SCOPE: March 2011

Thursday, March 31, 2011

The Surgeon's Archive

Almost 150 years after a collection of extraordinary Irish surgical photographs were captured by the photographer’s lens they are published for the first time ever in Scope. Eimear Vize delves into the medical archives to find out more about these unique Victorian images

A rare and historical collection of 19th century Irish surgical photographs has been retrieved from virtual obscurity by ophthalmic surgeon, Dr Stanley Burns. The New York-based physician, and internationally distinguished photo-historian, has amassed one of the world’s largest and most important portfolios of early medical photographs. Among these iconic images he has acquired some of the earliest Irish surgical photographs in existence, none of which have ever been published. Now, Scope is honoured to reproduce these important photographs for the first time in a two-part special.

Viewing this spectacular collection, which dates back to the 1870s, one is first struck by the fact that such a large collection of unusual surgical cases, some with severely disfiguring malignancies, should be gathered in one album. Most of the 26 images depict patients with large tumours on their face or body; some are “before” and “after” shots that demonstrate the surgeon’s skill in treating these challenging diseases at a time when surgical procedures were frequently crude.

Intrigued, one wonders if this could be the case portfolio of several surgeons or perhaps just one talented individual, who had the good fortune of being referred a large number of fascinating cases? And what happened to these unfortunate patients? Did they survive their radical surgery?

Dr Stanley Burns

Dr Burns is similarly interested in the narratives behind these incredible images but his efforts to investigate further have proved limited. To this end, he gave Scope access to this precious cache in the hope that a hunt on this side of the Atlantic in our medical archives might unearth the long-forgotten stories behind these images.

He felt sure that all of these images had appeared as engravings in a Dublin surgical journal, mostly during the years 1874 to 1878.

So, with contact sheet in hand, Scope sought the expertise of Mary O’Doherty, who is Assistant Librarian (Special Collections and Archives) at the RCSI’s Mercer Library in Dublin. She had encountered a similar album before, credited to the esteemed 19th century surgeon Mr Maurice Henry Collis, and suggested that these patients could have come under the care of just one physician. A trawl through the yellowing annals of one of the top medical periodicals of the time, the Dublin Journal of Medical Science (DJMS), might turn up enough cases linking this portfolio to a particular surgeon.

Starting with volumes published in 1870, it wasn’t long before the first lithograph copied from Dr Burns’ photographs appeared. In fact, five of these artistic reproductions by John Falconer, Dublin, featured in one important article: “Reporting on twelve cases of excision of tumours” by the brilliant and controversial Mr Edward Stamer O’Grady, who was one of the top surgeons of the day at the Mercer’s Hospital, Dublin. A later edition of the same journal also documented another case by Mr O’Grady that features in Dr Burns’ photographs. It appeared we had identified our surgeon whose patient portfolio had found its way into the Burns Archive more than a century later.

“I have from time to time been indebted for a large share of important surgical cases – operative or otherwise,” wrote Mr O’Grady in the DJMS (Volume 60, Number 1 / July, 1875). His good fortune, in this regard, he attributed to “the affectionate remembrance borne to Mercer’s Hospital” by its past pupils, who referred on these odd surgical cases. “It has been my practice to keep accurate and more or less extended “notes” of these cases under observation in the hospital wards,” he added.

Mr O’Grady also acknowledged that it was of “comparatively infrequent occurrence” to have the opportunity to operate on tumours that had “reached a size of any considerable magnitude, and are so situated in the soft parts as to be capable of excision”.

By 1875, he had taken under his care a total of 23 tumour cases since commencing his duties as senior surgeon at the Mercer’s in 1866. A number of these fascinating cases are detailed below:

Removal of large fatty tumours from sub-occipital region and back of neck; Recovery.

A 50-year-old labourer, whom Mr O’Grady referred to as “MM”, was admitted to Mercer’s Hospital on 17 February, 1875, for a large tumour “situated on the back of the neck and encroaching considerably on the base of the skull”.

Mr O’Grady observed that, while the tumour gave the appearance of being “firmly attached to the parts beneath”, it was quite free from pain and caused inconvenience only from size and sense of weight.

He described the operation to remove the sizable growth: “During the separation of the lateral integumental coverings, the haemorrhage was inclined to be free, and was carefully restrained by pressure, several small vessels being secured as the dissection progressed. As the tumour became fully exposed it was seen that tendinous bands crossed its superficial and deep surfaces, running from above downwards, and being most numerous towards the mesial line. These had very firm attachments above and below, as if the growth had been originally developed in and expanded the posterior ligamentous structures of the neck.”

Successfully removed, the mass weighed 27 ounces and exhibited, on section, “the ordinary appearance of fatty tumours.” Although “the operation was well borne and subsequent condition of the patient was most satisfactory,” five hours after surgery another problem arose.

The patient, wanting to urinate, found he could not. Mr O’Grady inserted a full-sized gum elastic catheter, which “passed in with all possible facility” and eight ounces of urine were drawn off.

“Immediately after MM fainted, and became badly collapsed; the pulse for several minutes was not to be felt at the wrist, the heart scarcely more than beat, surface cold, lips blue, and general appearance very alarming. Mustard sinapisms were quickly applied over the region and to the calves of the legs, hot punch and aromatic spirits of ammonia being also freely given. After a time the patient slowly rallied.”

To avoid repeated distress, on four other occasions that the catheter had to be employed, the patient first received “an opiate and stimulant draught, and no further unpleasantness occurred”. The patient “went home quite well” on the 22 March.

Removal of a very large tumour from the right Parotid, Facial and Cervical Regions; Recovery

From his written account, one could imagine Mr O’Grady sitting across from the 60-year-old widow whose lower right face and neck was severely disfigured by a large tumour. “It has been 15 years growing and now in size equalled that of a cocoa-nut with the husk on,” O’Grady remarked with his typical penchant for detail. “The patient, a tall wiry looking woman but with feeble circulation, says she has been healthy and accustomed to walk long distances, but for the last year and a half the shaking of the mass, specially when the wind chanced to be high, made locomotion on foot or otherwise very painful.”

The operation took place on 27 September 1873 and all of his hospital colleagues gave their “able assistance,” Mr O’Grady noted.

He recounted the intricate procedure: “Two incisions, enclosing between them an elliptical piece of integument an inch wide in the middle, were made, extending from the upper to the lower margins of the tumour, and kept well forward on it. The posterior flap or curtain of the skin was then shelled back, and the ear freed, by careful dissection, from the intimate attachments.

