Adonis Diaries

Archive for May 2011

Chicago: Short history of public health

Part of Commencement Address given by Dr. Bechara Choucair to Feinberg PPH, May 4, 2011

“Today is about you. You decided to invest in your education. You decided to focus on public health. You worked hard. You read many articles.

I am sure you wrote many papers. You participated in many work-groups. You sat for many exams. You gave many presentations. It is all paying off today.

Brief description of the history of public health in Chicago.

The population-based approach of public health has had a tremendous impact on the health of our communities for almost two hundred years.  In Chicago, the formal establishment of public health took place in 1834, when the Board of Health was established to fight the threat of cholera.

During this Early Sanitation era, sanitation and quarantine were our best tools for fighting disease. The first sanitation regulations were passed and required all men over 21 years old to help clean the city’s streets and alleys.

We conducted home visits to persons with infectious diseases and boarded ships in Chicago’s harbor to check on the health of crewmen.   Our deepest public health roots can be traced to disease control.

The earliest public information efforts starting in the 1850’s. 

The efforts in the era of sanitary reform, focused heavily on sewers, water and food and dairy. During this period, the Health Department issued regulations governing the drainage and plumbing of new buildings (1889); we initiated meat inspections at Chicago’s Union Stock Yards (1869), and full milk inspection activities began (1892).

We saw some of our highest death rates during this era due to diphtheria, typhoid and scarlet fevers, measles and whooping cough. Using his regulatory authority, the health commissioner at the time, Dr Oscar Coleman De Wolf, required the reporting of contagious diseases by physicians in 1877.

By 1887, our advancements in medical understanding helped us see that typhoid would continue to kill, unless we stopped the flow of contaminated water into Lake Michigan–the source of the water we drank, the water we cooked with, and the water in which we bathed.  Building the 28-mile Sanitary and Ship Canal, which reversed the flow of the Chicago River by 1900, was a major medical/public health intervention.

With the advent of the Hygiene Movement (1880’s-1950’s), and the continued advances in understanding disease and medical practice, the focus of public health shifted to individual hygiene and medical care, particularly children’s health.

In 1890, a Chicago child had only a 50% chance of reaching 5 years of age. By 1900, the odds of surviving to age 5 had increased to 75%.

In 1899, with the support of 73 physician volunteers, the City initiated its first campaign against infant mortality.

Service delivery focused on the provision of dental services in schools in 1915, public health nurse home visits to infants in 1925 and educational campaigns against venereal disease in 1922.   These remain among our priorities today.

The early public health nurses at work.

The nurses “finders of sick infants” would seek out sick babies and refer them and their mothers to Tent Camps, where they would receive medical treatment and hygiene education.

In 1956,  516 persons were stricken with polio. Public health authorities assigned 90% of the city’s health workers to reach a goal of one million inoculations in 2 weeks. One year later, Chicago had only 28 cases, and in 1959 when the U.S. went through a record- breaking year for polio, Chicago had only one case.

The 1950’s saw the beginning of dramatic growth in medical interventions which prompted the era of health care services. During this time, the delivery of personal health care services, primarily to low-income populations, was becoming the primary public identity of public health in Chicago.

In 1959, the Health Department opened the Mid-South Mental Health Center, the first of what would become a network of community mental health centers by the early 1970’s.

The first half of the 1970’s  saw the development of several Department neighborhood health centers, under the federal Model Cities Program.

The first of our centers, in the Uptown community, was established in 1970. On this slide, you can see our clinics in Lakeview, and the 1987 groundbreaking for the expansion of our West Town clinic.

The 1960’s and 1970’s brought significant changes at the federal level as well. The passage of Medicare and Medicaid in 1965 greatly expanded access to care for some of our most vulnerable populations.

Since that time, CDPH has greatly expanded its capacity in Epidemiology, Policy, Planning, Resource Development, and more recently, Information Technology, while maintaining its efforts in critical public health functions such as disease prevention and control, and in the last decade, emergency preparedness.

Note:  This article is part of the Commencement Address at Feinberg School of Medicine at Northwestern University, delivered by Dr. Bechara Choucair, Commissioner of public health of the city of Chicago.  This speech covered all the grounds and it is impressive.

Earth Atmosphere from “A short history of nearly everything” by Bill Bryson

Without our atmosphere that extends 190 kilometers, Earth would be a ball of ice averaging minus 50 degrees Celsius.  Altogether, the gaseous padding is equivalent to 4.5 meters of protective concrete.  The immediate layer is the troposphere that represents 80% of the atmosphere mass and contains water vapor and oxygen; it is 16 kilometers’ thick at the equator and around 11 kilometers in the temperate climates.

The crowding of atoms in the troposphere and, although they travel at a mere speed of 8 millionths of a centimeter per second, their collisions provide enough warmth for our survival.

