball can come into the stands,” Loos, 60, told reporters Monday. “In the stands, you know, you are sitting behind the plate, you can’t tell when the ball is contacted, you can’t tell where the ball is going, you can’t tell the rate of speed it’s going until it’s on top of you.”
But like DeJesus, whose lawsuit was dismissed outright by the Indiana Supreme Court in 2014, Loos faces long odds of winning in court.
Not only have judges across the country thrown out such lawsuits, but Illinois is one of four states where the legislature enshrined into law the so-called Baseball Rule, which absolves stadium owners of liability so long as an adequate number of seats — largely in the area looking onto home plate — are behind protective netting. Fans who sit elsewhere are presumed to have willingly assumed the risk of being hit by a ball or bat, according to the rule, which is now more than a century old.
The debate over increased safety — versus fans enjoying unobstructed views and the chance to catch a souvenir foul ball — was reignited in September when a little girl was hit by a rocketing foul ball at Yankee Stadium, prompting Major League Baseball’s commissioner, Rob Manfred, to say the league is looking again at extending protective netting.
“The events at yesterday’s game involving a young girl were extremely upsetting for everyone in our game,” Manfred said in a statement, adding: “We will redouble our efforts on this important issue.”
In 2015, the league issued recommendations that ballparks have protective netting between the dugouts for any field-level seats within 70 feet of home plate. Those recommendations prompted the Cubs to extend the netting out that distance at Wrigley Field before the 2016 season, a Cubs spokesman has said.
The team’s president of business operations, Crane Kenney, told WSCR-AM 670 The Score last month that the Cubs would add at least 30 more feet of netting before next season as Wrigley Field renovations move the dugouts farther down the foul lines. Last year the White Sox also extended netting at Guaranteed Rate Field.
Beyond the Baseball Rule, legal obstacles include difficulty proving that spectator injuries are so commonplace that the courts should intervene. Last year, a federal judge in California threw out a class-action lawsuit against MLB filed by two fans who argued protective netting should be strung up along the entire length of the foul lines at all stadiums. The judge ruled that the plaintiffs had failed to show they and any other fans faced enough risk of injury to give them legal standing to sue.
In Loos’ case, his attorney argues there are two exceptions in the law that could allow them to win the lawsuit. He hopes to convince a judge that the MLB isn’t covered by Illinois’ stadium owner liability law and that the Cubs’ conduct in failing to install netting was reckless — both high hurdles. Another injured fan who alleged the Cubs recklessly removed netting behind home plate in 1992 to make way for skyboxes saw his case dismissed, records show.
“It’s obvious that the Cubs have known people are being seriously injured — it’s happened there before,” said Loos’ attorney, Colin Dunn. “It’s at least going to be a jury question as to whether this was willful and wanton conduct.”
But Dunn indicated the case may get settled. “I got a feeling that they want to talk to us,” he said of the Cubs, whom he reached out to before filing suit. “They do care about their fans. I’m hopeful that they’ll do the right thing.”
A Cubs spokesman declined to comment but directed a reporter to the statement issued by the team Monday that said “the safety of our fans is paramount to a great game day experience.”
It’s not publicly known whether these types of injuries are on the rise, though the class-action lawsuit alleged that they likely were, as pitching speeds go up and batted balls travel faster. A 2003 study found that about 35 fans were injured by foul balls per 1 million spectator visits to major league stadiums.
The risks of being hit by an errant ball or broken bat are low, according to lawsuits filed against other major league teams over injuries. But the injuries they cause can be catastrophic, especially to children.
A 7-year-old Cubs fan attending his first baseball game at Wrigley Field in 2008 was left with a fractured skull and swelling around his brain after being hit in the head by a line drive, the Tribune reported. There are no records indicating the family ever filed a lawsuit.
The Atlanta Braves reportedly settled a lawsuit recently filed by the father of a 6-year-old girl whose skull was fractured by a line drive in 2010.
But in an aside in her ruling to toss a California class-action lawsuit, the judge questioned why the league hadn’t done more to mitigate the danger to its youngest fans.
“Why Major League Baseball, knowing of the risk to children in particular, does little to highlight this risk to parents remains a mystery,” wrote Oakland U.S. District Judge Yvonne Gonzalez Rogers in her ruling throwing out the class-action lawsuit over protective netting.
In 2014 a Bloomberg Businessweek report found that about 1,750 spectators are injured annually by baseballs that fly into the stands. Around 73 million people attend major league games each year.
Spokespeople for the Cubs and White Sox declined to provide figures on how many fans are similarly injured each year.
Figures unearthed in the class-action lawsuit show that during the 2015 season at Dodger Stadium in Los Angeles an average of about two people were hurt by foul balls per game out of the 46,000 on average in attendance. In Seattle, about 300 people attending Mariners games were injured by errant baseballs out of the 10 million who attended games between 2005 and 2009, according to an appeals court ruling upholding the dismissal of another fan injury case.
This week, the Chicago City Council passed a toothless resolution calling for the city’s major league teams to surpass MLB’s minimum standards for protective netting and instead “lead the league.” The resolution also asks the teams to “reconsider” the Baseball Rule that transfers liability for spectator injuries to fans who sit in unprotected areas.
In the early 1990s, two rare legal victories for spectators injured while attending separate Cubs and White Sox games may have been the impetus for an Illinois law that now protects stadium owners from similar suits.
Delbert Yates Jr., a fourth-grader, was sitting behind Wrigley Field’s home plate in 1983 when he was struck under his right eye by a Leon Durham pop-up seconds after betting his sister whether Durham would get a hit, court records show. His attorneys at trial presented evidence that the screen behind home base was inadequate, and the family won a $67,500 jury verdict.
A state appeals court upheld the verdict in 1992. That same year, another appellate panel reinstated a lawsuit filed by a woman whose jaw was broken at a White Sox game when she looked up from her popcorn and was struck in the face by a foul ball, finding that the issue of whether the Sox had provided proper warning of her injury risks was a trial issue.
Just six months later, state lawmakers stepped in and passed the Baseball Facility Liability Act, shielding stadium owners from most lawsuits by turning the Baseball Rule into state law. James Jasper, who was struck by a foul ball at a Cubs game, filed a lawsuit over his injury and argued the new law was an unconstitutional handout to stadium owners. But in 1999 an appellate court upheld the law and the lower-court dismissal of Jasper’s lawsuit, essentially ending the legal issue in Illinois.
Outside of Wrigley Field during a recent scheduled playoff game, many fans sided with the Cubs organization on the issue of fan injuries. Among them was Naomi Rodriguez, 56, of Wrigleyville, who said spectators must pay attention to flying balls and bats.
“When you walk in the park, you have to know that this can happen,” Rodriguez said. “It’s just what happens, but I love my Cubbies. I back them up 100 percent.”
Others welcomed more protective netting at Wrigley Field. Mike Ford, 46, of Crown Point, said he believes fans are assuming the risk of being injured by sitting in areas where foul balls typically land. Standing outside of Wrigley Field with his 11-year-old son, Ford said the risk of being hit with one of the balls is one of the reasons why he buys seats in the terrace reserved outfield area.
He would like to see the spectator netting extended at the ballpark, which would expand his seating options.
“I’d be willing to go down to that section if I had the opportunity to,” he said.
sschmadeke@chicagotribune.com
emalagon@chicagotribune.com
Twitter @steveschmadeke
Twitter @elviamalagon

Pap test lost its value?

 

Has the Pap test lost its value?

