Adonis Diaries

Posts Tagged ‘Bernard Debre

Good Old Days: Let’s Review (Part 2, February 18, 2009)

Alexander Fleming published his discovery of penicillin in 1928 and with the aid of Chain and Florey antibiotic was born effectively in 1940. In 1942, enough amount of penicillin was produced to treat 170 injured English soldiers in Africa.

At the end of the war, 300,000 British soldiers were given priority to penicillin treatments, among them 100,000 cases of syphilis and 200,000 of gonorrhea Nietzsche died of syphilis in 1900; he suffered the agony of syphilis progression and devastations for over 34 years. Anyone still longs for the Good Old Days before penicillin?

Suppose these millions of returning soldiers were not treated with penicillin, how many generations of afflicted “crazies” would be running amuck among us? Millions upon millions of civilians were not treated with penicillin because there was not enough in production and millions of new-born “crazies” were afflicted with just this single disease.

The British know how to be first in recycling everything.  In 1847, Victor Hugo wrote “The British dailies state that several millions of human and horse bones were shipped to Hull. These bones were retrieved from the battle fields during the Napoleonic wars. The bones were transported to Yorkshire and grinde into powder and then sent to Duncaster as fertilizer and feed for cows”

A decade later, the first symptoms of “mad cow” were observed in Duncaster and lasted till recently. Only three decades ago did Creutzfeldt and Jacob discover the link between the “mad cow” disease (MCJ) and what the cows were offered to eat. Cows are supposed to eat grass and not the bones and flesh of the dead and dying sheep grinde in powder as feed! Worst, people were contracting a variant of the MCJ disease by eating cow meat.

The biochemist Stanley Prusiner discovered in 1982 that the variant of MCJ in human called “prion” (an acronym) is a protein mutation and not a virus, or bacteria, or a parasite. For an entire decade, Prusiner had to suffer the sarcasm of the medical profession before they came around and gave this protein mutated transmissible agent the label of Non Conventional Transmissible Agent (NCTA).

The MCJ disease was found among a primitive tribe in New Guinea in 1957; the sickness was called Kuru or “The laughing dead” because the terminally ill individual had no control over laughter and died of hunger for failure to swallow.

Adult women accounted for 66% of the afflicted because they were left to eat the innards of dead cadavers after the men had eaten the muscles. Anyone to board a time machine back to primitive New Guinea?

Note: Most of these accounts are extracted from “Amorous Dictionary of Medicine” by the surgeon Bernard Debre.

The rights to know and be informed; Abortion cases (February 17, 2009)

            The rights to know and be informed include the rights to voluntary deciding not to know and not to be informed.  There are various domains that are affected by these rights but this essay will focus on the cases of fetuses that are known to be born handicapped because of development in medical technologies and knowledge. The legal consequences for those who want to know and those who refuse to know are different but their offspring are not supposed to bear the consequences of the parents’ decision as long as the acts of the offspring do not legally affect the parents.

            The medical field has the capabilities to predict a wide array of ailments and diseases that a new born might experience by testing a blood sample from a pregnant woman.   Let us take the case of parents, for some kinds of principles or religious beliefs, opt not to know and the new born is handicapped for life.  Who is to pay the bills and the physical and psychological maintenance of the handicapped? If the State legislates against abortion then it is the State responsibility to support both the handicapped person and the parents.  If the State legislates for abortion in specific cases but the parents decide to keep the baby then can the State refuses to shoulder its responsibilities because it permitted choices?  If a State refuses to give choices then people would label it authoritarian, patriarchal, dictatorial, and other defaming connotations. In any case, it is the whole lot of citizens, “the community of the larger village”, that would sustain the brunt of the calamity.

The surgeon Bernard Bebre published an interesting case.  A pregnant mother fears that she contracted rubella from her one of her sons and tells her gynecologist that she prefers to have abortion if she has contracted rubella.  The laboratory tests were negative; she has no rubella.  The new born is handicapped and shows all the signs that the mother indeed had rubella.   After many years in courts and counter appeals the highest court in France decides that both the parents and the new born are to be materially compensations in the millions of Francs.

Dr, Debre is not happy that the court has compensated for the handicapped new born on the ground that a causality link was established that “what did not prevent abortion of a handicapped baby has contributed to the handicap”.  Dr. Debre is perturbed that the medical profession would get on the defensive and physicians would no longer exercise personal decision; Dr. Debre complained that the appreciation of the court is not competent and has no means to evaluate what the medical practioner could have “decided in his soul and in his conscious”.  I beg to differ.

The supposedly independent court of justice has to do its job as the physician has to do his job of warning his patients of potential diseases.  If the court fails to remind the State administrations that there are important cases to study seriously and legislate for them then who will do it?  The Parliament in France finally legislated that only the parents can demand compensations for wrong doing; and the law ended by stating that the solidarity of the whole community should take charge of any deficiencies in handicapped born babies.  Thus, the whole burden is laid on the parents to demand to know and to be informed of the status of their fetus and then to decide for an abortion.  France would be glad to save tons of money on handicapped persons by permitting abortions before 12 weeks of conception if parents care to save their potential handicapped baby from physical and mental miseries.

Simone de Beauvoir wrote “If a single individual could be regarded as detritus then one hundred thousand people are a mound of garbage” That quote is fundamentally valid of how apartheid, totalitarian, theocratic, and racist political systems think of and act toward their citizens.  But this saying is not relevant to our case.  If a handicapped person thinks all his life that he is detritus in the view of society at large and that he just show brief moments of revolts against his conditions and the attitude of society, then should this handicapped individual be permitted to live on the ground of potential brief spiritual victories over his condition?