Human can live to altitude around 4,500 meters by developing large chests and lungs and increasing the density of oxygen-bearing red blood cells by a third but we are not made for high altitudes.

At an altitude of over 6,000 meters, every step demands a colossal effort of will. The temperature drops about 1.6 degrees with every 1,000 meters you climb. Around an altitude of 10,000 the temperature reaches minus 57 degrees.

A rise of an inch in the barometer represents half a ton of air piled upon us, and the reason we don’t feel crushed is that our body is almost of water that is not compressible.  Only 0.035% of the Earth’s fresh water is floating around as cloud soaked water vapor.

The next layer is the stratosphere, followed by the mesosphere and the ionosphere or thermosphere where temperature reaches 1,500 degrees Celsius.

The rejuvenating processes on Earth

Huge amount of heat, energy and electricity are created and transferred around the globe every second. A single thunderstorm contains an energy equivalent to 4 days use of electricity for the whole USA.

At any moment an average of 1,800 thunderstorms are in progress around the world. Day and night about 100 lightning bolts hit the ground every second.

A typical weather front may consist of 750 million tons of cold air pinned beneath a billion tons of warmer air; the strength of wind grows exponentially so that a wind blowing at 300 kilometers an hour is 100 times stronger than 30 kilometers per hour wind. Thus, a tropical hurricane can release in 24 hours as much energy as France uses in a year.

Air always flows from areas of high pressure coming from the equator to areas of low pressure to keep pressure in balance. Moist and warm air from the equator rises until it hits the barrier of the troposphere and spreads out. As it travels away and cools, it sinks. When it hits bottom, some of the sinking air looks for an area of low pressure to fill and then heads back for the equator, completing the circuit through convection.

This convection process is explained by the Coriolis effect that results from the fact that Earth spins at 1,675 kilometers an hour at the equator but the spin reduces its velocity as it is closer to the poles to become almost negligible; a straight line seems to curve to the right at the north hemisphere and to the left at the southern hemisphere.  The Coriolis effects sends hurricanes spinning off like tops.

The other current that is the main agent of heat transfer is known as thermohaline circulation.  For example, England and Ireland are very lucky that the Atlantic is more saline than the Pacific; the denser saline water sink at the bottom, and aided by the Coriolis effect, huge amount of warm water are charred by the Gulf Stream to warm the weather and keep many part of Western Europe from becoming icy like Canada and Russia.

As the water of the Atlantic gets to the vicinity of Europe, it grows denser and sinks to great depths and begins a slow trip back to the southern hemisphere.  When they reach Antarctica, they are caught up in the Antarctic Circumpolar Current and driven onward into the Pacific.  This process takes 1,500 years for water to travel from the North Atlantic to the mid-Pacific, but the volume of heat and water they move are very considerable and the influence on the climate is enormous.

Unfortunately, with the increase of the greenhouse effect, the higher melting rate of the Greenland ice is diluting the Atlantic Ocean and could disrupt the cycle disastrously.

Earth experienced many periods of Ice Age; we are in one Ice Age but within a period of a warmer one.  Just figure an ice sheet 800 meter thick and many kilometers long and wide progressing at 150 meters a year; no obstacles can resist the progress of this monster ice sheet: boulders are carried away and placed at mountain tops and many islands were thus attached to mainland such as Cape Code, Long island, and Nantucket in the east of the USA.

The Swiss Natural History professor Louis Agassie borrowed that idea from his colleague Jean de Charpentier and then toured the world lecturing his theory and traveling and climbing the craggiest Alpine peaks.  The USA was the homes that embraced his idea and offered him a chair in Harvard and build him a first-rate Museum of Comparative Zoology.

The cause of ice age starts in cool summers that prevent snow to melt in the poles and incoming sunlight bouncing off by the reflective surface and thus, exacerbating the cooling effect and encouraging more snow to fall and stick.  It is not necessarily the amount of snow that causes ice sheets but the fact that snow is lasting.  The process is self-enlarging and unstoppable.

The last chapter of “A short history of nearly everything” by Bill Bryson described how Man came to exist 100,000 years ago. Modern human is so recent on Earth that the genetic differences among 55 chimpanzees are much larger than the entire human species.

Yet, modern human has managed to damage extensively Earth, its environment, and thousands of species in such a short period. Apparently, human activities are causing more than one thousand species to go extinct per week.

The nineteenth century, especially in the USA and Britain, experienced a deliberate wiping out of any animal species that was not considered a pet such as animals living in farms.

The States in America paid out bounties for eastern mountain lions and other pests. The dodo flightless bird was wiped out from the island of Mauritius in 1693 simply because the ship crews needed to have something to do.