By John Biemer and Guliz A. Barkan   source
The Pap test — a staple of women’s health checkups for generations — is one of medicine’s greatest success stories, saving the lives of countless women by detecting abnormal cells on the cervix that could turn into cancer. Yet the Pap test could be on the decline due to changing technology.
The Pap test is widely considered the most effective cancer screening test. As recently as 2000, an estimated 61 million Pap tests were performed in the United States, according to surveys conducted by the National Center for Health Statistics. But if recent proposals from the United States Preventive Services Task Force are approved, fewer Paps may be performed going forward, with a molecular test replacing them.
This month, the task force proposed that screening healthy women ages 30 to 65 for cervical cancer could be performed by either a Pap test or by a human papillomavirus DNA test instead — although a Pap would be performed every three years while the HPV test alone could be performed every five years.
The task force proposals, which are now in a public comment period, follow a study of 47,208 women undergoing routine cervical exams that demonstrated that a DNA test for HPV was more sensitive than the Pap at picking up lesions on the cervix that could progress into cancer.
However, critics of the HPV molecular test say it also is more likely to turn up with erroneously “positive” results (when there is no precancerous condition), which may lead to unnecessary treatment such as colposcopies and biopsies for patients who don’t need them. There also are concerns that setting the screening at five-year intervals may lead to women failing to follow up with gynecological checkups, which are also important for other health concerns besides cervical cancer screening. As a result, for the patient’s benefit, it may be better to have co-testing — both a Pap test and HPV testing at the same time — to ensure higher sensitivity in detecting cancer.
Cervical cancer was the most common cause of cancer deaths of women in the United States in the 1930s, but deaths dropped dramatically after the introduction of the low-cost, easily performed Pap test, which was developed by Dr. George Papanicolaou, a pathologist who emigrated from Greece.
In the Pap test, commonly referred to as a “Pap smear,” cells collected from the uterine cervix with a tiny brush are later placed on a glass slide.
Cytotechnologists and pathologists examine those slides under a microscope, scouring thousands of cells for any abnormality. From the perspective of patients, collecting cells for the HPV molecular tests also requires a speculum exam, so they won’t notice much difference.
Some strains of the human papillomavirus — the same virus that causes warts — have been linked to the development of cervical cancer. Infection by HPV, which is spread by sexual contact, still is common, especially in sexually active young men and women.
At least half of sexually active people will have HPV at some point in their lives, but the infection is usually transient and the body clears it on its own. That’s why the Pap test, rather than the HPV DNA test, is still preferable in women under 30 to see if precancerous changes in cervical cells already have taken place.
Some women, however, do develop persistent infections that can progress over time into invasive cancer. There are still nearly 13,000 new cases of cervical cancer in the United States each year and more than 4,000 deaths due to the disease, according to the American Cancer Society — though it now ranks as the 21st most common of cancers in women, according to the National Cancer Institute.
The biggest reason for its precipitous decline is vigilant surveillance. Although HPV vaccines and the HPV testing ultimately may lead to fewer Pap tests being performed, the goal remains the same: to stop a deadly disease in its tracks.
John Biemer, M.D., a former Tribune reporter, is a cytopathology fellow at Loyola University Medical Center in Maywood; Guliz A. Barkan, M.D., is the director of cytopathology at LUMC.

Deafening mystery grows in Cuba

Physics of injuries, methods don’t add up, officials say
Secretary of State Rex Tillerson said Sunday the Trump administration is considering closing the U.S. embassy in Havana. (Desmond Boylan/AP 2015)
By Josh Lederman, Michael Weissenstein and Matthew Lee Associated Press
WASHINGTON — The blaring, grinding noise jolted the American diplomat from his bed in a Havana hotel. He moved just a few feet, and there was silence. He climbed back into bed. Inexplicably, the agonizing sound hit him again. It was as if he’d walked through some invisible wall cutting straight through his room.
Soon came the hearing loss, and the speech problems, symptoms both similar and altogether different from others among at least 21 U.S. victims in an astonishing international mystery still unfolding in Cuba.

The top U.S. diplomat has called them “health attacks.” New details learned by The Associated Press indicate at least some of the incidents were confined to specific rooms or even parts of rooms with laser-like specificity, baffling U.S. officials who say the facts and the physics don’t add up.
“None of this has a reasonable explanation,” said Fulton Armstrong, a former CIA official who served in Havana long before America re-opened an embassy there. “It’s just mystery after mystery after mystery.”
Suspicion initially focused on a sonic weapon, and on the Cubans. Yet the diagnosis of mild brain injury, considered unlikely to result from sound, has confounded the FBI, the State Department and U.S. intelligence agencies involved in the investigation.
Some victims now have problems concentrating or recalling specific words, several officials said, the latest signs of more serious damage than the U.S. government initially realized. The United States first acknowledged the attacks in August — nine months after symptoms were first reported.
It may seem the stuff of sci-fi novels, of the cloak-and-dagger rivalries that haven’t fully dissipated despite the historic U.S.-Cuban rapprochement two years ago that seemed to bury the weight of the two nations’ Cold War enmity.

But this is Cuba, the land of poisoned cigars, exploding seashells and covert subterfuge by Washington and Havana, where the unimaginable in espionage has often been all too real.
The Trump administration still hasn’t identified a culprit or a device to explain the attacks, according to interviews with more than a dozen current and former U.S. officials, Cuban officials and others briefed on the investigation. Most weren’t authorized to discuss the probe and demanded anonymity.
“The investigation into all of this is still under way. It is an aggressive investigation,” State Department spokeswoman Heather Nauert said last week. “We will continue doing this until we find out who or what is responsible for this.”
On Sunday, Secretary of State Rex Tillerson said the Trump administration is considering closing down the U.S. embassy in Havana. Tillerson’s comments were the strongest indication to date that the United States might mount a major diplomatic response, potentially jeopardizing the historic restart of relations between the U.S. and Cuba.
“We have it under evaluation,” Tillerson said of a possible embassy closure. “It’s a very serious issue with respect to the harm that certain individuals have suffered.”
Investigators have tested several theories about an intentional attack — by Cuba’s government, a rogue faction of its security forces, a third country like Russia, or some combination thereof.