“The integument over the anterior portion of the tumour was raised with the greatest ease, a firm fibrous expansion was next divided, and the growth was now grasped by a large and powerful vulsellum, which gave great assistance by lifting and drawing it in various directions, as the deeper portions of the dissection proceeded.

The adhesions now were intimate, and a part of the tumour dipped in deep behind the jaw; excision here had to be effected with great caution, by repeated short touches of the knife.”

The excised tumour weighted a hefty 5 pounds 8 ounces. He recorded that, during the patient’s month-long recovery in hospital, her face was swollen and “quite bland and devoid of expression” on the right side. However, by the time she was discharged, she had regained facial movement, and “I have since learned that, after a little time, the puckered appearance of the skin at the operation site also faded away completely,” O’Grady stated.

Removal of a fatty tumour from the perineum; apparent recovery, and subsequent death from pyaemia.

“A health-looking man, 42 years-of-age” was admitted on 17 August 1874 for a sizable tumour in the perinaeum that had been growing about six years. Mr O’Grady said it bore a general resemblance to the shape of a large kidney, although far exceeded in size. He added that “the peculiarity of shape” was not captured by the photograph, from which the lithographic plate was copied, “owing to the constrained position, as the man lay for the photograph”.

On inspection, he found that the skin was quite free and moveable over the tumour. Subsequently, the surgery proved uncomplicated: “The integument was divided lengthwise over it, and the mass extracted with no other pressure than what had been employed to steady the parts for the cut, a very small surface posteriorly being alone adherent to the skin or deeper parts. No vessels required to be secured; there was no bleeding”.

Mr O’Grady was pleased to record that the progress of the case was all that could be desired; the wound contracted and healed rapidly, and by the end of the month was almost entirely cicatrized, the patient going about apparently in perfect health.

“He was to have left for home on September 1st but awoke that morning, anxious and depressed, feeling chilly and unwell, and with pain in the right chest. At morning visit his pulse was 140, temperature 103.4…general condition very low.”

The next day, the patient was in much the same state but was now complaining of pain in the upper part of the leg; he had also become quite deaf.

“The principle trouble now was a severe pain in the left hip, which had seized on him suddenly, nothing amiss could be detected with or near the joint…..matters now grew worse and worse….eventually death took place on the 10th, profuse sweating and high temperature having been present for some days. On the day before death both knees rather suddenly swelled. The deafness also disappeared the day before his decease, the hearing returning and becoming even acute. At the autopsy a small abscess was found in the base of the right lung, with surrounding inflamed tissue; there was congestion of liver and spleen, and pus in both knee joints…”

Mr O’Grady stressed that this case illustrated the fact “now and then brought home to all surgeons that at no period of convalescence can any patient with breech of surface be pronounced safe.

“Fortunately our acquaintance with pyaemic complications in Mercer’s Hospital has heretofore been very scant,” he remarked, adding that this is one of only two cases of death in his patients after excision of tumour.

Disarticulation of shoulder joint for malignant disease of humerus

In this case, which was published in the DJMS in 1878, Mr O’Grady encountered a pensioner aged 35 with severe pain and swelling above his elbow. He observed: “This man had led an irregular life but had married young and never had syphilis. In India he suffered severely from ‘liver’, intermittent fever, and dysentery...the general aspect of the patient is in a marked degree leucocythaemic. He, however, considers himself, not withstanding, to be a strong healthy man.

“Some five months previously to his apply at Mercer’s, the left humerus, immediately above the elbow, began to be the seat of severe pain, and was soon after noticed commencing to swell, the growth being attended with increasing suffering, which soon became and continued to be, intense. There was also oedema of the forearm.”

When the man came under Mr O’Grady’s care, he noted that the lower end of the humerus was now greatly enlarged, “being in size fully equal to that of a large orange or Spanish onion...it was the seat of severe and uninterrmitting pain”.

The surgeon was keenly aware that his patient’s “sufferings were very urgent”, and a few days after his admission the limb was amputated through the shoulder-joint. “The operation was well rallied from; the patient, relieved from his long standing suffering, slept as it were through the first few day.

His recovery was not uneventful, however, as on the fifth day he developed sudden and “considerable febrile disturbances”, accompanied by severe swelling of the stump. “Newly formed adhesions” were observed which were ruptured and “about 10 ounces of stinking sanguinolent fluid escaped with a gush”.

Drainage was secured, the stump was then poulticed and a brisk purgative enema given, Mr O’Grady recalled. “In a few hours the alarming symptoms had entirely disappeared, and thereafter amendment rapidly progressed.”

The patient was able to sit up on the tenth day; in three weeks the wound had virtually healed and in a month he took his discharge in excellent health and able at once to resume his ordinary duties as one of the City Commissioners. The photograph was taken more than four years after the operation.

Dr Stanley Burns

Dr Stanley Burns is a New York City ophthalmic surgeon and Clinical Professor of Medicine and Psychiatry at New York University Langone Medical Center. That alone would keep most professionals unquestionably busy but Dr Burns has also turned his passion for vintage photography into an internationally distinguished career as author, curator, historian, collector and archivist.

He is the man behind the renowned Burns Collection containing more than one million images in every imaginable 19th century genre. It is the most important private comprehensive collection of early photography (1840-1950) and the world’s largest collection of historic medical photography. Among these 70,000 medical images are the medical photographic “national treasures” of several countries, including Ireland. The vast majority of the photographs depict patients with diseases long since conquered, and medical treatments, technologies and practices long since outmoded. They also depict hospital and nursing personnel at work, along with related healthcare practitioners.

In 1975, when Dr Burns first became interested in daguerreotypes – the first successful photographic process – and other early photographs, he embarked on an aggressive buying and connoisseurship agenda. By 1978, he had acquired one of America's most important collections of early photography.

Around that time, he founded the Burns Archive to share his discoveries and embarked on a prolific writing career. He has since authored 42 photo-historical texts and over 1,000 articles, while also curating over 50 photographic exhibitions worldwide. Among his 30-plus medical photographic historical books are the medical specialties series – four volumes each on respiratory disease, oncology, psychiatry, dermatology, nephrology and ophthalmology. The books can be seen on www.burnspress.com.

Dr Burns’ photographs have also been the source of numerous Hollywood feature films, documentaries and museum exhibitions. Among the films are The Others, Fur, Jacobs Ladder, Sleepers, Starship Troopers, and Looking for Richard. A film company produced the documentary “Death in America”, which was based on his 1990 classic book “Sleeping Beauty: Memorial Photography in America”.