In the USA, thirty genera of very large animals disappeared; ten million mammoth carcasses are thought to be frozen in the Siberian tundra.  A walrus-like creature called Steller’s sea cow, 9 meters in length and weighting 10 tones got extinct in the mid 18th century. The golden head and emerald-green Carolina parakeet was wiped out because it was considered a pest by farmers. The dog-like Tasmanian tiger was wiped out in Australia by 1936.

“A short history of nearly everything” by Bill Bryson

Physics, the quantification of Earth, and the Universe

The physicist Michio Kaku said: “In some sense, gravity does not exist; what moves the planets and stars is the distortion of space and time.”

Gravity is not a force but a byproduct of the warping of space-time, the “ultimate sagging mattress”.

This new understanding of the universe that time is an intrinsic dimension as space was offered by Albert Einstein through his Special Theory of Relativity.

Among other principles, Einstein realized that matter is energy that can be released under specific conditions so that energy is defined as the product of mass and the square of the speed of light c = 300,000 km/s.

In his attempt to unify classical and relativity laws, Einstein offered his General Theory of Relativity and introduced a constant in the formula to account for a stable Universe.  Einstein declared that this constant was “the blunder of his life”, but scientists are now trying to calculate this constant because the universe is not only expanding but the galaxies are accelerating their flight away from the Milky Way.

In 1684, Edmond Halley, a superb scientist in his own right and in many disciplines, and the inventor of the deep-sea diving bell, visited Isaac Newton at Cambridge and asked him what is the shape of the planetary paths and the cause of these specific courses.  Newton replied that it would be an ellipse and that he did the calculation, but could not retrieve his papers.  The world had to wait another two years before Newton produced his masterwork: “Mathematical Principles of natural Philosophy” or better known as the “Principia”.

Newton set the three laws of motion and that for every action there is an opposite and equal reaction.  His formula stated that force is proportional to the product of the masses and inversely proportional to the square of their corresponding distances.  The constant of gravity was introduced, but would wait for Henri Cavendish to calculate it.

It is to be noted that most of his life, Newton was more serious in alchemy and religion than in anything else.

Henry Cavendish was born from a dukes families and was the most gifted English scientist of his age; he was shy to a degree bordering on disease since he would not meet with anyone and, when he visited the weekly scientific soirees of the naturalist Sir Joseph Banks, guests were advised not to look him straight in the face or address him directly.

Cavendish turned his palace into a large laboratory and experimented with electricity, heat, gravity, gases, and anything related to matter.  He was the first to isolate hydrogen, combine it with oxygen to form water.  Since he barely published his works many of his discoveries had to wait a century for someone else to re-discover the wheel.

For example, Cavendish anticipated the law of the conservation of energy, Ohm’s law, Dalton’s law of partial pressures, Richter’s law of reciprocal proportions, Charles’ law of gases, and the principles of electric conductivity. He also foreshadowed the work of Kelvin on the effect of tidal friction on slowing the rotation of the earth, and the effect of local atmospheric cooling, and on and on.  He used to experiment on himself as many scientists of his century did, such as Benjamin Franklin, Pilate de Rozier, and Lavoisier.

In 1797, at the age of 67, Cavendish assembled John Michell’s apparatus that contained two 350-pound lead balls, which were suspended beside two smaller spheres. The idea was to measure the gravitational deflection of the smaller spheres by the larger ones to calculate the gravitational constant of Newton.

Cavendish took up position in an adjoining room and made his observations with a telescope aimed through a peephole.  He evaluated Earth weight to around 13 billion pounds, a difference of 1% of today’s estimate and an estimate that Newton made 110 years ago without experimentation.

John Michell was a country parson who also perceived the wavelike nature of earthquakes, envisioned the possibility of black holes, and conducted experiments in magnetism and making telescopes. Michell died before he could use his apparatus which was delivered to Cavendish.

The 18th century was feverish in measuring Eart: its shape, dimensions, volumes, mass, latitude and longitude, distance from the sun and planets and they came close to the present measurement except its longivity, and had to wait till 1953 for Clair Patterson (a male geologist) to estimate it to 4,550 million years using lead isotopes in rocks that were created through heating.

Part 1. Antics of lovable late dog Misha

Around noon October 2003, I was having a cigarette in the court-yard.  My nephew William had just parked his Honda; he arrived from the university of NDU.  William carried out a skinny dog got out of the car, no more than 5 month-dog-age, looking scared and disoriented, fidgeting, and refusing to look in the eyes of anyone.  I asked William: “What’s the story?”  He said: “She is a stray dog. For the second day I found her hiding under the car”.  William had already set his mind to own a dog:  It was a matter of a few days before William carries out his decision.  Most probably, William wanted to test the Internet suggestions on how to train a dog?