Yet they’ve left open the possibility an advanced espionage operation went horribly awry, or that some other, less nefarious explanation is to blame.
Aside from their homes, officials said Americans were attacked in at least one hotel, a fact not previously disclosed. An incident occurred on an upper floor of the recently renovated Hotel Capri, a 60-year-old concrete tower steps from the Malecon, Havana’s iconic, waterside promenade.
The cases vary deeply: different symptoms, different recollections of what happened. That’s what makes the puzzle so difficult to crack.
In several episodes recounted by U.S. officials, victims knew it was happening in real time, and there were strong indications of a sonic attack.
Some felt vibrations, and heard sounds — loud ringing or a high-pitched chirping similar to crickets or cicadas. Others heard the grinding noise. Some victims awoke with ringing in their ears and fumbled for their alarm clocks, only to discover the ringing stopped when they moved away from their beds.
The attacks seemed to come at night. Several victims reported they came in minute-long bursts.
Yet others heard nothing, felt nothing. Their symptoms came later.
The scope keeps widening. Last week, the State Department disclosed that doctors had confirmed another two cases, bringing the total American victims to 21. Some have mild traumatic brain injury, known as a concussion, and others permanent hearing loss.
Even the potential motive is unclear. Investigators are at a loss to explain why Canadians were harmed. Fewer than 10 Canadian diplomatic households in Cuba were affected, a Canadian official said. Unlike the U.S., Canada has maintained warm ties to Cuba for decades.
Sound and health experts are equally baffled. Targeted, localized beams of sound are possible, but the laws of acoustics suggest such a device would probably be large and not easily concealed. Officials said it’s unclear whether the device’s effects were localized by design or due to some other technical factor.
And no single, sonic gadget seems to explain such an odd, inconsistent array of physical responses.
“Brain damage and concussions, it’s not possible,” said Joseph Pompei, a former MIT researcher and psychoacoustics expert. “Somebody would have to submerge their head into a pool lined with very powerful ultrasound transducers.”
Other symptoms have included brain swelling, dizziness, nausea, severe headaches, balance problems and tinnitus, or prolonged ringing in the ears. Many victims have shown improvement since leaving Cuba and some suffered only minor or temporary symptoms.
After the U.S. complained to Cuba’s government earlier this year and Canada detected its own cases, the FBI and the Royal Canadian Mounted Police traveled to Havana to investigate.
FBI investigators swept the rooms, looking for devices. They found nothing, several officials briefed on the investigation said.
In May, Washington expelled two Cuban diplomats to protest the communist government’s failure to protect Americans serving there. But the U.S. has taken pains not to accuse Havana of perpetrating the attacks.
Cuba’s government declined to answer specific questions about the incidents, pointing to a previous Foreign Affairs Ministry statement denying any involvement, vowing full cooperation and saying it was treating the situation “with utmost importance.”
“Cuba has never, nor would it ever, allow that the Cuban territory be used for any action against accredited diplomatic agents or their families, without exception,” the Cuban statement said.

Violence to Nurses

 

 

Note–Through my many surgeries, starting at age 4 (1939), I’ve gained a lot of respect for nurses, men and women.  We’ve had nurses in the family: my mother Marjorie, my sister Carol, my sister-in-law Jenny and her son Chris, and my daughter Laura.

When I had an appendectomy at age 12, I  fell in love with a student nurse from Indiana who was kind to me but I sensed  did not reciprocate my passion.

Before colleges entered nursing education, girls trained in hospital programs. Mom and Carol had tuition, room and board free at St. Francis Hospital in Evanston and worked long hours at such tasks as cleaning beds as well as nursing duties. They wore white dresses, stockings, and shoes.  At graduation they received their white caps to which they added a stripe after a period of service.  Laura trained at Lutheran General Hospital in Niles, Illinois, and worked there  in the cancer unit.

Now we have highly trained advanced practice nurses who do much of the work of a primary care doctor.  Rachel Foote treated patients in Spanish at a clinic in Boston. Nurses can earn master and doctor degrees in nursing.  Some physicians don’t like to have nurses addressed as doctor.

RJN

 

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On the front line of hospital violence, nurses seek reform  Chicago Tribune 8/11/17

‘Part of the job’ culture in health care must change, advocates say

Carina Johannessen, 40, said being a nurse is rather like “being in an abusive relationship.”

By Kate Thayer and Hannah Leone Chicago Tribune

One woman describes getting slapped and groped on the job. Another was punched in the head repeatedly. A third was bitten so hard that a spike in blood pressure burst an aneurysm in her brain, altering her life forever.

All three are nurses, who say their jobs place them in harm’s way as the rate of violent incidents at hospitals appears to be growing.

U.S. Bureau of Labor Statistics data show that the rate of hospital employees intentionally injured on the job at the hands of another person is significantly higher than the rate across all private industries. In 2015, the most recent year available, there were 8.5 cases of injuries per 10,000 full-time hospital workers, versus 1.7 cases for all private industries.

The data also show that injury number for hospital workers steadily rose from 2011 to 2014 but dropped slightly the following year.

According to an Occupational Safety and Health Administration guide on addressing violence in hospitals, 70 to 74 percent of workplace assaults between 2011 and 2013 happened in health care settings.

And hospitals in the Chicago area have not been immune to such violence in recent years.

In May, two nurses at Northwestern Medicine Delnor Hospital in Geneva were taken hostage by a Kane County jail inmate after he got hold of the gun of a corrections officer guarding him. One of the nurses was sexually assaulted, according to a lawsuit filed in the case, before the inmate was fatally shot by police, authorities said.

Less than a month later at Presence St. Joseph Medical Center in Joliet, a convicted murderer who was there for treatment used a makeshift weapon to hold a corrections officer and a nursing assistant hostage.

In 2014, a man who had been taken to NorthShore Highland Park Hospital after a car crash was shot and killed by police after removing a gun from his waistband, according to police accounts.

Experts say facilities across the country have been affected. In June, a disgruntled doctor opened fire at a New York City hospital, killing another doctor and injuring several other people before taking his own life. In 2015, at a Boston hospital, a man shot and killed the surgeon who’d operated on his mother before she died.

While such extreme examples are rarer, many health care workers — especially nurses — say they deal with more minor incidents of physical aggression or verbal abuse on an almost daily basis. Many have stories of intoxicated or delusional patients who spit, claw and hit, or angry family members who threaten lawsuits or even lives.

For too long, nursing advocates say, aggression toward hospital workers has been chalked up to just an unfortunate part of the job, and patients are rarely held accountable.

Yet a movement to change this culture seems to be gaining momentum, with nurses groups speaking out at protests and on social media, and lobbying for legislation that aims to curtail violence against health care workers.

The Delnor attack seems to have been the tipping point for many activists locally, and in response to it, a nonprofit group called Show Me Your Stethoscope plans to gather nurses at a rally Friday in front of the Kane County sheriff’s office to shed light on their efforts.

Nurses point out that they’re the ones with the most contact with patients and their families, often during times of crisis and intense stress. Heartbreak over a serious diagnosis, anger over a long emergency room wait or even a general disdain for the health care and insurance fields — all can translate into hostility toward nurses, experts say.

“Just going into work is a high-risk endeavor,” said Lisa Wolf, director at the Institute for Emergency Nursing Research at the Emergency Nurses Association and a registered nurse who has studied emergency room violence. “You’re going to work and people are in some ways feeling like they can kill you.”

Nurses groups generally would like to see more staffing and more training. Other observers say there’s no single solution that would work for all hospitals — an industry struggling to do more with fewer resources.

While many states, including Illinois, have enhanced penalties for offenders who attack nurses, there’s also a push for federal legislation or an OSHA standard that would regulate hospital staffing levels and install other violence prevention measures.

Some who’ve studied the problem say it’s even worse than the statistics suggest. Verbal abuse is not included in government reporting, and while many hospitals have a system for employees to report acts of violence, nurses say they often don’t have or take the time to take advantage of them.

‘Part of the job’

Trauma nurse Carina Johannessen said her job is somewhat like “being in an abusive relationship.”

Nurses get hurt, but they keep going back to work, said Johannessen, 40, who is employed by an RN placement firm and has worked in several Illinois hospitals.

While on a shift at the emergency room at St. Joseph in Joliet, she said, a large male patient punched her in the head five times after he attacked someone else and she tried to intervene.

Johannessen, of Joliet, said she didn’t suffer severe injuries and felt she had to finish her shift, despite a “raging headache.” No one suggested she file a police report, she said, or even go home for the day. And if she had left, she said there wouldn’t have been enough nurses to cover the rest of her shift.

“This just seems to be the culture. It’s part of the job,” Johannessen said, adding her “greatest fear” is that violence against nurses will only escalate.

