Medicine Archive

Ethics and Medicine: The Guatemalan Syphilis Crisis

By Amy Thibodeau, October 3, 2010, 5:06 am in History, Medicine, Present

Syphilis

In addition to the Tuskegee Syphilis Study and the heartbreaking story of Henrietta Lacks, the US has recently admitted to and apologized for experimentation they did on prisoners, mental patients and soliders in Guatemala in the 1940s. In addition to using tax dollars to pay infected prostitutes to sleep with prisoners, officials also did things such as pour “the bacteria onto scrapes made on their penises, faces or arms, and in some cases it was injected by spinal puncture.” (source) This activity happened at the same time the US was involved in prosecuting Nazis for committing similar crimes in concentration camps across Europe.

The ‘purpose’ of the study was to look at the effects of penicillin on the disease but although the infected were treated with the drug “whether everyone was cured is not clear”. Perhaps it is no surprise that Doctor John Cutler was behind this study and was also the driving force between the reprehensible Tuskegee Study, which he defended throughout his life.

This continues the seemingly endless dark history of the practice of medical experimentation on human beings, without their consent.

From 1963 to 1966, researchers at the Willowbrook State School on Staten Island infected … children [with disabilities] with hepatitis to test gamma globulin against it. And in 1963, elderly patients at the Brooklyn Jewish Chronic Disease Hospital were injected with live cancer cells to see if they caused tumors. (source)

Further Reading:

Image Credit: Syphilitic Diseases by Taberandrew

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Imagined Itches: Post Bed Bug Stress Disorder

By Amy Thibodeau, August 8, 2010, 1:43 am in Domestic, Medicine, Present

Bed Bugs

I recently spent six weeks in Mexico in a small village bordered on one edge by the sea and on the other by a large fresh water mangrove estuary. The natural state of things was intensified by the rainy season, this meant a lot of bugs. The beautiful sea shore was a mine field of sand flies while everywhere else was swarming with bat-size mosquitoes. After six weeks, my skin was a mess of red welts and the scabby remains of bites I’d over scratched.

En route to Canada I spent a few days in Puerto Vallarta in a relatively nice, well-sealed air conditioned hotel. On my second morning there, I woke up with about ten red itchy welts along the outside of one of my legs. Irritated, I shared this information on Facebook and my aunt, who has spent a lot of time traveling in North Africa, informed me that it might be bed bugs and that if we had them, we would surely carry them in our clothing and luggage along with us wherever we went. Immediately, I became obsessed – examining sheets, duvet covers, in between mattresses and within the smaller folds of my clothing and suitcase. Apart from being disgusting, one of the most difficult things about bedbugs is that they are nocturnal, very small and good at hiding; so it’s not easy to determine if you have them.

After that morning, apart from the odd set of bites I could trace to time outside, I didn’t seem to get any additional welts and my bed mate remained mostly bite free; in the absence of a bed bug sniffing dog, I’ve decided that we did not have bed bugs; but not before spending hours on Google reading about them and looking at horrible pictures.

The most interesting thing that I read about the pests is the phenomenon of ‘Post Bed Bug Stress Disorder’, which I can very much relate to though I don’t think mine is a serious case:

Many formerly rational people are waking up in the middle of the night inspecting themselves or their children for bed bug bites. They often feel phantom bed bugs crawling on their bodies while lying in bed. Perhaps the most worrisome are those individuals who are sleeping in ounces of DEET, spearmint oil or other less-friendly concoctions in the hope that bed bugs — real or imagined — will be thwarted from biting them …

These people are suffering from what I like to call PBBSD — Post Bed Bug Stress Disorder — an illness characterized by irritability, sleeplessness, anxiety and bed bug hallucinations. Yes, these people also suffer from the physical effects of bed bug bites, but the bites go away. (source)

In 2008 a former Fox News employee successfully sued the maintenance company at NewsCorp headquarters for post traumatic stress syndrome brought on by a bed bug infestation in the building.

“My client is so acutely injured that she can’t take the subway and she is being seen by a doctor three times a week,” said Mr. Schnurman [the plaintiff's lawyer], who has handled “hundreds” of bedbug cases, most of which have been settled out of court. “She would literally take off all her clothes at the door and put on house clothes before she would even touch her baby. (source)

Oh, and by the way: bed bug infestations are on the rise.

Night, night!

Image: Whose that jumping on the bed?!? by Sappymoosetree

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The Tuskegee Syphilis Study: Another Look at Unethical Medicine

By Amy Thibodeau, May 31, 2010, 10:41 pm in Medicine, Past

Tuskegee is a small city in Alabama, which has played a pivotal role in the civil rights movement. It still houses Tuskegee University, which began as the Tuskegee Normal School for Colored Teachers founded in 1881 by Booker T. Washington; it is also where Rosa Parks was born. Sadly, it is also the location of the Tuskegee Syphilis Study.