William got in the business of training Misha.  Misha was not to approach the dish of food before getting the order “Eat Misha”, “Good dog Misha”…  William had to move out of home and mother would cook for Misha rice and leftover meat that I bring from the supermarket Storiom.  Misha would still not come close to the dish until I prompt her “Okay Misha, eat!”  Stranger would think Misha might be sick or on a fasting diet.  Friends of William would think Misha was trained on the strict vegetarian diet of her master; like the notion that most kind of grains induce stomach ulcer and…

The irony is that William turned vegetarian and refused to bring leftover meat for Misha, kind of “I don’t carry meat, don’t expect me to ask for meat”.  And I am thinking “What is Misha to eat then? Has Misha been trained early on to eat vegetables?”  It is confirmed that Misha don’t like carrots:  She would sort out carrot pieces from any mixture of vegetables, rice, and meat.

Mother would bring food to Misha by hollering “Misha, Mishaaa…aaa”.  The cats would get the hint, eat the meat and leave the rice.

Two years ago, a tiny beautiful stray cat, no older than two months, entered the hall of the building.  Misha and I were there and I said “No Misha”. Little niece Chelsea happened to be there on time and carried the kitten up her apartment.   The cat was raised in the apartment of my sister.

Ever since, Misha would retreat and make room when she sees the cat. Kind of Misha is making sure not to be tempted to hurt the cat.  All other cats, trapped inside the staircase, would be found hanging on the windows bars.  Twice, we thought the cats in serious predicament and tried to help them out of the windows:  We finally learned that they were too afraid to step down in Misha’s presence.

Chelsea once boasted to William: “Our cat is ferocious: Misha is too scared of her.”  William reasoned with his little sister that cats are no match to dogs.  I personally witnessed the previous wild dog swiftly bite a kitten instantly dead and resume his walk as if nothing happened:  The poor beautiful white kitten just peeked her head out of her hiding.

I also witnessed many times cats eating their own dead kitten; as if it is pretty normal to have first right on this fresh meat. I once saw a mother cat taking her dead kitten in her mouth and drop the body to ground several times to reanimate the corpse.  Anyway, it seems that male cats try hard to kill the kitten, as lions do.

We had a weird black male cat that retreated on her hind legs when frightened.  I used to think this cat was gay or something:  This male cat took longer than needed to “mature”.  And then suddenly, this year, the black cat never stop moaning his “in heat” state all year round, in all kinds of melodies that drove me crazy.  I think he was faithful to the cat raised in Chelsea’s apartment: Another sign of his weirdness.  For two weeks now, our black very matured cat disappeared.

A couple of days after we buried Misha in the garden, I saw half a dozen girl scouts visiting Misha grave.  I thought: “Oh Oh, Misha grave is a visiting destination”  The next day, I beautified the place:  I spread roses of different colors and a poster of Misha.

We have printed postcards of Misha with messages of what she meant for everyone in the family. We are distributing them to all houses in Cornet Chehwan, Bikfaya, and Beit Chabeb to raise awareness against intentional dog poisoning. There are a lot of houses to cover, and the girl scouts are kindly helping us, but we would really appreciate an extra hand if anyone can spare some time.

‎Hanane Kai and a few of her friends  knocked on the door of over 200 houses, giving them letters.
Letters saying: “Misha was like a sister to me! what would you do if they poisoned your sister?”

Thanks to the help of the Guide of Beit Chabab we were able to give letters to almost 200 houses!!! Every one of the girls had her story about her dog or her cat that got poisoned. It seems like it’s a trend for people to poison pets.  They were happy to be doing this! They adopted Misha’s case as if she was their dog, and they went around “asking” to stop cruelty against pets

Our immune system and Fish: From “A short history of nearly evrything” by Bill BrysonI

Is our immune system still functioning properly?

In 1952, penicillin was fully effective against all strains of staphylococcus bacteria.  The US surgeon-general, William Stewart declared: “The time has come to close the book on infectious diseases. We have basically wiped out infection in the USA”.

Remarkably, 70% of the antibiotics used in the developed world are given to farm animals in stock feed, to promote growth or as a precaution against infection. The bacteria mutated and evolved a resistance to antibiotics and 90% of the strains developed immunity to penicillin. Only one type of antibiotics called vanomyncin remained effective.

In 1997, vanomycin failed to check a new strain.  The pharmaceutical industry hasn’t given the world an entirely new antibiotic since the1970s, preferring to produce a whole gamut of antidepressants that people take everyday for ever.

There is a process of discovery that many ailments may be bacterial in origin such as ulcers, heart disease, asthma, arthritis, multiple sclerosis, several mental disorders, many cancers, and even obesity.

On Fish abundance

Fish is no longer that abundant in the surface seas. According to one estimate, there could be as many as 30 million species living in the sea, most are undiscovered. However, the world’s seas are not uniformly bounteous.