He spends his time lecturing, creating exhibits, and writing books on underappreciated areas of history and photography. He is now preparing five catalogues on various aspects of the collection. His blog – www.theburnsarchive.blogspot.com – offers a wonderful opportunity to view some of the photographs.

O’Grady - The powerhouse surgeon

For more than 30 years, Mr Edward Stamer O’Grady was the proverbial thorn in the sides of the Governors of Mercer’s Hospital in Dublin. He persistently and publicly accused officers of the Board of nepotism, of turning a blind eye to slipshod practices, and even of “an indecent outrage… on the modesty of a female patient”.

While historical records indicate that O’Grady had a reputation for being bull-headed and abrasive in his dealings with some nursing and medical colleagues, many accounts reinforce this remarkable surgeon’s huge popularity among his patients and peers.

Mr O’Grady was born on 23 November 1838 in Baggot Street, Dublin. He studied medicine at Trinity College Dublin against the wishes of his relatives and, after graduating in 1859, he perused further study at hospitals and medical schools across Europe and the US, before returning to work in the City of Dublin Hospital, Upper Baggot Street. He also lectured on surgical anatomy at the Carmichael School of Medicine, Dublin.

Mercer's Hospital, Dublin

He joined the surgical staff in the Mercer’s Hospital in 1866 and “threw himself into the work with great energy. He was a bold operator, and earned a high reputation throughout Ireland for his skill in this department,” a colleague later wrote of him (British Medical Journal, 23 October, 1897).

But Mr O’Grady attracted considerable controversy during his years at the Mercer, and on more than one occasion he found himself at the centre of an inquiry into the conduct of hospital governors as well as his own behaviour towards certain staff. The BMJ first reported in November 1884 on a rumpus within the Mercer’s walls sparked by the defiant Mr O’Grady. Apparently, he broke all protocol in urging the recently widowed wife of a patient, who he believed was mismanaged by the resident medical officer, to request the coronor to inquire into the circumstances of his death “for the sake of the other patients”.

It emerged from the subsequent inquest that Mr O’Grady had made several similar accusations of neglect against this resident medical officer, in writing to the proper hospital authority, but without producing any result, despite evidence to the contrary.

Not surprisingly, the officer in question had a close family connection on the Board of Governors. O’Grady felt a coronor’s inquest was the only way to get “an unbiased general inquiry held”. He was to be disappointed, however, as the inquiry “limited itself to the circumstance of the patient’s death, returning a simple verdict that the deceased died from typhus fever, and declined to attach any rider to it”.

The Board of Governors was livid that the whole sordid affair had been laid bare for public consumption. Mr O’Grady was seen as a troublemaker. The following year, he was rocking the Governor’s boat once again. At a meeting of the house committee held in March 1885, the surgeon gave notice of a motion: “that in consequence of an indecent outrage by a governor on the modesty of a female patient, no lay governor shall persistently dally in the female wards at unreasonable hours”.

In 1887, a case was taken to the Four Courts in Dublin by some members of the Board of Governors physicians against the senior surgeon to have him dismissed for offences “against the duty of his office”. The case dragged on for years and provided salacious reading in the national and international press.

The numerous hearings expounded details of O’Grady’s mutinous behaviour directed towards the hospital authorities, and claims that he was verbally abusive towards nursing staff and some of his medical colleagues. His earlier accusations of indecent behaviour by a Governor as well as his breach of protocol involving the coroner’s court were raised by the prosecution.

In Mr O’Grady defence, several of his colleagues gave evidence as to his competence and efficiency as a surgeon, his popularity among the students and staff, and his “zeal and his kindness” to patients. “He often paid out of his pocket for wine, chickens and other extras for his patients,” Dr George F Duffy, a former surgeon to the hospital testified.

By December 1887, the case against Mr O’Grady completely collapsed and he was exonerated. “Mr O’Grady has come out of the ordeal unscathed and with the sympathy of the public. The institution ought to be reformed and the governors could not do better than to set about this work at once,” the BMJ reported on 24 December 1887.

However, the enduring disagreements between the Mercer’s governors and some members of the staff culminated in May 1897 when the board dismissed the entire medical and surgical staff. But Mr O’Grady – “a stout man” – refused to leave, according to Sir John Lumsden in his article “Personal reminiscences of Mercer’s Hospital” (Irish Journal of Medical Science, January 1935).

The “discarded officers’ were allowed to reapply for their jobs but Mr O’Grady refused to seek re-election. In defiance, he continued to visit the wards and tend to his patients. He disputed the power of the governors to deprive the staff of their appointments, without notice or cause, and would have had his day in court – he had initiated proceedings against the Board - but for his sudden death on 18 October that year.

“No one who knew anything of him could fail to recognise his high sense of right and honour; and his dogged persistence in holding to the view which he believed to be right had much, perhaps, to do with the opinion, of those who looked at him askance. He was a generous friend of the poor, and if his friendships in the profession were not many they were very true,” his obituary in the BMJ stated.

“His death puts an end apparently to the legal side of the Mercer's trouble; but, however that ending may be desired, the public and the profession have lost a good surgeon and a man of high and unswerving honour.”

AUTHOR'S NOTE: For more rare and unusual photographs from the Burns Archive, check out these incredible slideshows on Newsweek http://www.newsweek.com/2010/10/04/a-collection-of-vernacular-and-historical-images.html and CBS News http://www.cbsnews.com/2300-204_162-10007019.html

Wednesday, March 23, 2011

Killer Clinicians

The thought that the helping hand of a doctor can turn into the claws of a monster preying on patients is uniquely terrifying, Dr Stephen J Cina, forensic pathologist and co-author of a recent book about murderous medics, tells Eimear Vize.

Herman Webster Mudgett is not a name that inspires terror. But then doctors should be a source of comfort rather than a cause for alarm. This particular medical man, however, who changed his name to Dr Henry Holmes after graduating medical school, designed and built the proverbial house of horrors where he terrorised, tortured and slaughtered hundreds of victims.

A crew of 800 workers laboured for two years to construct his very impressive three-story ‘castle’, complete with turrets, battlements and 105 rooms. Some of its more disturbing features included soundproof asbestos-lined vaults, quicklime pits, trap doors, chemical labs, a glass-bending furnace and a nine-room basement hooked up to the city’s gas mains.

It was late 19th century Chicago and Dr Holmes, with his thriving clinical practice and charming nature, was the paragon of polite society. But when his Horror Castle was finished, he embarked on a relentless killing spree. Over a period of three years, the handsome doctor selected his victims from among his employees, lovers, and at least 50 paying hotel guests. They were mostly women, but men and children too. The victims’ bodies went by secret chute to the basement where many were meticulously stripped of flesh, crafted into skeleton models and then sold to medical schools.

