an interesting article from the new york times...
On a Sunday in July 1832, a fearful and somber crowd of New Yorkers gathered in City Hall Park for more bad news. The epidemic of cholera, cause unknown and prognosis dire, had reached its peak.
The cholera epidemic in New York is recalled in “Plague in Gotham! Cholera in Nineteenth-Century New York” at the New-York Historical Society. The exhibition includes sketches of cholera patients treated at a hospital on Rivington Street.
A map showing the Five Points area, highlighted in blue, the center of the epidemic.
People of means were escaping to the country. The New York Evening Post reported, “The roads, in all directions, were lined with well-filled stagecoaches, livery coaches, private vehicles and equestrians, all panic-struck, fleeing the city, as we may suppose the inhabitants of Pompeii fled when the red lava showered down upon their houses.”
An assistant to the painter Asher B. Durand described the scene near the center of the outbreak. “There is no business doing here if I except that done by Cholera, Doctors, Undertakers, Coffinmakers, &c,” he wrote. “Our bustling city now wears a most gloomy & desolate aspect — one may take a walk up & down Broadway & scarce meet a soul.”
The epidemic left 3,515 dead out of a population of 250,000. (The equivalent death toll in today’s city of eight million would exceed 100,000.) The dreadful time is recalled in art, maps, death tallies and other artifacts in an exhibition, “Plague in Gotham! Cholera in Nineteenth-Century New York,” at the New-York Historical Society. The show will run through June 28.
The outbreak, as portrayed in the exhibition and other documentation, highlighted the vulnerabilities of life in overcrowded cities in a time of deplorable sanitation and before medical science recognized the role of germs in disease. Cities were growing faster in population than in understanding what it took to make them fit places to live — an urban problem probably as old as the Sumerians of Mesopotamia.
The initial response to the epidemic, Kenneth T. Jackson, a professor of history at Columbia University, said recently, exposed more than ever the city’s divisions of class, race and religion. The disease hit hardest in the poorest neighborhoods, particularly the slum known as Five Points, where African-Americans and immigrant Irish Catholics were crowded in squalor and stench.
“Other New Yorkers looked down on the victims,” said Dr. Jackson, editor of The Encyclopedia of New York City. “If you got cholera, it was your own fault.”
Unlike most upper-class residents, John Pintard, the respected civic leader who was the historical society’s founder, remained in the stricken city. His letters to one of his daughters are included in the exhibition.
The epidemic, he wrote in an attitude typical of his peers, “is almost exclusively confined to the lower classes of intemperate dissolute & filthy people huddled together like swine in their polluted habitations.”
In another letter, his judgment was even harsher. “Those sickened must be cured or die off, & being chiefly of the very scum of the city, the quicker [their] dispatch the sooner the malady will cease.”
Dr. David D. Ho, a biomedical scientist at Rockefeller University, noted the similarities between the views on cholera and the initial reaction to a more recent epidemic that took science by surprise: AIDS.
When the first AIDS cases were reported in 1981, the victims were almost all white gay men. They were treated as outcasts.
“It was a repeat of the cholera experience,” said Dr. Ho, the founding chief executive of the Aaron Diamond AIDS Research Center. “The cause of the disease was unknown, and it affected a subset of the population. It was easy to brand the victims and blame the disease on their lifestyle.”
Scientists moved quickly and effectively to isolate the virus that causes AIDS, which is by no means confined to gay men and is rampant in developing countries, particularly in Africa.
Science and medicine advanced more slowly in the 19th century. It was 1883 before the bacterium Vibrio cholerae was discovered to be the agent causing the gastrointestinal disease. But a turning point in prevention came in 1854, when a London physician, Dr. John Snow, established the connection between contaminated water and cholera.
Dr. Snow tested the idea by plotting cholera cases on a map of Soho. This showed that most of the victims drew their water from a public pump on Broad (now Broadwick) Street. An infected baby’s diapers had been dumped into a cesspool near the well. A recent book, “Ghost Map,” by Steven Johnson, recounts the discovery.
The cholera research was an early application of mapping in medical investigations, a technique that has become widespread now that computers facilitate the display and analysis of such data. Historians of medicine credit Dr. Snow with advancing the modern germ theory of disease and laying the foundations of scientific epidemiology.
The cholera menace thus prompted cities to begin cleaning up their fouled nests. This came too late for victims of the 1832 epidemic in New York, or one that followed in 1849. By then, the city’s population had doubled, to 500,000, and deaths by cholera rose to 5,071.
The city in 1832 had expanded as far north as 14th Street. People were squeezed out of the lower wards by the influx of immigrants. Some, escaping earlier outbreaks of malaria and yellow fever, had sought a haven in the clean air and open land of the village called Greenwich.