On May 13, Tywon Salters, a Kane County jail inmate admitted to Delnor for medical treatment, was left unshackled by a corrections officer, according to a lawsuit filed by Delnor nurses.

Salters, 21 and in jail for alleged car theft, got hold of the officer’s 9 mm handgun, and while the officer ran down the hall and hid, Salters found a nurse in a nearby office, threatened her with the gun and made her remove her clothes, the complaint states. When another nurse entered, he led her to another room, where he held her captive for hours in the dark, raping her and beating her at gunpoint, according to the lawsuit.

A SWAT team officer eventually shot and killed Salters. The fatal bullet also struck the nurse in the arm, according to the lawsuit.

Johannessen said the Delnor incident was partly what prompted her to speak out. She said she sometimes struggles to remember why she chose to be a nurse in the first place.

“It is so incredibly rewarding,” she said, “but it’s sad because it’s becoming more and more infrequent that you get the patient who reminds you why you wanted to be a nurse.”

ER nurse Valerie Zage said she’s been subjected to regular verbal abuse in her 10-year career.

“People scream at you, they swear at you. I’ve been called so many names,” she said. “It seems the culture of hospitals in general is, you kind of have to just take it.”

Zage, 33, of Bensenville, said two incidents prompted her to file official reports, not just with her employer but also with police.

The first occurred a few years ago at Advocate Condell Medical Center in Libertyville, where Zage said a patient charged at her and slapped her across the face after being denied a pain pill prescription.

Zage was shaken and called police. She said the patient received a minor ordinance violation ticket but never appeared in court so the matter went unresolved.

More recently, while working at Advocate Lutheran General Hospital in Park Ridge, Zage said an intoxicated patient grabbed her breast while she was setting up an IV. Zage also went to police but said she found it “frustrating” that he, too, merely received a ticket and was fined $100.

“You go through nursing school and you think, ‘Wow, I’m going to help people and save lives,’ ” she said. “No one really warns you in school that people are as mean and horrible as they’re going to be.”

Sally Griepentrog, 52, of downstate Eureka, is an educator trying to prepare nurses for those realities of the profession. A workplace violence course she teaches to employees at OSF St. Francis Medical Center in Peoria includes techniques for recognizing cues for possible violence and de-escalation methods.

Griepentrog said she’s uniquely suited for the job, as an act of workplace violence changed her life.

In 2015, Griepentrog was staffing a medical tent at a summer music festival. A young woman came in, topless, saying she had been taking drugs all day and was dehydrated. When Griepentrog tried to start an IV, she said, the woman clamped her teeth down hard into the nurse’s shoulder and would not let go.

It took the intervention of multiple staff members to eventually wrestle the woman away.

Griepentrog was treated for the gash in her shoulder, but a lingering headache led to further testing. Days later, doctors learned the pain from the bite caused her blood pressure to spike, bursting an undiagnosed aneurysm in her brain.

She underwent surgery and spent weeks in the ICU. She was left with short-term memory loss and said she can no longer read more than a sentence at a time.

“I’ve been swatted at, hit, spit on, puked on, you name it,” Griepentrog said. “But this was the first time it almost cost me my life.”

It might have cost her career, too, had Griepentrog not already had a master’s degree and experience teaching. She can no longer treat patients but now works solely as an educator, using computer software that reads aloud to her.

The woman who attacked Griepentrog was eventually convicted of a misdemeanor and sentenced to six months in jail, court records show.

“Now that this has happened, I think, no more. This can’t be considered part of our jobs anymore. I think too many of us are being hurt,” Griepentrog said.

Alice Johnson, executive director of the Illinois Nurses Association, said it’s time for hospitals to make nurses’ safety a priority and dedicate resources accordingly.

“Nurses are taking action on their own as part of a grass-roots efforts to address this issue,” she said.

Hospitals and other employers, on the other hand, “have a long way to go,” Johnson said, adding they seem focused on the bottom line but not enough on the care of the workforce.

Adequate staffing is one key way to improve hospital safety, she said.

Pam Cipriano, American Nurses Association president, said mandatory staff training and better record-keeping should be done at all hospitals — whether voluntary or through federal legislation.

“We need to be able to reverse the culture to make sure no nurse should … be exposed to violence on the job,” she said.

More research needed

Emergency medicine physician James Phillips started studying hospital violence after the surgeon was killed at the Boston hospital. At the time, he was working at nearby Harvard University, writing about mass shootings.

But when he turned his attention to medical settings, “I came across a plethora of nursing literature of violence in hospitals,” he said. Last year, he published an article in the New England Journal of Medicine arguing that hospital violence is under-reported, tolerated and ignored.

Phillips notes that government statistics on workplace violence only track incidents that result in injuries and time off of work. He said more accurate tracking is important to persuade hospitals to put more resources toward security and violence prevention methods.

During Phillips’ residency in Chicago with the University of Illinois hospital system, he was working a shift at a suburban hospital and was trying to calm an agitated, intoxicated patient when the man “spit a mouthful of blood right into my eye.” Phillips soon learned the man was infected with hepatitis C.

The doctor never contracted the virus but had to undergo testing multiple times for months.

“I blew it off at the time. I thought it was part of the job,” he said. “No one ever said, ‘Did you file a police report? You were a victim of a violent crime.’ ”

Later, Phillips was working in Massachusetts when a patient spit in his face and threw a cellphone at him. In that case, he said he did call police, and the man was charged and served community service.

“I’m so sick and tired of being yelled at, screamed at and threatened,” he said. “I finally thought it was time to stand up for myself.”

Phillips said nursing and medical schools “should be the first place future doctors and nurses learn about the fact that they are entering into a violent industry and have a significant chance of being verbally and physically assaulted in their careers.”

Active shooters in hospitals are rare, he stressed, but assaults on staff by patients and visitors are much more common.

Wolf, of the Emergency Nurses Association, said hospitals need to assess risk factors, down to things like poor lighting, and should implement detailed reporting systems and encourage staff members to use them. Hospitals also need adequate staffing and should take “a firmer stance on patients who start acting out.”

Wolf said it’s a challenge for hospitals to acknowledge any risks because “everyone wants to feel like the community is safe.”

Wolf’s group surveyed thousands of nurses across the country, and the results, published in 2009, showed more than half were physically assaulted at work. “This is a very, very common, deeply disturbing aspect (of the job),” she said.

No single solution

Several Chicago-area hospitals contacted by the Tribune declined to comment on security measures and staff training relating to workplace violence.

Advocate, Presence and Northwestern health systems issued statements, noting security is a priority and they take precautions, including de-escalation techniques and drills, and continue to study the issue.

“Unfortunately, this is something that continues to be seen more and more, and we continually have to talk about it,” said Melissa Granato, associate vice president of security for Amita Health.

In 2015 at Alexian Brothers Medical Center in Elk Grove Village, one of the hospitals under the Amita banner, a man locked his estranged wife in a bathroom and stabbed her to death with a screwdriver.

Granato said the case prompted the security team to review and improve its procedures. Those approaches vary by location, she said, but can include drills and simulation training with staff. She also said they work closely with local law enforcement.

At the Chicago-based American Hospital Association and the Illinois Health and Hospital Association, the issue of workplace violence is taken seriously, officials said. Members can access resources on how to address security at their facilities.

But every facility is different, said Dr. Jay Bhatt, AHA president. That’s why he and others question whether a national standard on staffing levels or violence prevention for hospitals would work.

“Nurses aren’t widgets, neither are patients,” said Cathy Grossi, a vice president at the IHA. “One size fits all rarely ever works.”