I take the position that a pregnant mother should by law know and be informed on the potential diseases of her fetus; and yes parents who refused to abort based on full knowledge should be judged for carrying through a handicapped baby.  Handicapped individuals too have rights to taking to justice parents who let them suffer, be humiliated, be treated worse than dirt, in isolated basement or attics and away from the common people.  I challenge all those people who refuse to know and to abort to sign up for taking the responsibility of the handicapped new born.

Relentless Therapeutic: Ariel Sharon’s case (January 26, 2009)

The topic of relentless medical attempts to keep a dying person physically alive, though technically brain dead, was exposed by Bernard Debre in his French book “Amorous dictionary of medicine“. 

The term relentless therapeutic is not appropriate because a therapy means hope to a healthy survival state of a patient, and the relentless endeavors connote a feasible resolution within a short limited duration.

            Keeping an individual artificially alive is generally for political reason. 

In 1970, the Spanish dictator Franco was kept alive for a month in order for the Spanish to resolve a peaceful transition of power. 

The case of Ariel Sharon, Israel ex-PM is past a political transition of power since he has been in coma for over three years; (I am under the impression that the Zionist State is expecting the emergence of another “Biblical Prophet” before they decide to put Sharon to rest). 

I don’t know what happens to a person artificially living; is he seeing nightmares of Hell? In that case Sharon has done his well deserved punishment. 

Is the person experiencing heavenly dreams?  In that case Sharon is not entitled to such recompense.  Either way, Ariel Sharon has to go morally and ethically.

            There are many kinds of “relentless therapies”. For example:

Therapies for the conscious terminally ills are interesting in their problematic.  The excuses for alleviating sufferings in euthanasia requests should be non-issues anymore: medicine has a wide gamut of pain killers for every kind of suffering. 

The choice for the conscious terminal patient is whether he prefers to abridge his life with massive doses of pain killers or lengthen life a while longer with suffering. 

Ultimately, it is a matter of dying in dignity; especially when excretions are no longer voluntary acts and the support system is totally lacking for caring to a person who is no longer functional. 

Patients on pain killers die suddenly and generally with high morale because, after a while, they forget that they are terminally ill and live a euphoric period.

The great breakthrough in these cases is that lines of communications are open among the family members, the patient, the physicians, and most importantly, the nurses who are in frequent touch with the patient.

Opinions are shared and the last decision is for the patient if he is still conscious.

What is most needed are specialized centers or “units for the terminally ills” where the patient can live in a “normal facility” and supported by skilled nurses and personnel.

What was not natural is a pretty common occurrence: Elderly children walking as slowly as their parents.

Surgeons:  of “The Good Old Days?”,  (January 27, 2009)

Surgeon Bernard Debre described the surgeon job in one of his chapters.  The first paragraph is about technicalities.  The surgeon arrives to work before dawn to visit yesterday’s patients, he reassure the ones submitting to surgery, and then he reviews his files.  The operating room is ready and occupied by the nurses and anesthesiologists.  Five to seven hours later, the surgeon re-emerges happy, tired and a bit tense. The post operative stage starts with the patient sleeping off his anesthetic, in a special room in order to monitor all the vital parameters before his waking phase.

Now comes the paragraph on the good old attributes of surgeons during the good old days.  The surgeon is in consultation with his patients and fields questions and apprehensions, listens intently, and encourages communication and comprehension of the procedures.  He then visits those who were operated in the morning.  Many surgeon have to stay for night shift to receive emergency cases. 

Usually, the surgeon is off by 8 p.m. to return at dawn.  The surgeon is to “serve and share”; he is to serve man and alleviate his suffering and keep him alive; he is to share the emotions, apprehension, suffering, anxieties, sadness, and possibly happiness of the patients.  The surgeon might not sleep a wink worrying about whether “he has done all that should have been done, has he been up-to-date on the latest procedures and technologies”.  Being a surgeon is not just being dext in the fingers but resolving to many sacrifices.

I have submitted lately to a surgery. I saw the surgeon a fleeting moment before going to sleep (anesthesized) and then ten days later.  Yes, the surgeon serves barely two days in this hospital, and by his next arrival I was already out.  Ten days later, the surgeon didn’t have the tools or patience to remove the stitches so that he sent me to the emergency room for that task. 

Nobody explained to me what to expect after surgery, the complications for being overdosed on antibiotics, the deformations in my face (my normal figure not to my liking that much anyway), how long I should expect to revert to normalcy, whether a nerve has been severed, why I have the impression that I am chewing my mouth, and why the surgeon is not returning my calls.   

Nowadays surgeons have still dexterity in the fingers, I like to assume, and enjoy a wide range of support systems to perform surgery and they are still trained to wake up early.  Is the new generation surgeons’ motto “to serve and share” still valid practically? 

No wonder that the best candidates in medicines are opting for other lucrative specialties that set distances with the patients and their bothering inquiries.  No wonder that surgeons are enlisted in many hospitals for “part-time” tasks of performing the surgery and be gone and letting the nurses take care of everything. No wonder nurses are prized additions to hospital staff, since they are shouldering most of the responsibilities for modicum wages.


adonis49

adonis49

adonis49

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