Walking in Greenwich Village today, one is struck by the number of small brick houses bearing markers with dates immediately after 1832. It may be no coincidence that John Blauvelt, a carter working the piers, built his on West 10th Street (then Amos Street) the year after the cholera epidemic.
New Yorkers should have suspected that the scourge was on its way. Cholera, originally confined to South Asia, had started spreading in 1817 from seaport to seaport, presumably carried by infected sailors. The disease struck London in 1831 and reached New York the next June.
No one was prepared, not even doctors. They generally believed that miasmas, the noxious vapors from rotting organic matter, carried infections, an idea inspiring literature of death in Rome and Venice. The cholera in Five Points seemed to bear out the hypothesis.
Five Points was a slum that had metastasized from an intersection of five streets north of City Hall through the area that is now Foley Square and Chinatown. “All that is loathsome, drooping and decayed is here,” Charles Dickens wrote after a visit. Martin Scorsese’s movie “Gangs of New York” captures the lowlife there later in the 19th century, when it was still an urban sinkhole.
The exhibition includes illustrations of the thugs and gamblers, the stray dogs and pigs that inhabited the streets of mud and manure. The pigs at least were useful as garbage collectors and sources of food.
For victims, the onset of cholera was sudden: an attack of diarrhea and vomiting, followed by abdominal cramps and then acute shock, signaling the collapse of the circulatory system. Some survived the illness, despite the lack of effective remedies.
Posters from the time described recommended treatments, including laudanum (morphine), calomel (mercury) as a binding laxative, and camphor as an anesthetic. High doses sometimes did more harm than good. Poultices of mustard, cayenne pepper and hot vinegar were also applied, as well as opium suppositories and tobacco enemas.
Many victims, nearly half the cases at one hospital, died within a day of admission. After private hospitals began turning away patients, the city set up emergency public hospitals in schools and other buildings. One, on Rivington Street, bore the brunt, and sketches of its patients’ faces contorted in the throes of death look down from the exhibition walls.
In stark contrast, Asher Durand, who had escaped with his family to their country home in New Jersey, painted his children happily eating apples in a sunny orchard. The idyllic canvas hangs a few feet, and a world, away from the scenes of Five Points.
While many Protestants sat out the epidemic at safe distances, the city’s Catholics, many of whom were poor immigrants, mostly Irish, had no choice but to stay. Their nuns and priests also remained to offer comfort and some help, and they emerged as the few heroes in the ordeal. “The Sisters of Charity performed heroic service, and many of them died,” said Stephen R. Edidin, co-curator of the exhibition, with Joseph Ditta. “As a result, there was some reduction of anti-Catholic sentiments and a new respect for the Catholic clergy, who risked their lives in the epidemic. The feeling didn’t last, of course.”
Despite the epidemics of ’32 and ’49, people still flocked to New York and other teeming cities. But the first outbreak bolstered support for the Croton Aqueduct system to bring clean upstate water to the city, a project, completed in 1842, that led to the phasing out of private and neighborhood wells that were often polluted with human and animal waste. In 1849, the municipal government banished more than 20,000 pigs to the outer reaches of the city. A similar effort in previous years had provoked riots, but this time a public chastened by epidemic complied.
Finally, after the work of Dr. Snow in London and a lesser cholera outbreak in New York in 1866, the Metropolitan Board of Health was established with doctors in commanding roles and broad powers to clean up the city. Inspectors went to houses and burned clothing of people who had just died. They cleared the filth, spread lime and instructed survivors in proper sanitation.
Cities had learned, or should have, that epidemics as a consequence of urbanization were their responsibility to prevent and control.
Cholera is still a threat wherever drinking water is polluted. But Dr. Ho says that people should no longer die of it, if they are treated promptly and properly with rehydration fluids to restore their ravaged bodies.
in room 412
as Madge McKeithen discusses her poignant and powerful book:blue peninsula
essential words for a life of loss and change.
Read the New York Times Article.
Healthy fare will be served immediately following the talk.
Join the Health Stream for a screening of
SICKO
Monday, 11/26
Meet in the Lobby of Broome at 7:15PM
Discussion to follow with Prof. Rogan Kersh
from the WSJ Heath Blog:
A belief that good things will happen in our lives appears to be hard-wired in our brains, Robert Lee Hotz writes in his WSJ column today.
nullBeing somewhat optimistic is often related to positive behaviors, such as working hard, saving money and taking care of our health. (The images from NYU at right show greater activity in the brain’s rostral anterior cingulate cortex (top) and amygdala (bottom) when subjects imagined positive future events.)
Optimism is so fundamental to us that it probably relates somehow to basic survival. But beware of extreme optimism — that’s more likely to lead to frivolous spending and activities like day trading, he writes.