However, California recently enacted legislation that many nurse advocates say is groundbreaking and a potential model for a national standard. The law addresses the reporting of violent acts, staff training and correcting any violence hazards, including staffing levels. The union that lobbied for it is also pushing for OSHA to come up with a standard.

The Joint Commission, the Oakbrook Terrace-based nonprofit that accredits hospitals across the country, does not have a uniform standard related to workplace violence. But the commission does address safety and security when accrediting hospitals, and offers violence prevention resources, said Dr. Ana Pujols McKee, the commission’s chief medical officer.

“We expect our organizations to understand security risks and respond in a proactive way,” she said.

McKee said one challenge is finding a uniform way to gather data and use it to set guidelines. She uses the example of a nurse being hit by a patient with a brain tumor that has altered the patient’s behavior. “Is that violent? To me, it is, but it may be perceived as a patient who has uncontrollable behaviors.”

McKee said she’s watching California as a “test site,” to see if the new law leads to a decrease in hospital violence.

Are hospitals secure?

Security experts also agree more study is needed to determine the best way to keep hospitals safe.

“The historic feeling that places like … hospitals (are) sacred ground is gone,” said Kevin Tuohey, president-elect of the International Association for Healthcare Security and Safety.

The Glendale Heights-based group researches and offers guidelines for the security industry, including hospital guards.

Another association official, Tom Smith, who runs a health care security consulting company, said hospitals are typically subjected to few regulations dealing with security, and some don’t place enough emphasis on it.

“Family-friendly and patient-centered doesn’t mean it shouldn’t be secure,” he said.

The association has provided feedback to OSHA as the workplace safety agency contemplates hospital security regulations. Some local law enforcement agencies, though, have already made changes in how they handle inmates who need outside medical care.

Within weeks of the Delnor attack, Kendall County updated their policies, including requiring detainees to remain handcuffed or shackled at all times unless medical staff specifically orders restraints removed or the detainee is giving birth.

Deputies who are guarding inmates at hospitals are also barred from using the phone unless there’s an emergency and may not use social media or the internet or play games. According to the lawsuit filed by the Delnor nurses, corrections officers assigned to guard Salters were seen sleeping or on the computer.

Sheriff offices in Cook and McHenry counties also listed several guidelines for transporting and guarding inmates who need outside medical attention.

The Illinois Department of Corrections, as well as DuPage, Kane, Lake and Will counties, declined to provide their policies, citing security concerns.

Kate Thayer is a Chicago Tribune reporter; Hannah Leone is an Aurora Beacon-News reporter. kthayer@chicagotribune.com

Bugs on our Bills (and dope)

The dirt and dope that’s on your cash

By Johanna Ohm  Chicago Tribune 6.22.17

We live in a dirty world. Wherever we go, we are among microbes. Bacteria, fungi and viruses live on our phones, bus seats, door handles and park benches. We pass these tiny organisms to each other when we share a handshake or a seat on the plane.
Now, researchers are finding we also share our microbes through our money. From tip jars to vending machines to the meter maid — each dollar, passed person to person, samples a bit of the environment it comes from, and passes those bits to the next person, the next place it goes.
The list of things found on our dollars includes DNA from our pets, traces of illegal drugs, and bacteria and viruses that cause disease.
The findings demonstrate how money can silently record human activities, leaving behind so-called “molecular echoes.”
What’s on a $1 bill?
In April, a new study identified more than 100 different strains of bacteria on dollar bills circulating in New York City. Some of the most common bugs on our bills included Propionibacterium acnes , a bacteria known to cause acne, and Streptococcus oralis , a common bacteria found in our mouths.
The research team, led by biologist Jane Carlton at New York University, also discovered traces of DNA from domestic animals and from specific bacteria that are associated only with certain foods.
A similar study recovered traces of DNA on ATM keypads, reflecting the foods people ate in different neighborhoods in New York. People in central Harlem ate more domestic chicken than those in Flushing and Chinatown, who ate more species of bony fish and mollusks. The foods people ate transferred from fingers to touch screens, where scientists could recover a bit of their most recent meals.
We don’t leave only food behind. Traces of cocaine can be found on almost 80 percent of dollar bills. Other drugs, including morphine, heroin, methamphetamine and amphetamine, can also be found on bills, though less commonly than cocaine.
Identifying foods people eat or the drugs people use based on interactions with money might not seem all that useful, but scientists are also using these types of data to understand patterns of disease. Most of the microbes the researchers in New York identified do not cause disease.
But other studies have suggested that disease-causing strains of bacteria or viruses could be passed along with our currency.
Bacteria that cause foodborne illness — including salmonella and a pathogenic strain of E. coli — have been shown to survive on pennies, nickels and dimes and can hide out on ATMs. Other bacteria, such as MRSA, a drug-resistant staph infection, are found on bank notes in the U.S. and Canada, but the extent to which they could spread infections is unknown.
Try as we may to avoid exposure to germs, they travel with us and on us. Even if disease-causing microbes can survive in places like ATMs, the good news is that most exposures don’t make us sick.
Money laundering
Disease transmission linked to money is rare, and no major disease outbreaks have started from our ATMs. Although it doesn’t seem common for diseases to transmit through money, there are ways we could make our money cleaner.
Researchers are working on ways to clean money between transactions. Putting older bills through a machine that exposes them to carbon dioxide at a specific temperature and pressure can strip dollar bills of oils and dirt left behind by human fingers, while the heat kills microbes that would otherwise linger.
U.S. money is still made from a blend of cotton and linen, which has been shown to have higher bacterial growth than plastic polymers. Several countries are transitioning from money made of natural fibers to plastic, which may be less friendly to bacteria. Canada has had plastic money since 2013, and the United Kingdom transitioned to a plastic-based bank note last year.
Even if our money is not directly responsible for spreading disease, we can still use the dollar’s travel history to track how we spread disease in other ways.

The website WheresGeorge.com, created in 1998, lets users track dollar bills by recording their serial numbers. In the almost 20 years since the site’s creation, WheresGeorge has tracked the geographic locations of bills totaling more than a billion dollars.
Now, physicists at the Max Planck Institute and University of California at Santa Barbara are using data from the WheresGeorge site to track epidemics. Information on human movement and contact rates from WheresGeorge was even used to predict the spread of the 2009 swine flu.
Although we don’t know the extent to which money allows diseases to spread, Mom’s advice is probably best when handling cash: Wash your hands and don’t stick it in your mouth.
The Conversation
Johanna Ohm is a graduate student in biology at Pennsylvania State University.

SUGAR VS. FAT=FRAUD

A newly discovered cache of internal documents reveals that the sugar industry downplayed the risks of sugar in the 1960s.  Luis Ascui/Getty Images

50 Years Ago, Sugar Industry Quietly Paid Scientists To Point Blame At Fat

National Public Radio   source
In the 1960s, the sugar industry funded research that downplayed the risks of sugar and highlighted the hazards of fat, according to a newly published article in JAMA Internal Medicine.

The article draws on internal documents to show that an industry group called the Sugar Research Foundation wanted to “refute” concerns about sugar’s possible role in heart disease. The SRF then sponsored research by Harvard scientists that did just that. The result was published in the New England Journal of Medicine in 1967, with no disclosure of the sugar industry funding.
Sugar Shocked?

The Rest Of Food Industry Pays For Lots Of Research, Too
The sugar-funded project in question was a literature review, examining a variety of studies and experiments. It suggested there were major problems with all the studies that implicated sugar, and concluded that cutting fat out of American diets was the best way to address coronary heart disease.