According to Tuskegee University, it all began in the 1920s when a Chicago-based charity approached the government via the Public Health Service (PHS) with some ideas for improving the health of African Americans. The PHS had a special interest in addressing Syphilis as they’d recently completed a study that showed that upwards of 25% of a 2,000 person sample were afflicted with it.

Although the study may have began with good intentions, it shifted from being about helping those afflicted with the disease to becoming a study about the effects of untreated Syphilis on live patients.

the time of the project, African Americans had almost no access to medical care. For many participants, the examination by the PHS physician was the first health examination they had ever received. Along with free health examinations, food and transportation were supplied to participants. Thus, it was not difficult to recruit African American men as participants in the study. Burial stipends were used to get permission from family members to perform autopsies on study participants. (source)

You can imagine where they went with this. With a captive audience of living subjects at their disposal, the PHS made the horrifying decision that in order to study the disease in living patients they would not disclose the illness and instead would watch as patients slowly deteriorated and eventually died from it. In some cases, they even prevented subjects from receiving treatment from other sources: “During World War II, about 50 of the study subjects were ordered by their draft boards to undergo treatment for syphilis. The PHS requested that the draft boards exclude study subjects from the requirement for treatment. The draft boards agreed.” (source)

Unbelievably, this study continued until the late 1970s. When the director of the PHS department responsible for the study between 1943 and 1948 was interviewed in 1981 he admitted, “The men’s status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.” (source)

Further reading: Henrietta Lacks and the Tragic Story of Medical Ethics, Racial Politics and Health Care Reform in America.

Image: Disease by Erik Starck

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Eccentric Torments – The Glass Delusion

By Amy Thibodeau, May 11, 2010, 2:43 am in Books, Medicine, Past

I am in the thick of reading Brian Dillon’s excellent book Tormented Hope: Nine Hypochondriac Lives. There is an interesting passage on an imagined affliction I’ve never heard of before:

In the history of such eccentric torments, none is stranger or more instructive than the so-called ‘glass delusion’. From the late Middle Ages onwards, this remarkably specific and consistent notion appears time and again in the literature on melancholia and hypochondria. The patient, as the reader will have surmised, fantacies that he or she is made of glass, either in part or in whole. (In a series of related delusions, patients may imagine that they have lost limbs, that they have been turned into animals, that they are dead, that they do no exist or, as in the case of an unforuntae baker who was afraid to go near his oven, that they are made of butter.) This has predicatable consequences: the ‘glass man’ fears for his physical safety, avoiding not only hard knocks but in some cases any touch at all from another person, as well as such delicate operations as sitting or lying down. The broad outlines of the delusion – imagining that one is made of a brittle substance – were not unknown to antiquity: classical accounts of earthenware men abound, but the spread of glass in the Early Modern period brought with it the possibility of thinking oneself made of less sturdy stuff …

The book features famous hypochondriacs including Darwin, Florence Nightengale, Charlotte Bronte and Andy Warhol, with a particular focus on the specific kind of craziness so completely epitomized by the Victorians. It’s a very interesting read.

Image: Broken Glass by Davetoaster

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How Roger Ebert Got his Voice Back

By Amy Thibodeau, March 9, 2010, 9:55 pm in Film, Medicine, Present

Recently, Esquire published an exquisite cover story on film critic Roger Ebert, who is best known for the decades he spent debating great and not-so-great films with his counterpart Gene Siskel on the popular television programme, At the Movies. Since the article came out last month, people can’t get enough of Ebert. His blog, which was already popular, has developed cult popularity, he has well over 100,000 followers on Twitter, he’s recently created a Fan Club (inspired by an old friend who also happens to be a successful web porn entrepreneur) and he was a guest on Oprah.

Although there are hundreds of hours of footage of Ebert’s voice in At the Movies, it seemed very unlikely, if not impossible, that he would ever be able to speak again, using anything other than an artificial voice that bears no resemblance to the original. Recently, a Scotland-based company called CereProc used archival recordings to recreate an artificial voice that sounds like Ebert. Although it is still in beta, it even has the potential to eventually take on emotional inflection. CereProc is “an advanced voice synthesis company… [which] creates customized text-to-speech software. Instead of producing flat computerized voices, the company says its voices include realistic, animated and emotional dimensions.” (source)

The company undertakes a great deal of research on, what they call, the emotional continuum to stimulate realistic emotional states in voice reproductions:

CereVoice uses two separate techniques to simulate emotional states. The first is to select tense or calm voice quality. This compares closely with the perception of negative and positive emotional states (however, it also has an active/passive effect to some extent). The second is to use digital signal processing (DSP) techniques to alter the speech to active or passive states. Active states involve: faster speech rate, higher volume and higher pitch, Passive states involve: slower speech rate, lower volume and lower pitch. (source)

Pretty inspiring stuff!

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