The exception to the rule, however, appears to be lawyers. Hotz writes:
Surveying law students at the University of Virginia, he found that pessimists got better grades, were more likely to make law review and, upon graduation, received better job offers. There was no scientific reason. “In law,” he said, “pessimism is considered prudence.”
So who were the bigger pessimists? Merck’s lawyers? Or those for the plaintiffs? Sorry, we had to ask.
Health Blog Halloween: Horror Show Doctors
from WSJ.com: Health Blog by Jacob Goldstein
Deranged in the pursuit of knowledge, lusting for power or just stone crazy, the mad scientist is always called “Doctor” — though it’s rarely clear what his specialty might be, or whether he’ll accept your insurance.
This much is clear, though: Intentionally or not, the mad scientist has hitched his brilliance to a dark star, and the inhabitants of planet Earth — or at least a few torch-wielding villages — are in big trouble. The ivory tower types will call him (and yes, it’s basically always a him) a metaphor for science run amok. But to us he’s the bad doctor, the emblem of the Health Blog’s Halloween. Here’s a rogue’s gallery of our favorites.
Dr. Victor Frankenstein created the eponymous fiend. Frankenstein’s been a fan favorite (and cautionary tale for those who would synthesize life) since he first appeared in Mary Shelley’s 19th-Century novel. But maybe nothing about him has been as terrifying as the reported $450 it will cost to get good seats to Mel Brooks’ new Broadway production of Young Frankenstein.
Hannibal Lecter was a psychiatrist who came in for a bit of analysis himself in the scientific literature. This 2002 paper in the American Journal of Psychotherapy says he “relies heavily on schizoid defenses, such as splitting and projective identification, but is unable to avoid psychotic breaks with reality to reenact his early traumas.” Sure. Just make sure you keep that mask on him so he doesn’t bite our face off.
Dr. Henry Jekyll seemed like a nice enough guy, but his alter ego Edward Hyde was another story. Little-known fact: This split-personality fable is also a morality tale about the importance of careful record keeping in pharmaceutical manufacturing. Jekyll had to swallow a potion to keep from turning into Hyde. But when he re-ordered the ingredients for his potion, he found it didn’t work. He concluded the initial supplies were effective because an “unknown impurity.” Doomed to remain Hyde, he took his life.
Doctor Faustus reminds us that — centuries before legions of perky sales reps brought lunch for harried docs — a sole practitioner sold his soul to the devil in exchange for a look at Helen of Troy (along with unlimited knowledge and power). “Was this the face that launch’d a thousand ships, and burnt the topless towers of Ilium?” Faustus asked when he saw the mythical beauty. Yes, doc. Now if you’d just take a look at these data, which show why our drug is better tolerated than the generic alternative…
Doctor Evil said it best: “It’s Dr. Evil. I didn’t spend six years in Evil Medical School to be called ‘mister,’ thank you very much.”
An honorable mention goes to Anton Phibes, with doctorates in music and theology. Phibes, as played by Vincent Price in “The Abominable Dr. Phibes,” turns serial doctor slayer to avenge the poor care he blames for his wife’s death.
We couldn’t possibly pay tribute to all the deserving docs. Which evil doctors (fictional only, please!) did we leave out?
Race row Nobel scientist James Watson scraps tour after being suspended
0 comments Posted by Dina at 2:27 PMFrom Times Online
Race row Nobel scientist James Watson scraps tour after being suspended
James Watson: he said last night he was mortified about the furore caused by his comments
Helen Nugent
A Nobel Prize-winning geneticist has cancelled a string of speaking engagements in Britain after being suspended from a prestigious scientific laboratory for claiming that black people are less intelligent than whites.
James Watson is on his way back to the United States to "sort out" his job at the Cold Spring Harbor Laboratory in Long Island, NY. His comments caused a storm of controversy.
The scientist, who won the Nobel prize for his part in discovering the structure of DNA, was quoted in an interview in The Sunday Times saying he was “inherently gloomy about the prospect of Africa” because “all our social policies are based on the fact that their intelligence is the same as ours - whereas all the testing says not really.”
Although Dr Watson tried to quell the row with an apology last night, he was too late to prevent widespread condemnation of his comments.
The Cold Spring Harbor Laboratory board joined a throng of prominent researchers and institutions who said they found the remarks Dr Watson was quoted as saying to be offensive and scientifically incorrect.
In a statement, the laboratory said it had “decided to suspend the administrative responsibilities of Chancellor James D. Watson, Ph.D., pending further deliberation by the Board”.
The board went on: “This action follows the Board’s public statement yesterday disagreeing with the comments attributed to Dr. Watson in the October 14, 2007 edition of The Sunday Times UK.”