Dr Holmes dissected some of the bodies, performed chemical experiments on a few and saved pieces of several corpses in his vaults.

The number of this murderous medic’s victims has been conservatively estimated between 30 and 100, though his total may have been as high as 230. On May 7 1896, Dr Holmes was hanged in Philadelphia. One of his last requests was to be buried in cement so that no one could ever dig him back up.

Dr Henry Holmes

“Who would?” remarks Dr Stephen J Cina, a forensic pathologist working as the Deputy Chief Medical Examiner in Fort Lauderdale, Florida. His humorous quips, frequent and dry, belie the grim reality of his chosen field. A recognised leader in forensic pathology in the US and internationally, Dr Cina has spent several years in the US Air Force as a Regional Medical Examiner, flying around the world to investigate homicides and suspicious deaths.

Who better, then, to co-author a book about homicidal physicians? He and his collaborator Dr Joshua Perper have a combined medical expertise spanning 60 years. As forensic pathologists, they witness death daily and have investigated hundreds of murders. They accept that most doctors are a force for good, but their recently published book – When Doctors Kill: Who, Why, and How – contains accounts of horrible atrocities and features descriptions of graphic murders committed by ‘healers’, such as Dr Henry Holmes, America’s first serial killer.

Dr Cina explains that he was initially approach by Dr Perper, the Chief Medical Examiner and his boss, to collaborate on the book. “We had teamed up before on various projects. We have written several scientific papers together and occasionally give joint lectures. We make a good team,” he says.

“I don't believe doctors as a general rule focus on death as much as forensic pathologists do, and rightly so. Physicians who kill are not a widespread problem. When you think about it, we looked at all doctors involved in killing going back hundreds of year and we were able to cover the topic in a few hundred pages. That says a lot. That being said, when a doctor does ‘go bad’ it is usually a sensational story since people put so much trust in their physicians.”

They capsulate this point in their book with the comment: “If you kill one person, you may make the local news. If you kill five, you will probably end up on national television for a week, maybe longer if nothing else is going on in the world. If you are a physician-murderer, you will probably get a juicy book contract and have your life immortalised in a made-for-TV movie.”

Of course, doctors have the same genetic library of both endearing qualities and character defects as the rest of us but their vocation places them in a position to intimately interject themselves into the lives of other people. The vast majority, fortunately, work to ease pain and save lives rather than killing patients.

Dr Stephen J Cina

Well researched, colourfully descriptive and often humorous, When Doctors Kill explores frightening cases of doctors who cross the line from healing to murder. The book covers a wide span, beginning with the dawn of medicine and reaching into the 21st century. And it appears that history is replete with “good doctors gone bad”.

These killer physicians have murdered thousands in the name of advancing science and medicine. They have been recruited by despots who twist their life-saving skills into tools of control, intimidation, and unspeakable horror. Some doctors have focused their intellect on ruling countries with an iron fist instead of a comforting touch. They have even been active participants in terrorism, holding key roles in al-Qaeda and several Palestinian organisations. Simply put, when the Hippocratic oath states “above all do no harm to anyone,” these doctors have claimed an exemption.

In their book, Drs Cina and Perper present riveting profiles of serial killer physicians, as well as mass-murdering doctors. And they stress that there is a significant difference between these two categories. Murderers of multiple people are classified in three major groups: Spree killers murder multiple victims over a short period of time in an outburst of rage. But, we are assured that there are no reported cases of spree killing doctors.

Serial killers, with their high IQ and so-called “mask of sanity” have cooling periods between attacks when they act in an apparently normal fashion. They are more calculating and may hone their sadistic fantasies for decades. Most of the high-profile physician killers fall into this category.

Unfortunately, a number of doctors have also assisted, either willingly or under duress, in mass murders, the third category. The role of physicians in Nazi concentration camps is a case in point. Forty-five percent of German doctors became members of the Nazi party and, as officers in the SS, were active participants in the killing of the “unfit” and "undesirable racial pollutants".

Dr Cina confides that he finds the involvement of doctors in war atrocities most disturbing: “The ‘scientific experiments’ performed on people by the Nazis, Japanese in World War II and American physicians are revolting. I have served in the US Air Force and understand following orders, but doctors answer to a higher calling and cannot subjugate their morality to unethical military directives.”

He explains that doctors take lives for a variety of reasons, many of which are shared by other members of society. They may kill for financial gain or out of jealousy. They may maim or dismember in search of sexual gratification. They may torture to impose their will on another helpless human being simply because they have the opportunity to do so. They may kill just to prove they can get away with it. Or they may just become addicted to death and pain.

Physician killers, however, have also been involved in murder for reasons not shared by the average Joe. Sometimes doctors have killed out of real or perceived "Acts of Mercy”. The detection of doctors committing clinicide (intentional murder in the setting of providing care) is very difficult. Crafty medical serial murderers are usually those who use poisons or medications with lethal consequences on patients who are expected to die and whose death will not arouse suspicion. “These killers likely will never come to trial,” Dr Cina adds, ominously.

Dr Harold Frederick Shipman

A prominent example of this class of killer doctor is Dr Harold Frederick Shipman, who was the most prolific serial killer in recorded history. This British doctor has 218 murders positively ascribed to him (mostly elderly women) although the real number is likely to be higher than this. It was only through forging the will of one of his wealthy elderly victims, whose daughter was a solicitor, that he was caught and the entire houses of cards fell on him. If this hasn’t happened, his murderous ways may have continued unchecked for many more years.

“We look up to the doctor as a figure of wisdom and compassion. The thought that this helping hand can turn into the claws of a monster preying on patients is truly terrifying. Nevertheless, such monsters have existed and likely still practice in the medical profession,” the authors warn.

Another timely topic addressed in the book is the potentially unhealthy, master/pet relationships characteristic of celebrities and their personal physicians. The authors highlight a number of doctors who have treated high-profile celebrities, including Judy Garland, Elvis Presley, and Anna Nicole Smith, and whose treatment may have led to their deaths. The role that doctors played in Michael Jackson’s drug abuse and demise also receives an in-depth discussion and exploration.

The authors offer their insights into the ethical conflicts inherent in modern medicine, including the prospect of the first genetic homicide – murder by means of chromosomal manipulation.