For example, Australia has the longest coastline of 36,735 kilometers, yet it is not a fishing nation because it has no fish for lack of nutrients from the rivers that do not carry much there. In the 1970s, Australia and New Zealand discovered vast shoals of “orange roughy” at a depth of 800 meters.  The fishing fleet was hauling 40,000 tons of roughy a year.  In no time the roughy was disappearing because this type of fish was leading an unhurried lifestyle, spawning once in a lifetime, for the water was resource-poor.

Sharks are captured, the fin tail sliced off, and then dumped back to die: In the Far East, the kilo of fins is sold for $110 and a bowl of shark-fin soup retail for $100 in Tokyo.

As of 195, some 37,000 industrial-sized fishing ships, plus about a million boats, were taking twice as many fish as they had 25 years earlier.  A quarter of a fishing net contains “by-catch” that has to be dumped back, mostly dead, because they are too small or the wrong type. For every kilo of shrimp harvested, about 4 kilo of fish is destroyed.  Cod and halibut are almost extinct off the northeast coast of America.

A single lobster in the catch used to weight 9 kilos and they don’t weight one kilo presently: lobster can live up to 70 years but is not given time to mature.  Fishermen are reduced to fishing the hideous hagfish; these days, “fish” is whatever is left.  It seems that the crab-eater seals are the mammal species of large size that are the most numerous after humans and they live on the pack ice around Antarctica.

“A short history of nearly everything” by Bill Bryson


Thomas Midgley Junior was an engineer by training and he developed an interest in the industrial applications of chemistry.  With an instinct for the regrettable that was almost uncanny, Midgley invented chlorofluorocarbons CFC that is eating up our ozone layer in the stratosphere.

Midgley also applied tetraethyl lead that spread devastation to human health by killing millions from lead contamination and increasing the lead content in our bones and blood 650 times the normal dose.

Tetraethyl lead was used to significantly reduce the “juddering” condition known as engine knock.  GM, Du Pont and Standard Oil of New Jersey formed a joint enterprise called Ethyl Gasoline Corporation with a view to making as much tetraethyl lead as the world was willing to buy this new gasoline and introduced this product in 1923.

Lead can be found in all manner of consumer products; food came in cans sealed with lead solder, water was stored in lead-lined tanks, and lead arsenate was sprayed onto fruit as a pesticide and even as part of the composition of toothpaste tubes.

However, lead lasting danger came as an additive to motor fuel.

Clair Patterson turned his attention to the question of all the lead in the atmosphere and that about 90% of it appeared to come from car exhaust pipes.  He set about to comparing lead levels in the atmosphere now with the levels that existed before 1923.

His ingenious idea was to evaluate these levels from samples in the ice cores in places like Greenland. This notion became the foundation of ice cores studies, on which much modern climatological work is based.

Patterson found no lead in the atmosphere before 1923.  Ethyl Corporation counter-attacked by cutting off all research grants that Patterson received.  Although Patterson was the unquestionable America’s leading expert on atmospheric lead, the National Research Council panel excluded him in 1971.

Eventually, his efforts led to the introduction of the Clean Air Act of 1970 and to the removal from sale of all leaded petrol in the USA in 1986.  Lead levels in the blood of the Americans fell by 80% almost within a year; but since the atmosphere contains so much lead and cannot be eliminated and is for ever, we are to live with a new constitution of heavy lead concentration in our blood stream and our bones.

Lead in paint was also banned in 1993, 44 years after Europe has banned it.  Leaded gasoline is still being sold overseas.  Ironically, all the research on lead effects on health were funded by the Ethyl Corporation; one doctor spent 5 years taking samples of urine and faces instead of blood and bones where lead accumulate.

Refrigerators in the 1920s used dangerous gases and leaks killed more than a hundred in 1929 in a Cleveland hospital.  Thomas Midgley came to the rescue with a safe, stable, non-corrosive, and non-flammable gas called CFC.

A single kilo of chlorofluorocarbon can capture and annihilate 70,000 kilo of atmospheric ozone, which is no thicker than 2 millimeter around the stratosphere and whose benefit is to capture the dangerous cosmic rays.

CFC is also a great heat sponge 10,000 times more efficient than carbon dioxide responsible for the greenhouse effect of increasing atmospheric temperature.

CFC was banned in 1974 in the USA but 27 million kilo a year are still being introduced in the market in other forms of deodorant or hairspray for example.  CFC will not be banned in the third world countries until 2010.

The natural level of carbon dioxide in the atmosphere should be 280 parts per million but it has increased to 360 and is roughly rising 0.025% a year and might be around 560 by the end of the century.

The seas soak up tremendous volumes of carbon and safely locked it away.  Since the Sun is burning 25% more brightly than when the solar system was young, what keeps our Earth stable and cool?