The authors of the new article say that for the past five decades, the sugar industry has been attempting to influence the scientific debate over the relative risks of sugar and fat.

“It was a very smart thing the sugar industry did, because review papers, especially if you get them published in a very prominent journal, tend to shape the overall scientific discussion,” co-author Stanton Glantz told The New York Times.

Money on the line
How The Food Industry Manipulates Taste Buds With ‘Salt Sugar Fat’
In the article, published Monday, authors Glantz, Cristin Kearns and Laura Schmidt aren’t trying make the case for a link between sugar and coronary heart disease. Their interest is in the process. They say the documents reveal the sugar industry attempting to influence scientific inquiry and debate.

The researchers note that they worked under some limitations — “We could not interview key actors involved in this historical episode because they have died,” they write. Other organizations were also advocating concerns about fat, they note.

There’s no evidence that the SRF directly edited the manuscript published by the Harvard scientists in 1967, but there is “circumstantial” evidence that the interests of the sugar lobby shaped the conclusions of the review, the researchers say.

For one thing, there’s motivation and intent. In 1954, the researchers note, the president of the SRF gave a speech describing a great business opportunity.

If Americans could be persuaded to eat a lower-fat diet — for the sake of their health — they would need to replace that fat with something else. America’s per capita sugar consumption could go up by a third.
In ‘Soda Politics,’ Big Soda At Crossroads Of Profit And Public Health
But in the ’60s, the SRF became aware of “flowing reports that sugar is a less desirable dietary source of calories than other carbohydrates,” as John Hickson, SRF vice president and director of research, put it in one document.

He recommended that the industry fund its own studies — “Then we can publish the data and refute our detractors.

The next year, after several scientific articles were published suggesting a link between sucrose and coronary heart disease, the SRF approved the literature-review project. It wound up paying approximately $50,000 in today’s dollars for the research.

One of the researchers was the chairman of Harvard’s Public Health Nutrition Department — and an ad hoc member of SRF’s board.

“A different standard” for different studies

Glantz, Kearns and Schmidt say many of the articles examined in the review were hand-selected by SRF, and it was implied that the sugar industry would expect them to be critiqued.

Obesity And The Toxic-Sugar Wars
13.7: COSMOS AND CULTURE
Obesity And The Toxic-Sugar Wars
In a letter, SRF’s Hickson said that the organization’s “particular interest” was in evaluating studies focused on “carbohydrates in the form of sucrose.”

“We are well aware,” one of the scientists replied, “and will cover this as well as we can.”

The project wound up taking longer than expected, because more and more studies were being released that suggested sugar might be linked to coronary heart disease. But it was finally published in 1967.

Hickson was certainly happy with the result: “Let me assure you this is quite what we had in mind and we look forward to its appearance in print,” he told one of the scientists.

The review minimized the significance of research that suggested sugar could play a role in coronary heart disease. In some cases the scientists alleged investigator incompetence or flawed methodology.

“It is always appropriate to question the validity of individual studies,” Kearns told Bloomberg via email. But, she says, “the authors applied a different standard” to different studies — looking very critically at research that implicated sugar, and ignoring problems with studies that found dangers in fat.

Epidemiological studies of sugar consumption — which look at patterns of health and disease in the real world — were dismissed for having too many possible factors getting in the way. Experimental studies were dismissed for being too dissimilar to real life.

One study that found a health benefit when people ate less sugar and more vegetables was dismissed because that dietary change was not feasible.

Another study, in which rats were given a diet low in fat and high in sugar, was rejected because “such diets are rarely consumed by man.”

The Harvard researchers then turned to studies that examined risks of fat — which included the same kind of epidemiological studies they had dismissed when it came to sugar.

Citing “few study characteristics and no quantitative results,” as Kearns, Glantz and Schmidt put it, they concluded that cutting out fat was “no doubt” the best dietary intervention to prevent coronary heart disease.

Sugar lobby: “Transparency standards were not the norm”

In a statement, the Sugar Association — which evolved out of the SRF — said it is challenging to comment on events from so long ago.

“We acknowledge that the Sugar Research Foundation should have exercised greater transparency in all of its research activities, however, when the studies in question were published funding disclosures and transparency standards were not the norm they are today,” the association said.

“Generally speaking, it is not only unfortunate but a disservice that industry-funded research is branded as tainted,” the statement continues. “What is often missing from the dialogue is that industry-funded research has been informative in addressing key issues.”

The documents in question are five decades old, but the larger issue is of the moment, as Marion Nestle notes in a commentary in the same issue of JAMA Internal Medicine:

“Is it really true that food companies deliberately set out to manipulate research in their favor? Yes, it is, and the practice continues. In 2015, the New York Times obtained emails revealing Coca-Cola’s cozy relationships with sponsored researchers who were conducting studies aimed at minimizing the effects of sugary drinks on obesity. Even more recently, the Associated Press obtained emails showing how a candy trade association funded and influenced studies to show that children who eat sweets have healthier body weights than those who do not.”
As for the article authors who dug into the documents around this funding, they offer two suggestions for the future.

“Policymaking committees should consider giving less weight to food industry-funded studies,” they write.

They also call for new research into any ties between added sugars and coronary heart disease.

 

MIDDLE EAST
Department Of Defense Investigating U.S.-Led Coalition Airstrike In Syria
Mike Pence speaks to Republicans at the Ronald Reagan Presidential Library in Si

 

 

Secretly Sick Presidents

THE SECRET AILMENTS OF PRESIDENTS

A history of illnesses kept from public

By Joel Achenbach and Lillian Cunningham                                                                                       The Washington Post in Chicago Tribune 9.13.16

In his second term as president, Dwight Eisenhower looked like an old man. He’d had a serious heart attack in 1955, requiring extensive hospitalization. He later suffered a stroke. In contrast, his successor, John F. Kennedy, seemed vibrant and flamboyant.

The reality was that Eisenhower wasn’t really that old — he was just 62 when he was first elected. And Kennedy wasn’t that vigorous and indeed was secretly afflicted by serious medical problems, including Addison’s disease*, that his aides concealed from the public.

In his second term as president, Dwight Eisenhower looked like an old man. He’d had a serious heart attack in 1955, requiring extensive hospitalization. He later suffered a stroke. In contrast, his successor, John F. Kennedy, seemed vibrant and flamboyant.

The reality was that Eisenhower wasn’t really that old — he was just 62 when he was first elected. And Kennedy wasn’t that vigorous and indeed was secretly afflicted by serious medical problems, including Addison’s disease, that his aides concealed from the public.

The history of the presidency includes a running thread of illness and incapacity, much of it hidden from the public out of political calculation. A stroke incapacitated Woodrow Wilson in 1919, for example, but the public had no inkling until many months later. And when Grover Cleveland needed surgery in 1893 to remove a cancerous tumor in his mouth, he did it secretly on a friend’s yacht cruising through Long Island Sound.

Presidential history reveals a more subtle trend: Age isn’t what it used to be. American culture has redefined old age, pushing it back significantly as people live longer and expect to be more active into their eighth or ninth decade or beyond.

Hillary Clinton is 68, and Donald Trump is 70. They’re the oldest pair of major party candidates in history. If elected, Clinton would be the second-oldest person to assume the presidency, after Ronald Reagan. Trump would be the oldest.