They also pour over the controversial issue of assisted suicide and euthanasia - “the grey zone between comfort measures and homicide”. They suggest that a distinction should be made between assisting in suicide and enabling suicide. Enablement is a passive process, such as forgoing life-saving treatment or prescribing powerful medication that may be abused by the patient, whereas assisted suicide requires action. The difference between assisted suicide and euthanasia is that the patient is not an active participant in euthanasia, except that they have expressed a wish to die.

While researching this chapter, the authors decided not to seek the opinions of colleagues. “We attempted to gather objective evidence and present a fair and balanced discussion of this tricky issue,” says Dr Cina. The reader is left to ponder whether, in certain circumstances, euthanasia is ethical and, if so, how does it differ from the philosophy promulgated by the Nazi regime?

As forensic pathologists, Dr Cina witnesses death daily and has investigated hundreds of murders but, thankfully, he says he has never encountered a case where the perpetrator was a member of the medical profession.

“Evil doctors are a rarity, thank God!” he exclaims. “It is possible, though, that some apparently natural deaths have been victims of caregivers. It has been said that the easiest people to kill are those who are expected to die, such as the elderly or infirm.

“People should remember that their doctor is trying to do the best job possible for you despite working in an environment of increasing governmental regulation, diminishing reimbursement, a constant fear of lawsuits, and leaving school hundreds of thousands of dollars in debt. But doctors are people just like the rest of us - we are not perfect. We do make mistakes, and rare doctors do some terrible things-once again, just like the rest of us.”

Friday, March 18, 2011

A Giant Leap for Medicine

Image Credit: NASA

Fifty years after the first manned space flight, medical science is coming to terms with the unique challenges to the human body posed by life in zero gravity. The head of the European Space Agency's Medical Operations tells Eimear Vize about its progress.

Stepping out of a spacecraft to stretch your legs, take in the local scenery and pick up a sandwich are just not options when you’re hundreds or thousands of kilometres outside earth’s atmosphere.

While there are countermeasures for the strain our bodies experience during a long car journey or flight, keeping astronauts fit and healthy as they travel through the solar system gives rise to a multitude of serious medical concerns.

The concerted efforts of scientists, doctors and industry working to alleviate the stress of zero gravity on our terrestrial bodies has led to the advancement of a unique medical specialty - space medicine. Defined as the medical science of the biological, physiological, and psychological effects of space flight on humans, space medicine strives to both relieve the effects of debilitating conditions in space and to prevent them arising.

2011 marks the 50th year of manned space flight. Since the first blast-off by Russian cosmonaut Yuri Gagarin in 1961 and man’s historic steps on the moon in 1969, human activity in space has increased steadily. In fact, more than 500 people from 38 countries have made that incredible journey into space, according to the Fédération Aéronautique Internationale (FAI).

The reality is that space travel has its health hazards. Weightlessness, for example, is not a benign state. It has a multi system impact, including bone demineralisation, muscle atrophy, impaired co-ordination and neurovestibular tracking skills, cardiovascular deconditioning and orthostatic intolerance, motion sickness, and altered hormone concentrations. And that’s before you address the harmful effects of prolonged exposure to solar and galactic radiation.

“In the beginning of space life it was not known if humans could survive in space but luckily, with a little time, the biological system in the human is very adaptable,” says Dr Volker Damann, Head of the European Space Agency’s Medical Operations and a flight surgeon to many human space flight missions.

Dr Volker Damann

“An astronaut will experience dizziness and disorientation during their first few days in the microgravity environment. We call it space adaptation syndrome. Their vestibular system, which is key to our sense of balance, motion and body position, is pretty much messed up because of the lack of gravity in space.

“The system shuts down a little, gets disoriented and the usual reaction is stomach awareness, nausea, and even vomiting in roughly 70 to 75 per cent of new space flyers. There are varying degrees, not everyone is vomiting or completely disabled. Usually those symptoms have disappeared after about two days, that’s the initial adaptation,” the German doctor tells Scope.

Other body functions do not adapt as quickly, however, and changes in certain other physiological functions may prove to be lasting and could cause serious problems, especially when astronauts return to the "normal" gravity of Earth.

“Every part of our body has a purpose. Our bones and muscles are built to be upright, to work in a one gravity, 1G, environment. But if we leave the gravity field of Earth, our bodies no longer need the full strength of the skeletal and muscular systems for support of their ‘upright’ position. When the muscles and bones are not used, they deteriorate or ‘decondition’,” explains Dr Damann.

For short space flights of a week or so, these changes are small and pose no real problem, but for longer space flights, they are potential causes of concern, particularly as the heart is one of those muscles that will begin to deteriorate within the first two to three weeks in space.

“The heart muscle doesn’t need to pump upwards to the brain anymore, as there is no up or down, so the heart begins to decondition. We have developed countermeasures for every space flyer that is in space longer than two weeks. We impose a very strong exercise regime on the astronauts on a daily basis, two hours of exercise per day, to keep their cardiovascular condition and to keep muscle strength.

“Of course it takes longer to get rid of bone mineral or calcium, that takes weeks and months, but you can roughly consider a general bone loss of one to two percent per month. There are some bones that may loose even more mineral content - all of the weight-baring bones such as your femur, your pelvis, some of the lumbar spine for example may lose more calcium because they are used less. So after a six-month mission, there could be a bone loss of 12 per cent or more. That’s even with the daily exercise regime.”

An almost immediate effect, within a couple of hours to one day of entering microgravity, is a loss of blood volume. Under normal conditions, blood and other body fluids tend to pool in the legs. To counter this effect of gravity, veins in human legs have evolved valves that open and close to assist blood circulation back up to the heart. In orbit, however, this situation changes dramatically.

“All of a sudden our five litres of blood are equally distributed throughout the body. So the pressure sensors in our heart and other areas suddenly measure there is more blood, that there is high blood pressure. If there is high blood pressure this is usually a trigger to the kidney to get rid of fluid.

“So very quickly the kidney will excrete more fluid, resulting in a general reduction in the blood volume by roughly one litre, which is perfectly okay in space, but when you come back to earth then there may be problems. Your heart muscle may not be as conditioned as on earth, you have less blood, so what happens when you stand up getting out of the shuttle, you faint.

“There is nothing we can do about the loss of blood volume but shortly before they return to earth we get the astronauts to regularly drink in the order of one and a half to two litres of fluid just to replenish the lost volume.

“We are pretty good at maintaining cardiovascular fitness and muscle strength but there is a big problem still with bone loss,” Dr Damann admits.