It seems that there are trillions upon trillions of tiny marine organisms that capture carbon from the rain falls and use it to make tiny shells. These marine organisms lock the carbon and prevent it from re-evaporating into the atmosphere; otherwise, the greenhouse effect of warming the atmosphere would have done much damage long time ago. These tiny organisms fall to the bottom of the sea after they die, where they are compressed into limestone.

Volcanoes and the decay of plants return the carbon to the atmosphere at a rate of 200 billion tones a year and fall to the Earth in rain.  The cycle takes 500,000 years for a typical carbon atom.  Fortunately that most of the rain fall in oceans because 60% of the rain that fall on land is evaporated within a couple of days.

Human has disturbed this cycle after the heavy industrialization era and is lofting about 7 billion tones each year.

There is a critical threshold where the natural biosphere stops buffering us from the effects of our emissions and actually starts to amplify them.

“A short history of nearly everything” by Bill Bryson

Astronomy and cosmology

Around 1930, Vesto Slipher was taking spectrographic readings of distant stars at the Lowell Observatory in Arizona and discovered signs of a Doppler shift toward red, which meant that the stars were moving away.

Annie Jump Cannon, known as one of the “Computers” in the 1920′s at Harvard and who was studying photographic plates of stars and making computation, devised a system of stellar classifications still in use today.

Another Computer specialist at Harvard, Henrietta Swan Leavitt, noticed that a type of star as a Cepheid such as the Pole Star pulsated with a regular rhythm because they are dying giant red star.  Leavitt realized that by comparing the relative magnitude of Cepheids at different points in the sky you could work out where they were in relations to each other in relative distances.

Edwin Hubble began to measure selected points in space and showed in 1923 that M31 was a galaxy at least 900,000 light years away. Hubble inferred in 1930 that galaxies are moving away from us in all directions and that the further away the faster they were moving.

Stephen Hawking said if the universe was static it would collapse in upon itself and would have made the whole cosmos intolerably hot.  It was the Belgian priest-scholar Georges Lemaitre who suggested that the universe began as a geometrical point, a “primeval atom”, which burst into glory and had been moving apart ever since.

In 1965, Arno Penzias and Robert Wilson spent a year trying to shut out a persistent background noise when trying to make use of a large communication antenna owned by Bell Laboratory in New Jersey.  They phoned Robert Dicke at Princeton who was pursuing an idea suggested by George Gamow, a Russian astrophysicist, in the 1940s that if you looked deep enough into space you should find some cosmic background radiation in the form of microwaves reaching Earth originating from the Big Bang.

In 1934 the journal Physical Review published a concise abstract of a presentation that was conducted by Fritz Zwicky and Walter Baade.  Bade was responsible for most of the mathematical sweeping up.  This abstract provided the first reference to supernovae as neutron stars where all the other matters, even electrons, collapsed to the sort of densities found in the core of atoms; no light would penetrate that neutron star or Black Hole star.

A spoonful of a Black Hole star mass would weight 90 billion kilograms.

Very few supernovas explode but when they do then they release enormous amount of energy and matters that keep our universe alive and warm.

Cosmic rays are theorized to be consequences of the explosions of supernovas.

Robert Oppenheimer got all the credit five years later.  Now, if supernovae exploded at a distance less than 500 light years, then Earth is a goner; fortunately, in our near galaxies not a star is at least ten times bigger than our sun to form supernovae.

In 1987, Saul Perlmutter at the Lawrence Berkeley Laboratory used charge-coupled devices, like an excellent digital camera, and wrote a sophisticated program so that the powerful computer would systematically search for supernovas through the thousands of pictures.

Reverend Robert Evans in Australia searches the sky every night using a 16-inch telescope hunting for supernovae and he managed to locate 36 supernovas as of 2003.  How we recognize supernovae?  It is a black star and when we notice light in this dark location then we know a supernova has exploded.  Suppose that you spay salt randomly on 1500 black tables and then you add an extra grain; this is how Robert Evans has the knack of discovering supernovae.

It was Fred Hoyle who coined the term Big Bang in 1952 to express his exasperation of this theory because he favored a steady-state theory.  Hoyle realized that if stars imploded, such as supernovas, they would liberate huge amount of heat in the range of 100 million degrees which favor the formation of heavy elements from carbon onward in a process known as nucleo-synthesis.  His theory explained the existence of heavy elements, at least on Earth, since Big Bangs only releases the lighter elements only.  One of Hoyle’s collaborators W.A. Fowler received a Nobel Prize for this discovery.

Frank Drake, a professor at Cornell, worked out in 1960 an equation designed to calculate the chances of advanced life existing in the cosmos.  There might be millions of intelligent life forms in the cosmos but there are no ways of communicating with them because if any one of these advanced species, say 200 light years away, detects a signal from Earth then it would be looking at humans during the time of the American Revolution with horses and white wigs.

