What Doesn’t Make You Stronger Can Kill You

Bit of self promotion here:  I’ve got a piece in today’s Boston Globe, on one of the hidden consequences of failing to deal with the antibiotic crisis.  In it, I focus on the use of antibiotics as prophylactics in surgery. Nowadays, it’s standard procedure for a wide range of operations to dose the patient with antibiotics shortly before she or he goes under the knife; doing so has been shown to signficantly reduce the risk of post-surgical infections.

I took off from a study that modeled the consequences of increased microbial resistance for ten common procedures, mostly surgeries, along with chemotherapy for a particular set of cancers.

The results of that study were predictable:  more resistance leads to more post-op infections and to more deaths.  If the situation gets really dire, if common causes of infection associated with surgery become increasingly untreatable then the calculation behind all kinds of medical interventions will change:

That’s what scares Dr. James Maguire, an infectious disease specialist at Brigham and Women’s Hospital. “I think some of the worst feelings we have are when we have a problem with a patient and there’s nothing we can do.” Infections following joint replacements are bad enough. They are, Maguire says, “catastrophic in terms of what happens to the patient.” Were the risk of infection to go up enough, he adds, “having seen what an infected joint replacement is all about I would think twice.”

That’s a response to an operation that may be vitally needed to reduce pain and increase mobility — but, as Maguire went on…

…while someone contemplating a joint replacement can choose to forgo the risk, if they need a new heart valve or a ventricular assist device, “that’s potentially life and death.” In such circumstances, “if your life depending on having the device, even with great risk you’d do it. But more would die.”

Behind such specific possible horror stories, this is for me a deeply cautionary tale about the way choices our society — our politics — makes have much deeper effects than our usual debate admits.  Antibiotics are not just responses to disease; their use penetrates medical practice, to the point that basic expectations we may have about what how we can move through the stages of our life can be dashed, without our ever really grasping why.

That is:  joint replacements are part of our medical and mental landscape now.  There are over 330,000 hip replacements performed each year in the US.  We know (some of us, venerable as we are, more than others) that our knees, elbows, shoulders and so on won’t always work as well as they do today.  We know, most of us I’m sure, folks who’ve had the op and are now playing tennis again or whatever, and we have in the back of our minds (those of us fortunate enough to believe we’ll still have adequate health care available over time) that if and when that bit falls apart in our own bodies, we can look for the same outcome.

Except, of course, if the risks of surgery shift significantly in the meantime.

The last point I make in the piece, somewhat more gently than here, is that should the way we age, the way we give birth and so on deteriorates because of unchecked microbial resistance, that will be a more-or-less hidden consequence of political failure.

That’s because dealing with the antibiotic crisis boils down to doing two things:  regulating economic activity and funding research.  The GOP doesn’t want to do either.  And, as usual, people will die as a result.

So, on that note of cheer, a link, again, to the piece.

Oh…and open thread too.

Image: Follower of Jan Sanders van Hemessen, An Operation for a Stone in the Head, date unknown (to me).



Repub Horrorshow Open Thread: Sick Kids, Feh!


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Word is that Sen. Hatch is planning to retire, so I guess he now feels free to air his true GOP “I got mine, fvck you poor kids” philosophy in public.

I don’t know much about LDS theology, but from what little I do, there’s a bunch of [face*palm] going up back on Hatch’s home stake right now…



Thursday Morning Open Thread


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Apart from working together to lift everyone up, what’s on the agenda for the day?

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Wednesday Morning Open Thread: It’s Never A Sprint, It’s Always A Marathon

A nonbinding referendum conducted by mail found 61.6 percent of Australians in favor of allowing gay couples to wed. Even though the measure was expected to be approved, the size of the win and the unusually large participation of 12.7 million Australians out of the 16 million eligible voters added to its political legitimacy.

Though the vote isn’t binding, all major political party leaders have promised to implement the decision, which would make Australia one of approximately 26 countries that allow gay couples to wed.

“The people of Australia have spoken, and I intend to make their wish the law of the land by Christmas,” Prime Minister Malcolm Turnbull said. “This is an overwhelming call for marriage equality.”

In a wealthy, urbanized country where 52 percent of the population regards themselves as Christian, according to a census last year, the vote marks a defeat for Australia’s two big churches, the Catholic Church and the Anglican Church, whose leaders were behind a well-organized campaign to defeat the referendum…

GLAD!

Apart from sneaking a slab of rainbow cake, what’s on the agenda for the day?
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SAD!


Possible candidate:


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More Election Day Open Thread: Good News in Maine

We could turn winning into a habit:

Maine is one of 19 states whose Republican governors or legislatures have refused to expand Medicaid under Obamacare. Other holdouts like Utah and Idaho are closely watching the initiative, as newly formed committees in both those states are working to get a Medicaid expansion question on next year’s ballot. The outcome may offer clues about the salience of the issue in next year’s midterm congressional elections.

ETA:



Tuesday Morning Open Thread: GOTV


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There’s a lot of big important stories waiting to be written up, but none of them are what you want to be trying to puzzle out first thing in the morning. But it’s Election Day, so go do your civic duty — and make sure your social-media peeps are, too, especially if you’re in Virginia or New Jersey…

Apart from voting / waiting for results, what’s on the agenda for the day?

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For your further social-media consideration…

(Keith Knight via GoComics.com)
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Thursday Morning Open Thread: Hey, Remember That Guy?…

PSA:


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Readership capture:

Former President Barack Obama kicked off the inaugural summit of the Obama Foundation here Tuesday, calling it “an experiment in us trying to have a collective conversation.”

Set to be the central focus of his post-presidency, and seeded with Obama’s own ambition to have the rest of his life exceed the impact of his eight years in White House, the foundation launched with programs and goals still taking shape. There have been training sessions for young activists, with plans for more; 20 Obama Foundation fellows will be announced next year out of a 19,000-person applicant pool; and this meeting is meant to be the beginning of creating a hub and network of innovative up-and-coming leaders…

Organizers stressed that the key is to continue sorting out what exactly they will be doing in the decades to come.

“This is the literally the beginning,” said foundation CEO David Simas, who was previously the White House political director. “We are being deliberate over the course of the rest of this year and into next year about testing different approaches and getting it right before we take it to scale.”