“When astronauts return to earth, gradually we increase their workloads, we change their exercise regime, we do a lot of physiotherapy, then of course jogging and walking once the vestibular symptoms have improved.”

Whether lost bone is fully regained once astronauts return to Earth's gravity is not entirely certain. Medical experts fear that the body's calcium balance might be restored before the bones have replaced all the lost minerals, resulting in permanent damage.

Although cortical bone may regenerate, space physicians are concerned that loss of trabecular bone may be irreversible. According to Dr Jay Shapiro, team leader for bone studies at the National Space Biomedical Research Institute in the US, "The magnitude of this effect has led NASA to consider bone loss an inherent risk of extended space flights."

Italian astronaut Paolo Angelo Nespoli

Space physicians are just as concerned with the psychological effects of long-term stays on space stations as they are about the physical effects. In December 2010, Italian astronaut Paolo Angelo Nespoli embarked on Europe's third long-duration space mission. Currently on board the International Space Station (ISS), his mission will span approximately 180 days.

“Astronauts are highly-trained professionals but we are all human, stress and worry, overwork or boredom can all take an emotional toll. One component of stress is related to certain risks that human space flight has, of course if you start thinking about the risk while you’re sitting on the rocket then it’s really to late,” says Dr Damann. “So, of course, when the astronaut is assigned to a mission they have to think and talk about the risks they are taking; they have to discuss it with their families and go through “what if” scenarios so they are mentally prepared.

“When they are in space, we try to avoid putting them under additional stress in terms of overloading them with work for six months, or not loading them enough so that boredom becomes an issue. They need a good balance, a regular schedule,” he adds.

The astronauts rise early in the morning and work regular hours on weekdays. Each part of their day is planned, including time allotted for sleep, exercise, chores and meals. Saturday is typically divided between science and relaxation. Sunday is a day of rest. The astronauts can unwind by reading, watching a movie or listening to music. Family conferences are scheduled on Sunday when they can enjoy a two-way audio-video chat with their loved ones back on Earth.

“It’s really about giving them a regular schedule that they are happy with. One of the rules of responsibility for our team in the medical office is to be like union representatives for the astronauts, so to speak. Do they have enough leisure time? Do they get enough sleep? Do they have enough distraction? Are we overloading them with work? If stress occurs we have to be able to spot the signs.”

Two astronauts demonstrate the unique effects of zero gravity

Dr Damann’s medical team also includes psychologists who hold one-to-one psychological conferences each fortnight with members of the ISS crew. “We don’t expect any major issues but talking about work life and family life can really help the astronauts, particularly being so far removed from home if something happens, like a child is injured.”

Last summer saw a 520-day simulation of a Mars human exploration mission get underway in Russia, with researchers studying the mental and emotional impact on volunteers confined in space travel conditions for an extended period. The six men "landed" on Mars on Saturday 12 February and spent a few days researching the planet before beginning the months-long return flight to Earth, expected to be the most challenging part of the mission.

While the physical and psychological impact of such a long-duration mission will be challenging, the biggest concern for space physicians is prolonged radiation exposure, which can lead to numerous health problems, including nausea, vomiting, fatigue, skin injury and changes to white blood cell counts and the immune system. Longer-term radiation effects include damage to the eyes, gastrointestinal system, lungs and central nervous system. Exposure also increases cancer risk.
Soviet cosmonaut Valentin Lebedev, who spent 221 days in Earth’s orbit in 1982, lost his eyesight to progressive cataract. Lebedev stated: “I suffered from a lot of radiation in space. It was all concealed back then, during the Soviet years, but now I can say that I caused damage to my health because of that flight.”

“Radiation is still our biggest problem,” agrees Dr Damann. “It is not at all solved. We know that in earth orbit astronauts still receive a significant radiation dose depending on the solar cycle, and if we go beyond earth, further out towards the moon and Mars there is an increase in galactic radiation, which increases significantly the radiation dose.

“We know how harmful high-dose radiation is to the body but the problem in space is low-dose radiation over a long duration. We can measure radiation, that gives us a number, but the number doesn’t tell us what is the impact on the individual cell, on their DNA etc. There still needs to be a lot of research to see what are the genetic effects, what are the risks for the individual, and research to provide the appropriate shielding for the astronauts.”

Some protective measures are being taken, for example, NASA has developed a light weight polyurethane “brick”, which lines the sleep stations of the astronauts and provides some degree of shielding.

Dr Damann remarks that one of the most effective shields against radiation is water, but with one kilogram of upload to the space station costing roughly $25,000, this option is prohibitively expensive and logistically fraught.

“The only thing we can currently do is to measure the amount of radiation exposure that we can protocol and document in case there is some cancer development, for example, in the astronaut’s later life,” he says, detectibly unhappy with this status quo.

At present, the countermeasure for radiation is limiting astronaut exposure, which means limiting the amount of time they're allowed to be in space. But on a long-term mission of exploration, the astronauts will have to be in space for months on end, and, importantly, the type of radiation in deep space is more damaging than the kind in low earth orbit.

If humans ever hope to make long voyages to distant planets, we will first have to find a way to protect astronauts from this radiation.

But Dr Damann and his colleagues are already making plans for a future in which exploration-class missions will be a reality. Their focus, naturally, is on the provision of medical care delivered by appropriately skilled physicians, who may one day serve on-board such exploration-class spaceships.

“What we plan in the short to medium term is getting space medicine into the normal medical curricula in medical universities around Europe. There are only very few institutes on this globe that are dealing with space medicine, we want to expand that considerably.

“We’re still at the planning stage but we’re starting to make progress. For example, last year we started a new masters programme for space physiology and health with Kings College London. This now runs for the first year. We want to create a network of other universities, maybe even a virtual campus with Italian universities who may have a certain specialty that is interesting for life sciences, or a German university or an Irish university,” said Dr Damann, who has been described as a visionary in the career roadmap for life scientists and clinicians interested in space.

With a background in radiology and nuclear medicine, the majority of Dr Damann's training in space medicine was 'on the job' with the German Space Agency DLR and later, the European Space Agency.

“We are also preparing a job analysis for the role of space physicians in the future and how we would structure their education. We are at the very beginning of creating certain modules in universities that we can combine and which young people can select from very specific masters programmes in life science research activities or biomedical engineering or space medicine.”

Dr Leonard “Bones” McCoy

And how does he envisage the future role of doctors in space medicine should long-duration exploration of our solar system become more technologically feasible in the decades ahead? How conceivable is a medical position such as the one occupied by Dr Leonard “Bones” McCoy in the cult TV series Star Trek?