How Earth got to exists? Reginald Daly in the 1940s offered this explanation: about 4.6 billion years ago, 99.99% of the dust and gases swirling wildly in the universe went to making the Sun.

Out of the leftover materials the planets started to assemble in endless random permutations.  In just 200 million years the Earth was essentially formed.  An object the size of mars crashed into Earth and formed the companion Moon from the crust of Earth, thus the fact that there are no heavy elements on the Moon that constitute the core of Earth.

When Earth was about one third of its present size, its atmosphere was leaden with noxious gases like carbon dioxide, nitrogen, methane and sulfur. The carbon dioxide formed a greenhouse effect that prevented Earth from freezing because the Sun was still significantly dimmer and could not heat Earth efficiently.

Comets, meteorites and other galactic debris pelted Earth for a long time while creating water to fill the oceans.

Clinical medicine versus public health? What Dr. Bechara Choucair said?

From the Commissioner of public health of the city of Chicago in his Commencement Address at Feinberg School of Medicine at Northwestern University on May 4, 2011

Any intersection between clinical medicine and public health?

Clinical medicine and public health are often seen separate.

We often understand these two words as different disciplinary silos in which many of us spend entire careers. Ted Schettler, the Science Director of the Science and Environmental Health Network, frames both disciplines with respect to focus, scale, ethics, education and the nature of the science.

1. Focus: Clinical medicine focuses primarily on the individual, while public health focuses on the community.

2. Time frame: Relevant time frames in Clinical Medicine are usually single lifetimes, while public health thinks in terms of generations.

3. Ethics: From an ethics perspective, clinicians advocate for individual people. Public health practitioners advocate for the community, for a group of people.

4. Rights: In clinical medicine we focus on individual rights of a patient. In public health, we think about human rights, social justice, and environmental justice.

5. Education: From an education perspective, in clinical medicine we focus on the biomedical model with more emphasis on cure than prevention (although this is shifting now). In public health, we learn more about sociology, epidemiology, cultural anthropology, economics and more.

Think for a moment about the evidence of the science.

In clinical medicine we love to talk about controlled, double-blind clinical trials. We don’t find that type of approach often in public health.

Clearly, there are differences: differences in focus, differences in scale, differences in ethics, differences in education and differences in the nature of science.

But the reality is that the health of the individual and the health of the community are inter-related and inter-dependent. Maintaining two disciplinary silos is NOT the answer.

Bridging the gap is critical if we are serious about improving the quality of life of our residents.

Bridging the gap starts with education.

We have to enhance the understanding of public health principles among our students in the clinical field and we have to enhance the understanding of clinical medicine principles among our public health students.

Bridging the gap happens in research. We have to expand our research portfolio to focus on health disparities and other population level research.

Bridging the gap will not be successful unless we translate what we learn in research all the way into public policy.

And finally, it is people like you, like the faculty here and like me, who will take the lead in bridging this gap.

The good news is that here in Chicago, there are great people who have done great work in bridging this gap. I am forever grateful for their contributions.

At the Chicago Department of Public Health, we are exploring how to fully exploit the intersection of public health and medicine. We are excited about having the opportunity to use, as the foundation of such efforts, the proliferation of HIT initiatives, particularly in under served communities.

A major federally-funded initiative to help us achieve this goal is CHITREC, housed here at Feinberg and funded through stimulus funds (American Recovery & Reinvestment Act).

CHITREC (Chicago Health Information Technology Regional Extension Center) provides technical assistance to primary care providers serving predominantly uninsured, under insured, and medically under served populations in developing an Electronic Health Records system that will improve health outcomes.

CHITREC is collaboration between Northwestern University and the Alliance of Chicago Health Center Services, a health center-controlled network. It builds upon extensive collective Electronic Health Records implementation and clinical informatics experience.

We anticipate that as the participating providers come on line, there will be wonderful opportunities to use the wealth of data available through an Electronic Health Record to measure population health and be able to pinpoint where particular interventions are needed to improve outcomes.