Health has suddenly become a preoccupation on the campaign trail in the wake of Clinton’s wobbly episode Sunday when she left a 9/11 service in New York City. The Clinton camp initially called it merely a case of overheating. Late in the day, the campaign revealed that, in fact, she was diagnosed with pneumonia on Friday. On Monday, a Clinton spokesperson acknowledged that the campaign could have been more forthcoming on Sunday.

Neither candidate has released detailed medical records.

Clinton’s gender gives her an advantage on one respect: Women in the U.S. outlive men by several years. According to the Social Security Administration’s online life expectancy calculator, a woman of Clinton’s age is likely to live an additional 18.4 years. A man of Trump’s age is likely to live an additional 15.2.

Voters will have to determine if the murky health status of Clinton and Trump should be a factor in the November decision. What’s certain is that the campaign trail can be brutal and that the presidency itself can pound away at the health of whoever occupies the Oval Office.

President Cleveland kept his cancer surgery secret in part because cancer at the time was such a dreaded disease. He also didn’t trust reporters or think his medical condition was anyone’s business, Cleveland biographer Matthew Algeo, author of “The President is a Sick Man,” told The Washington Post.

Algeo makes a broader observation: The desire for secrecy led many American presidents to avoid the best doctors. “With presidents, a lot of times they don’t get the best care. You would expect they would, but they’re so paranoid about anyone knowing what’s wrong with them that they employ old family doctors,” Algeo said.

The public had limited information about Franklin Delano Roosevelt’s physical condition and the fact that he used a wheelchair. By the time he ran for a fourth term in 1944, he had heart disease, was constantly tired and had trouble concentrating. Frank Lahey, a surgeon who examined Roosevelt, wrote a memo saying FDR would never survive another four-year term. The memo was not disclosed until 2011.

Roosevelt sailed to another victory and died in April 1945, leaving Harry Truman to close out World War II.

Kennedy suffered from Addison’s disease and had to take steroids and other drugs to ward off the symptoms, but he did so secretly. As the Los Angeles Times reported: “During the 1960 campaign, Kennedy’s opponents said he had Addison’s. His physicians released a cleverly worded statement saying that he did not have Addison’s disease caused by tuberculosis, and the matter was dropped.

“Kennedy collapsed twice because of the disease: once at the end of a parade during an election campaign and once on a congressional visit to Britain.”

The history of the presidency includes a running thread of illness and incapacity, much of it hidden from the public out of political calculation. A stroke incapacitated Woodrow Wilson in 1919, for example, but the public had no inkling until many months later. And when Grover Cleveland needed surgery in 1893 to remove a cancerous tumor in his mouth, he did it secretly on a friend’s yacht cruising through Long Island Sound.

Presidential history reveals a more subtle trend: Age isn’t what it used to be. American culture has redefined old age, pushing it back significantly as people live longer and expect to be more active into their eighth or ninth decade or beyond.

Hillary Clinton is 68, and Donald Trump is 70. They’re the oldest pair of major party candidates in history. If elected, Clinton would be the second-oldest person to assume the presidency, after Ronald Reagan. Trump would be the oldest.

Health has suddenly become a preoccupation on the campaign trail in the wake of Clinton’s wobbly episode Sunday when she left a 9/11 service in New York City. The Clinton camp initially called it merely a case of overheating. Late in the day, the campaign revealed that, in fact, she was diagnosed with pneumonia on Friday. On Monday, a Clinton spokesperson acknowledged that the campaign could have been more forthcoming on Sunday.

Neither candidate has released detailed medical records.

Clinton’s gender gives her an advantage on one respect: Women in the U.S. outlive men by several years. According to the Social Security Administration’s online life expectancy calculator, a woman of Clinton’s age is likely to live an additional 18.4 years. A man of Trump’s age is likely to live an additional 15.2.

Voters will have to determine if the murky health status of Clinton and Trump should be a factor in the November decision. What’s certain is that the campaign trail can be brutal and that the presidency itself can pound away at the health of whoever occupies the Oval Office.

President Cleveland kept his cancer surgery secret in part because cancer at the time was such a dreaded disease. He also didn’t trust reporters or think his medical condition was anyone’s business, Cleveland biographer Matthew Algeo, author of “The President is a Sick Man,” told The Washington Post.

Algeo makes a broader observation: The desire for secrecy led many American presidents to avoid the best doctors. “With presidents, a lot of times they don’t get the best care. You would expect they would, but they’re so paranoid about anyone knowing what’s wrong with them that they employ old family doctors,” Algeo said.

The public had limited information about Franklin Delano Roosevelt’s physical condition and the fact that he used a wheelchair. By the time he ran for a fourth term in 1944, he had heart disease, was constantly tired and had trouble concentrating. Frank Lahey, a surgeon who examined Roosevelt, wrote a memo saying FDR would never survive another four-year term. The memo was not disclosed until 2011.

Roosevelt sailed to another victory and died in April 1945, leaving Harry Truman to close out World War II.

Kennedy suffered from Addison’s disease and had to take steroids and other drugs to ward off the symptoms, but he did so secretly. As the Los Angeles Times reported: “During the 1960 campaign, Kennedy’s opponents said he had Addison’s. His physicians released a cleverly worded statement saying that he did not have Addison’s disease caused by tuberculosis, and the matter was dropped.

“Kennedy collapsed twice because of the disease: once at the end of a parade during an election campaign and once on a congressional visit to Britain.”

 * Addison’s disease is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison’s disease, your adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well.  Read more at source.

Eating Deer, Elk, and People Spreads Disease

A sign said DEPOSIT DEER AND ELK HEADS HERE at a government building next door to our hotel in Fort Collins, Colorado.  The heads were to be used in the study of chronic wasting disease which is related to mad cow disease and kuru.  RJN

___________________________________________

WHEN PEOPLE ATE PEOPLE, A STRANGE DISEASE EMERGED

In 1962, a local leader in the Eastern Highlands of Papua New Guinea asks Fore men to stop the sorcery that he believes is killing women and children.  Courtesy Shirley Lindenbaum

Most of the world didn’t know anyone lived in the highlands of Papua New Guinea until the 1930s, when Australian gold prospectors surveying the area realized there were about a million people there.

When researchers made their way to those villages in the 1950s, they found something disturbing. Among a tribe of about 11,000 people called the Fore, up to 200 people a year had been dying of an inexplicable illness. They called the disease kuru, which means “shivering” or “trembling.”

Once symptoms set in, it was a swift demise. First, they’d have trouble walking, a sign that they were about to lose control over their limbs. They’d also lose control over their emotions, which is why people called it the “laughing death.” Within a year, they couldn’t get up off the floor, feed themselves or control their bodily functions.

Many locals were convinced it was the result of sorcery. The disease primarily hit adult women and children younger than 8 years old. In some villages, there were almost no young women left.

“They were obsessed with trying to save themselves because they knew demographically that they were on the brink of extinction,” says Shirley Lindenbaum, a medical anthropologist with the City University of New York.

But what was causing it? That answer eluded researchers for years. Afterruling out an exhaustive list of contaminants, they thought it must be genetic. So in 1961, Lindenbaum traveled from village to village mapping family trees so researchers could settle the issue.

But Lindenbaum, who continues to write about the epidemic, knew it couldn’t be genetic, because it affected women and children in the same social groups, but not in the same genetic groups. She also knew that it had started in villages in the north around the turn of the century, and then moved south over the decades.

Lindenbaum had a hunch about what was going on, and she turned out to be right. It had to do with funerals. Specifically, it had to do with eating dead bodies at funerals.