“Well, that’s one aspect that hopefully will change in the future, that we will have a physician on board a spacecraft. If you look back in history there have always been ships doctors on board every sea voyage or cruise. Only in space flight have we not done that yet. So I think it’s about time that we get a physician on board and into orbit.”

So space may yet be the new medical frontier. To paraphrase another Star Trek character: “It’s medicine, Jim, but not as we know it.”

Thursday, March 17, 2011

Divided Opinion

Mobile phones slaughter brain cells. Drugs and booze are bad for you. Crash helmets are good. Right? Well no, perhaps not. Researchers have discovered that what's bad for us, in certain conditions, might actually be good for us, writes Eimear Vize.

Contradictions abound in the tangle of ever-expanding clinical research; the undergrowth is thick with new truths that regularly spring up to replace conventional wisdom. Some of these conflicting facts suggest that what is bad for you is actually good and vice versa. Certainty is turned on its head, forcing us to question long-held beliefs.

Almost two decades ago, Dr Serge Renaud’s “French paradox” stunned the world with revelations that moderate and daily consumption of red wine is good for the heart, even tempering the adverse effects of eating inexcusable amounts of heart-stopping, artery-clogging saturated fats and smoking Gauloises cigarettes.

The French scientist went on to unveil another startling discovery in 1998: two to three glasses of wine a day reduces death rates from all ailments by up to 30%. In the Epidemiology article, Renaud also reported a 35% reduction from cardiovascular disease, and an 18-24% reduction from cancer.

Today, some of the latest research to challenge established opinions involves compounds considered so dangerous to public health they are illegal in most countries.

Agony and Ecstasy

A growing body of researchers are investigating the benefits of psychedelics and marijuana, used in proper settings, to treat conditions for which conventional medicines provide limited relief, such as post-traumatic stress disorder (PTSD), pain, drug dependence, anxiety and depression associated with end-of-life issues.

In July last year, the Journal of Psychopharmacology reported the results of the world’s first randomised, controlled trial of the class A drug Ecstasy. The study’s authors, led by Dr Michael Mithoefer, a South Carolina psychiatrist, gave Ecstasy or a placebo to patients with PTSD, whose condition had not been alleviated by any standard combination of psychotherapy and antidepressants. The new paper showed that Ecstasy is not only safe when administered in controlled settings but also remarkably effective in treating PTSD in conjunction with psychotherapy.

Participants treated with a combination of Ecstasy and psychotherapy saw clinically and statistically significant improvements in their PTSD – over 80% of the trial group no longer met the diagnostic criteria for PTSD following the trial, compared to only 25% of the placebo group. In addition, all three subjects who reported being unable to work due to PTSD were able to return to work following treatment with Ecstasy.

The investigators have now received the go-ahead from the US Food and Drug Administration (FDA) for a protocol for a three-arm, dose-response design that they expect will result in successful blinding. This new study is for US veterans with war-related PTSD, mostly from Iraq and Afghanistan and a few from Vietnam.

In vino sanitas?

Although excessive alcohol intake affects every body system, causing a wide range of health problems, drinking in moderation may actually prove beneficial – although, perhaps not to the extent claimed by some wine producers who began lobbying for the right to label their products ‘health foods’ following Renaud’s “French paradox” revelations.

Recently, several studies have added further value to indulging in the occasional tipple. Research published in the journal Rheumatology in November 2010 found that drinking alcohol could not only reduce the severity of rheumatoid arthritis (RA) but may also cut the risk of developing the disease, confirming the results of previous studies in this area.

The first author of the study, Dr James Maxwell, a consultant rheumatologist and honorary senior clinical lecturer at the University of Sheffield, said: “We found that patients who had drunk alcohol most frequently had symptoms that were less severe than those who had never drunk alcohol or only drunk it infrequently. X-rays showed there was less damage to joints, blood tests showed lower levels of inflammation, and there was less joint pain, swelling and disability. This is the first time that a dose dependent inverse association between frequency of alcohol consumption and severity of RA has been shown in humans.”

Dr Maxwell and his colleagues also found that non-drinkers were four times more likely to develop RA than people who drank alcohol on more than 10 days a month. Evidence that alcohol suppresses the activity of the immune system, influencing the pathways by which RA develops, may explain this phenomenon.

Meanwhile, recent claims that beer can help prevent osteoporosis are being credited to the brew’s significant source of dietary silicon, a key ingredient for increasing bone mineral density.

A study published in February last year in the Journal of the Science of Food and Agriculture, reported for the first time on the factors in brewing that influence silicon levels in beer. The authors explained that beers containing plenty of malted barley and hops could promote better bone health thanks to their rich dietary silicon content.

Memory loss may be an unpleasant side effect of excessive drinking, but in moderation alcohol consumption may actually prevent the onset of Alzheimer’s disease, especially if you avoid tobacco. That’s according to a study in the May 2010 edition of the Journal of Alzheimer’s Disease, which found that that effect was strongest in women.

Going to pot

The virtues of marijuana in helping post-traumatic stress disorder patients were extolled recently by Israeli scientists from the Learning and Memory Lab in the University of Haifa’s Department of Psychology.

Published in the prestigious Journal of Neuroscience, the results of this study show that cannabinoids can play an important role in stress-related disorders. “The results of our research should encourage psychiatric investigation into the use of cannabinoids in post-traumatic stress patients,” the authors suggested.

Research has also confirmed that cannabis is a viable treatment option for some patients with spasticity related to multiple sclerosis (MS). A systematic review, published in the open access journal BMC Neurology in December 2009, found that five out of six randomised controlled trials reported a reduction in spasticity and an improvement in mobility. “The therapeutic potential of cannabinoids in MS is comprehensive and should be given considerable attention,” urged the authors from the Global Neuroscience Initiative Foundation, Los Angeles.

While some investigations indicate that using cannabis increases the risk of psychotic symptoms or disorders – for example a meta-analysis reported in the Lancet in 2007 showed a 40% risk increase in people who had ever used cannabis – the evidence for the relationship between cannabis and schizophrenia or psychosis remains controversial.

Scientists from four universities in the UK found it would be necessary to stop 2,800 heavy cannabis users in young men and over 5,000 heavy cannabis users in young women to prevent a single case of schizophrenia. Among light cannabis users, those numbers rise to over 10,000 young men and nearly 30,000 young women to prevent one case of schizophrenia. Their study was published in Addiction in October 2009.

Crash helmet dummies?

Wearing a crash helmet is essential to a motorcyclist’s safety, but could it actually be harming their health and affecting their riding?