Other federal funding, including the 2010 Patient Protection and Affordable Care Act, has provided additional opportunities for investments in the electronic data infrastructure supporting population health. Chicago Department of Public Health (CDPH) is positioned to become a leader in the public health applications of Health Information Technology. Current CDPH activities include:

  •  Funding of 26 acute care hospitals in Chicago to assist in their efforts toward establishing capacity to transmit data of public health significance to CDPH;
  • Partnering with the Centers for Disease Control and Prevention (CDC), GE Healthcare and the Alliance of Chicago in a pilot evaluation the feasibility of targeted, pubic health-oriented clinical decision support for ambulatory providers, delivered at the point of care through Electronic Health Records;
  • Supporting Stroger Hospital of Cook County and two major Federally Qualified Healthcare Center (FQHC) networks (ACCESS Community Health Network and the Alliance of Chicago) in their efforts to establish robust transmission of immunization administration data to the Illinois immunization registry;
  • Engaging with the Illinois Office of Health Information Technology in statewide efforts to build a sustainable Health Information Exchange (HIE);

Feinberg PPH: Commencement Address given by Bechara Choucair, May 4, 2011

Note: Dr. Bechara Choucair is Commissioner of public health of the city of Chicago.  I liked his Commencement Address at Feinberg School of Medicine at Northwestern University and decided to publish the speech and three sections of the speech on

This speech covered all the grounds and it is impressive.  I found it acceptable to edit out sentences that are not closely related to the subject matter in order to shorten the message.

Communication technology activists: The challenge to the Syrians secret services

The Irish NGO Frontline, located in Jordan, trained Syrian activists on how to erase data at long distance, secretly exchanging e-mails, and saving sensible database (videos, pictures…). 

For example, the Iranians have provided the Syrian security forces GSM antennas that can expand (balloon) the reach of signals and thus, capture the coordinates of anyone using performing satellite mobiles.

Fidaa al-Sayed, communication Syrian specialist and activist, located in Sweden, countered that breach in security by asking his “operators” on the ground to shut down automatic mode and using solely the manual mode.

Since March 15, If you are caught in Syria publishing images and videos on YouTubes or sending videos to Al-Jazeera channel, you are more likely to be beaten silly or killed in prison.

Transmitting, emitting news from Syria is resembling to activities engaged in Radio London during the occupation of Nazi Germany to France.

Usama Monajed, 31 of age and residing in London since 2005, is one of the precursors for clandestinely supplying communication equipments into Syria.  Usuma had assimilated the “non-violence tactics” of Gene Sharp.  Usama held seminars on communication technologies to Syrian activists, able to visit Turkey, Jordan, and Lebanon without visas.

The sophisticated equipments included satellite modems, smartphones, and portable computer. Usama manages the network “Shaam News”, a site based in the USA and functioning since February, three weeks before the start of the Syrian uprising on March 15.

On March 15, 2011, two dozens of young activists demonstrated in the Souk of Damascus, by the Great Mosque.  They shouted: “Syrians, where are you?”  They shot a video of their demonstration that made the tour of foreign news media.  All these youth were detained, and not a single one has emerged from prison since then.

The Syrian regime tactics are to close-off a city, cut electricity and internet connections.  In Daraa, the activists recharged their mobiles using electric generators: They filmed the repression, particularly the beating to death of marchers by the security services, the “Mukhabarat”.  The activists vacated Daraa in the night, walked to nearby villages by the borders with Jordan, and remitted their communication equipments to their contacts.  The videos were transmitted on Al Jazeera.

The “authorities” or the 4th brigade of Maher Al Assad, brother of Bashar, ordered a few neighborhoods to either hand-over the activists or face occupation.  The neighborhoods opted for the second alternative. Maher Al Assad is on top of the wanted list for crimes against humanity.

Amrou is a Syrian activists residing in Paris.  He is 29 of age and has been transmitting live videos to Al Jazeera.  Amrou had smuggled to the activists in Banias quality communication equipments and explained to them how to use the software Bambuster. Bambuster can transmit high quality images directly from a phone. On Skype, the operator in Banias relayed the news: “It is done.  He is on the roof. The manifestation is starting.”  Amrou calls his contact in Al Jazeera in Doha and tells him: “All is in place”.  Three seconds later the live video is on TV stations.

The operator on the ground has to cut filming within 30 minutes, lest he is localized by the Syrian communication specialists to the regime.  Amrou prefers the Iridium satellite phone instead of Thuraya, because it is far secure.   Amrou suggests to his operators to use the software YouSendIT to post on YouTubes: It leaves “no trace on your portable computer.”

The Syrian activist Firas Atassi, residing in Riyadh (Saudi Arabia), is in charge of the “communicators” in Homs.  Ammar Abdulhamid of Silver Spring (USA) is managing the activists in Damascus. Syrian communication leaders overseas are centered in Germany, Turkey, Lebanon, Kuwait, and Australia; every where there are heavy Syrian immigrants.

Note 1:  Since March 15, over 15,000 Syrians have gone throught the prisons revolving doors, after suffering harsh and savage torture.  More than a thousands have been assassinated, even within the prisons.  Bashar Al Assad has called upon the retired old guards in the secret and intelligence services to join in the efforts of taming the revolts.  Most probably, things are getting out of hand and Bashar has to pay for not demonstrating firm control over his brutish oligarchies.

Note 2: Most of these information were taken from the French weekly “Le Nouvel Observateur”




May 2011

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