In many villages, when a person died, they would be cooked and consumed. It was an act of love and grief.

As one medical researcher described, “If the body was buried it was eaten by worms; if it was placed on a platform it was eaten by maggots; the Fore believed it was much better that the body was eaten by people who loved the deceased than by worms and insects.”

Women removed the brain, mixed it with ferns, and cooked it in tubes of bamboo. They fire-roasted and ate everything except the gall bladder. It was primarily adult women who did so, says Lindenbaum, because their bodies were thought to be capable of housing and taming the dangerous spirit that would accompany a dead body.

“So, the women took on the role of consuming the dead body and giving it a safe place inside their own body — taming it, for a period of time, during this dangerous period of mortuary ceremonies,” says Lindenbaum.

But women would occasionally pass pieces of the feast to children. “Snacks,” says Lindenbaum. “They ate what their mothers gave them,” she says, until the boys hit a certain age and went off to live with the men. “Then, they were told not to touch that stuff.”

Finally, after urging from researchers like Lindenbaum, biologists came around to the idea that the strange disease stemmed from eating dead people. The case was closed after a group at the U.S. National Institutes of Health injected infected human brain into chimpanzees, and watched symptoms of kuru develop in the animals months later. The group, whichwon a Nobel Prize for the findings, dubbed it a “slow virus.”

But it wasn’t a virus — or a bacterium, fungus, or parasite. It was an entirely new infectious agent, one that had no genetic material, could survive being boiled, and wasn’t even alive.

As another group would find years later, it was just a twisted protein, capable of performing the microscopic equivalent of a Jedi mind trick, compelling normal proteins on the surface of nerve cells in the brain to contort just like them. The so-called “prions,” or “proteinaceous infectious particles,” would eventually misfold enough proteins to kill pockets of nerve cells in the brain, leaving the cerebellum riddled with holes, like a sponge.

The process was so odd that some compared it to Dr. Jekyll’s transformation to Mr. Hyde: “the same entity but in two manifestations — a ‘kind’, innocuous one and a ‘vicious’, lethal one.”

The epidemic likely started when one person in a Fore village developed sporadic Creutzfeldt-Jakob Disease, a degenerative neurological disorder similar to kuru. According to the Centers for Disease Control and Prevention, about one in a million people in the U.S. develop CJD the difference is that others rarely come into contact with infected human tissue.

Though the Fore stopped the practice of mortuary feasts more than 50 years ago, cases of kuru continued to surface over the years, because the prions could take decades to show their effects.

According to Michael Alpers, a medical researcher at Curtin University in Australia who tracked kuru cases for decades, the last person with kuru died in 2009. His team continued surveillance until 2012, when the epidemic was officially declared over. “I have followed up a few rumoured cases since then but they were not kuru,” he wrote in an email.

When Shirley Lindenbaum visited a South Fore village in 2008, one man said excitedly, “See how many children we have now?”  Courtesy Shirley Lindenbaum

But while they remain rare, transmissible prion diseases did not die out with the last kuru case, as people have found repeatedly in recent decades. People have developed variant CJD after eating the meat of cattle infected with mad cow disease. Dr. Ermias Belay, a prion diseaseresearcher with the Centers for Disease Control and Prevention, says that’s the only scenario in which there is “definitive evidence” that humans can develop a prion disease after eating the infected meat of another species.

But, he says, there are still a lot of open questions about how and why humans get prion diseases.

For one, it’s still a mystery why animals, including humans, have those proteins in the first place — the Jekylls that can be so easily turned into Hydes. One leading hypothesis, described recently in the journal Nature, is that they play an important role in the protective coating around nerves.

But here’s the bigger question, says Belay: “How many of these diseases actually jump species and affect humans?”

Kuru showed that people could get a prion disease from eating infected people. Mad cow disease showed that people can get a prion disease from eating infected cow. But what about other prion diseases in other animals? Could, say, hunters get sick from eating infected deer? That’s what researchers in North America, including Belay, are trying to find out right now.

Chronic wasting disease in North America is spreading fast,” says Belay. The disease causes infected wild deer and elk to starve to death. “In early 2000, we had about three states that reported CWD in the wild in deer and elk. Today, that number is 21.”

Belay says the disease is “a little bit concerning” because, unlike mad cow disease and kuru, where infectious prions were concentrated in the brain and nervous system tissue, in an animal with chronic wasting disease, the misfolded prions show up all over the body. They can even be found in saliva, feces and urine, which could explain how the disease is spreading so quickly among wild deer and elk.

The CDC is working with public health authorities in Wyoming and Colorado to monitor hunters for signs of prion disease.

“Unfortunately, because these diseases have long incubation periods, it’s not easy to monitor transmission,” says Belay. He says he and his colleagues have yet to find any evidence that hunters have picked up chronic wasting disease from the meat of infected wild animals.

“And that, in itself, is good news for us,” he says.

But, as with kuru, it will take years — maybe even decades — before he can know for sure.

 

History on Glenview Road

 

Judge Abner Mikva

Abner Mikva.jpg   1926-2016

I learned about Abner Mikva at my first American Federation of Teachers convention at the Blackstone Hotel in Chicago.  Our delegation was composed of young teachers working to jump-start the the sleepy union local at our school.  Ab was a young state representative trying to fight the corruption and mismanagement in Illinois government.  In his speech he compared the state’s allowance for highways to that for education:  Said, The Department of Transportation has money up its asphalt!

The second time I saw him in person was in our house on Glenview Road when he rang our doorbell on a Sunday morning! He was campaigning to represent our largely Republican congressional district, having been been squeezed out of his home district  in Chicago by political powers, including Mayor Richard J. Daley, who didn’t like a smart,  honest,  progressive guy.   He said that it was lonely in the campaign and he wanted to meet some friends.  We drank coffee and had a good talk.

He’d been attracted by the car in our driveway with a lot of Democratic election signs on it.  Car belonged to a teacher who’d come to do some union work with me.  It was plastered with signs because he had a part-time political job.

I think Ab lost that election but later tried again and won the seat.

During a later campaign, he spoke at our school with opponent John Porter.  Porter spoke well,  a little stiff.  Ab came across warm, maybe even passionate. Ab won re-election narrowly.

Ab  was nominated by President Jimmy Carter to the D.C. Circuit Court of Appeals and became Chief Judge.  He has had a number of special assignments like  leading a commission to investigate the University of Illinois  for admitting unqualified applicants with political connections.  He was an advisor to President Obama.

Obama awarded him the Presidenrtial Medal of Freedom, the Nation’s highest civilian honor, presented to individuals who have made especially meritorious contributions to the security or national interests of the United States, to world peace, or to cultural or other significant public or private endeavors.

How did Ab get started?t

One of the stories that is told about my start in politics is that on the way home from law school one night in 1948, I stopped by the ward headquarters in the ward where I lived. There was a street-front, and the name Timothy O’Sullivan, Ward Committeeman, was painted on the front window. I walked in and I said “I’d like to volunteer to work for [Adlai] Stevenson and [Paul] Douglas.” This quintessential Chicago ward committeeman took the cigar out of his mouth and glared at me and said, “Who sent you?” I said, “Nobody sent me.” He put the cigar back in his mouth and he said, “We don’t want nobody that nobody sent.” This was the beginning of my political career in Chicago.  Wikipedia

 

Ab was a good guy,  a highly respected public servant, and I’m glad to have been in touch with him.

And I’m sorry he’s gone.

Very readable article on Ab’s life and service  here.

rjn