That is what academics from the two Bath universities in the UK are investigating in a new year-long research project, which concludes in February 2011.

“The noise inside the helmet at the legal speed of 70mph is higher than the legal limit for noise at work – more than enough to cause serious hearing damage,” said Dr Michael Carley, from the Department of Mechanical Engineering at the University of Bath. “The issue isn’t noisy engines or loud exhausts as you may think. The noise is simply from the airflow over the helmet. Earplugs won’t help much either as the noise is transferred into the inner ear from the rider’s bones. This has been known for 20 years yet little research has been done on the noise and its effects.”

The other lead researcher, Dr Nigel Holt from the Department of Psychology at Bath Spa University, added: “This isn’t about putting people off riding or wearing helmets; it’s about finding ways to reduce this damage so that riders can have a better riding experience.”

Tobacco's protective properties

One substance that gets a lot of bad press for its harmful effect on the body is tobacco. Smoking is known to cause cancer, cardiovascular disease, emphysema and other chronic lung diseases. However, new evidence shows that tobacco could actually protect against Parkinson’s disease.

Researcher Maurizio Facheris

In May 2010, a team from the Mayo Clinic in Minnesota presented their research findings that a particular variant of the gene CYP2A6 (which encodes the enzyme responsible for metabolising nicotine), when combined with smoking, considerably reduces the risk of contracting Parkinson’s disease.

It remains to be clarified whether the protection against the disease is provided by the particular gene variant or by the presence of cotinine, the substance into which nicotine is transformed through the action of the gene. “If this second hypothesis is confirmed, producing a cotinine-based drug would be a means to reduce exposure to the disease,” explained team member Dr Maurizio Facheris. The study was the first study of its kind to be presented at the annual convention of the American Academy of Neurology, and was selected as among the top 5% of over 2,000 articles received.

In the not-too-distant future, perhaps the tobacco plant may become as well known for keeping us healthy as it is for causing illness. In June last year, a scientist at the Hebrew University of Jerusalem succeeded in producing a replica of human collagen from tobacco plants – an achievement with tremendous commercial implications for use in a variety of human medical procedures, including in surgical implants and many wound-healing devices in regenerative medicine.

And, in March 2010, UK scientists announced the development of a genetically modified strain of tobacco that helps temper the damaging effects of toxic pond scum, scientifically known as microcystin-LR, which makes water unsafe for drinking, swimming, or fishing. This plant could serve as a major tool for helping keep water sources safe to use, especially in developing nations.

Puncturing the theory

Qi or energy. Sounds harmless enough. But wait, researchers are now arguing that this ancient healing practice has resulted in the emergence of a new clinical syndrome in the 21st century – acupuncture mycobacteriosis.

Professor Patrick Woo and colleagues from the University of Hong Kong describe the number of reported cases of acupuncture-transmitted diseases as “the tip of the iceberg”. Writing in the BMJ in March 2010 they called for funding to introduce proper infection control guidelines to tackle this growing problem.

While most patients recover from infections, says Prof Woo, 5-10% of the reported pyogenic bacterial infections end up with serious problems including joint destruction, multi-organ failure, flesh-eating disease and paralysis.

The 'Devil's Brew'

Multitudes of people worldwide begin each day with a cup of steaming hot coffee. Although it is sometimes referred to as ‘the devil’s brew’, coffee contains several nutrients, including calcium, as well as hundreds of potentially biologically active compounds, such as polyphenols, that may promote health.

Scientists are now reporting new evidence that drinking coffee may help prevent diabetes and that caffeine may be the ingredient largely responsible for this effect. Their findings appeared in the Journal of Agricultural and Food Chemistry in June last year.

In addition, two articles published in the April 2010 issue of the American Journal of Clinical Nutrition report results of two studies that support the potential health benefits of coffee.

The studies by Kempf and Sartorelli, respectively, revealed that coffee consumption may have beneficial effects on subclinical inflammation and HDL cholesterol, and also that caffeine intake is associated with a statistically significantly lower risk of diabetes.

D for Damage

Vitamin D is quickly becoming the ‘go-to’ remedy for treating a wide range of illnesses, from osteoporosis to atherosclerosis. However, new evidence from a US study suggests that supplementing vitamin D in those with low levels may have different effects based on patient race and, in black individuals, the supplement could actually do harm.

The study, which appeared in the Journal of Clinical Endocrinology and Metabolism in March last year, is the first to show a positive relationship between calcified plaque in large arteries, a measure of atherosclerosis, and circulating vitamin D levels in black patients.

“In black patients, lower levels of vitamin D may not signify deficiency to the same extent as in whites,” said the study’s lead investigator, Dr Barry Freedman, chief of the section on nephrology at the Wake Forest University School of Medicine in North Carolina. “We should use caution when supplementing vitamin D in black patients while we investigate if we are actually worsening calcium deposition in the arteries with treatment.”

Brain waves

There has been much controversy about whether electromagnetic waves from mobile phones cause brain cancer. Some researchers argue that the risk of glioma (40% of all brain tumours) doubles after 10 or more years of mobile phone use. However, others contend that since the overall lifetime risk of developing a brain tumour of any type is less than 1%, any doubling of this risk would still be very low.

And now the millions of people who spend hours every day on their mobile phones may have a new excuse for yakking. A surprising new study in mice provides the first evidence that long-term exposure to electromagnetic waves associated with mobile phone use may actually protect against, and even reverse, Alzheimer’s disease.

The study, led by University of South Florida (USF) researchers at the Florida Alzheimer’s Disease Research Center (ADRC), was published in January last year in the Journal of Alzheimer’s Disease.

“It surprised us to find that cell phone exposure, begun in early adulthood, protects the memory of mice otherwise destined to develop Alzheimer’s symptoms,” said lead author Gary Arendash, PhD, USF Research Professor. “It was even more astonishing that the electromagnetic waves generated by cell phones actually reversed memory impairment in old Alzheimer’s mice.”

“Our study provides evidence that long-term cell phone use is not harmful to brain,” another author remarked. “To the contrary, the electromagnetic waves emitted by cell phones could actually improve normal memory and be an effective therapy against memory impairment”

A little of what you like

Though often tagged with a disclaimer, studies that tell us to eat, drink, inhale and generally indulge in ‘bad stuff’ are music to our ears, particular after a holiday season of requisite guzzle and gorge. Perhaps the compulsory January detox can be abandoned after all? Certainly, the impulse is to plough ahead and enjoy these bad-for-you remedies, in moderation of course, at least until the next study inevitably overturns the research.