The newspaper also quoted Dr Watson, 79, claiming that people should not discriminate on the basis of colour, because “there are many people of colour who are very talented, but don’t promote them when they haven’t succeeded at the lower level.”
Dr Watson shared the 1962 Nobel prize for medicine with Francis Crick and Maurice Hugh Frederick Wilkins for their description of the double helix structure of DNA.
Last night Dr Watson told an audience in London that he was mortified by the public response.
At a book launch at the Royal Society, Dr Watson said: “To all those who have drawn the inference from my words that Africa, as a continent, is somehow genetically inferior, I can only apologise unreservedly.
“That is not what I meant. More importantly, there is no scientific basis for such a belief.”
He went on: “I cannot understand how I could have said what I am quoted as having said. I can certainly understand why people reading those words have reacted in the ways they have.”
Dr Watson has said before that there is a genetic basis for intelligence – something undisputed by other scientists. But experts deny there is any such thing as race on a genetic level.
Scientists expressed their disbelief at Dr Watson’s comments.
"They are wrong, from every point of view, not the least of which is that they are completely inconsistent with the body of research literature in this area,” Dr. Elias Zerhouni, director of the National Institutes of Health in the US, said in a statement.
“Scientific prestige is never a substitute for knowledge. As scientists, we are outraged and saddened when science is used to perpetuate prejudice.”
Another group of Nobel laureates also expressed revulsion.
“The Federation of American Scientists is outraged by the noxious comments made by Dr James Watson that appeared in the Sunday Times Magazine on October 14th,” said the group, founded by Manhattan Project atomic physicists.
Federation of American Scientists President Henry Kelly added: “At a time when the scientific community is feeling threatened by political forces seeking to undermine its credibility, it is tragic that one of the icons of modern science has cast such dishonour on the profession.”
Prior to Dr Watson’s departure, the Science Museum had decided to cancel a talk by the scientist, organised as part of his speaking tour to promote his new book “Avoid Boring People: Lessons From a Life in Science”.
A spokeswoman for Dr Watson’s publisher said: “Dr Watson feels he needs to go home and sort things out.”
from the NYT
8 States Plan to Press Bush on Health Bill
By SARAH KERSHAW
Gov. Eliot Spitzer said yesterday that New York, joined by six other states, would file suit against the Bush administration, challenging stricter eligibility rules for the government health insurance program that covers poor children. Separately, Gov. Jon S. Corzine announced yesterday that New Jersey filed a similar suit against the administration.
The protests from the states come in the wake of President Bush’s threat to veto legislation that would loosen those rules and increase federal funds for the State Children’s Health Insurance Program, or Schip. The bipartisan bill would expand coverage to 10 million children from the 6.6 million covered now.
More than 40 states have urged Washington to act quickly to reauthorize funds for the program, which has been the subject of angry debate in Congress over how much the federal government should contribute.
In their legal challenges, the eight states contend that the new eligibility rules, which went into effect in August and limit coverage to children living at or below 250 percent of the poverty level, will either force out children in the program or leave tens of thousands without coverage who would be eligible.
In August, federal health officials informed states that they could no longer receive federal matching funds for children in families living above 250 percent of the poverty level, except under special conditions that the states say would be almost impossible to meet. Three weeks ago the federal health officials denied a request by New York to insure more children by covering those in families with incomes up to 400 percent of the poverty rate, or $82,600 for a family of four.
“Despite every effort to negotiate in good faith, the Bush administration did nothing but put roadblocks and poison pills in our path,” Governor Spitzer said at a news conference yesterday. “The president was out of touch with the reality on the ground.”
Mr. Spitzer said that Maryland, Illinois and Washington would join New York in the lawsuit, with Arizona, California and New Hampshire filing amicus briefs in the case. He has argued that the new rules violate the intent of the federal law that created the children’s insurance program in 1997.
Jeff Nelligan, a spokesman for the federal Centers for Medicare and Medicaid, which administers Schip, issued a statement saying, “We are confident that our requirements are appropriate and will be sustained in a court of law.”
He added, “Our chief goal with Schip is to ensure that the poorest kids and those with no health insurance are placed at the front of the line.”
An expansion of the national program passed by both the House and Senate would provide $60 billion over the next five years, $35 billion more than current spending. President Bush has proposed adding $5 billion to current spending.
New Jersey, which estimates that 10,000 children will lose health insurance under the new eligibility rules unless the Congressional version prevails, filed its lawsuit yesterday in federal court in Trenton.
Governor Corzine, speaking at a news conference, criticized the White House for both the veto threat and the eligibility rules, saying: “The Bush administration has gone far beyond its regulatory rights. I think there’s going to be major, major pushback.”
New York health officials said that the Congressional version would allow the state to add 70,000 children to the 396,000 currently covered.
