medicine

Congress grills pharmaceutical firm Baxter International and the Food and Drug Administration about tainted drugs that killed 81.

For those scared or curious enough to pay attention, this week's hearings offered a jarring look at how globalization is affecting the medicines we take. True, some testimony was predictable: the FDA denied that it could have averted the tragedy with an earlier (and required) inspection of the suspect Chinese factory; Baxter's CEO played the victim card, claiming that his firm's heparin, an anticoagulant, was the target of a deliberate adulteration scheme. (The Chinese government, meanwhile, argued that the faulty ingredients weren't to blame for the deaths.) But the statement of David Nelson, the senior investigator of the committee holding the hearings, sandblasts the varnish off such evasions, especially Baxter's dubious behavior, and is worth a read.

A recent measles outbreak in San Diego highlights the growing number of parents who refuse to vaccinate their children against deadly diseases.

There's some nostalgia among doctors for the good old days when patients did what they were told, and doctors decided what to tell them. But it's hard for the rest of us to mourn this change; in general, patients probably know what they want better than their doctors. Increasingly, however, people are electing to make decisions that affect the whole community, not just themselves -- particularly in the area of childhood vaccinations. As the number of unvaccinated children grows, their right to make decisions about their own child's health is turning into the "right" to bring disease and death to the community. MORE

An Oregon man (recognized as male, anyway, by the law, his friends, and his wife) is pregnant.

More arresting than Thomas Beatie's words, published in The Advocate this month, are the photos of his stubbly face and swollen belly, now in its second trimester. Transexualism is documented and usually accepted, more or less, in many cultures; consider the waria in Indonesia, the mustarjil in Iraq, the mahu in Tahiti, the katoy on Soi Cowboy. But cases like these will challenge even the sensibilities that have gotten used to the occasional mismatch between anatomy and gender. It's one thing for a man to wear a dress, and another for him to wear a maternity dress.

The English Surgeon, a documentary about a London neurosurgeon who operated on Ukrainians' brains using a Bosch power-drill, raised questions about medical ethics.

Henry Marsh, the sawbones in question, has traveled to the Ukraine serially for fifteen years, always with the goal of helping Ukrainian colleagues make do with poor equipment, or none. Cutting open patients' heads and using screws and drills bought at a hardware store would be grounds for license-suspension and possibly imprisonment in England. Here, it appears to be an act of compassion -- and one that reveals a pernicious double-standard in medical ethics. MORE

On February 29, a leading South Korean research university announced it had suspended the author of two headline-generating papers for fabricating his data.

Tae Kook Kim's research, which appeared in Nature Chemical Biology and Science in 2005 and 2006, offered alluring possibilities for breakthroughs in fighting cancer and slowing (or even reversing) aging. His suspension for dishonesty follows several embarrassing retractions in other hyped research areas -- the most notable involving another South Korean scientist, Woo Suk Hwang, who falsely claimed to have created human stem-cells via cloning. (Ironically, newspapers reporting on Kim's ostensible accomplishments quoted Kim as saying he aspired to be "another Hwang Woo Suk.") MORE

A new study from the University of Hull says that SSRIs, the most commonly prescribed anti-depressants, do no better than sugar-pills at alleviating depression.

Don't hurl the Zoloft into the trash just yet. Though headlines trumpeted the paper as shocking news, in fact one of its authors published a study ten years ago showing the same results. The most interesting finding, in fact, is that for the seriously depressed, the drugs do have some effect. Moreover, critics have pointed to problems with the results of the study, which was really a "meta-study" that analyzed previous research, including unpublished work. Most notably, the studies it analyzed were often short (six weeks or less, which is about how long anti-depressants typically take to work). MORE

A paper in The Lancet argued that developed countries' recruitment of health-care workers from Africa constitutes an international crime.

Sub-Saharan Africa has it bad. The Lancet notes that it "carries 25% of the world's disease burden yet has only 3% of the world's health workers." The doctors tend not to get paid on time, and they often have to fight the world's ghastliest diseases with the medical equivalent of bows and arrows. A tropical disease specialist in London once advised his patient to save airfare: rather than visit the Congo, he said, just open your mouth and leap into a cesspool. MORE

The USDA recalled 143 million pounds of beef that had passed through a California plant -- more than all the recalled meat in the previous decade combined.

Workers at the Westland-Hallmark beef factory poked very sick cows, prodding them into the abattoirs with with the prongs of forklifts.  What makes a cow non-ambulatory?  Mad cow disease, for one thing.  The dreaded kuru relative attacks the central nervous system and leads to immobility and a terrible demise.

When the cows finally reached the killing floor, workers probably dispatched them with a captive bolt pistol -- which, as fans of Anton Chigurh will tell you, is an efficient but not entirely clean way to brain an animal.  Cortical tissue ends up smeared on the bolt, and can spread from one cow to the next, and perhaps into the meat itself.

We've been warned about the conditions of our slaughterhouses for years, and few of us have sought to protect ourselves, much less these poor diseased beasts.  This horror-show isn't our last warning, but it's not our first, either.  Get ready: after prions turn our brains into so much bubble wrap, the vegans will inherit the earth.

El Cheapo kidneys, get them while they're warm

In the grossest violation of the Hippocratic Oath since Mengele, a gang of surgeons in Gurgaon, India, allegedly rounded up beggars and day-laborers, drugged them, and sliced out their kidneys.  Other poor Indians surrendered their kidneys to the doctors for handfuls of cash. In all, the gang bought or stole as many as 500 organs in a nine-year medical crime-wave -- then installed them, for a price, in the renally-diseased bodies of rich Indians and foreigners. Leaving aside the surgery-at-gunpoint and the forcible anesthesia, two gruesome facts stand out.