Demystifying Medicine One Month at a Time

Category: disaster relief (Page 2 of 3)

“Rampart, this is Squad 51…”

Fans of the 1970s TV show Emergency! will remember that famous radio call. The show was the first to serialize and glamorize paramedics as first responders in crises large and small.

Building a culture of heroism for civil servants…

With the cleanup from Hurricane Sandy no longer a front page news story, it’s worth appraising a couple of aspects about disaster preparedness:

First, I found it heartening that the Northeast region was able to get the word out and communicate so effectively in terms of pre-storm evacuations and service closures to avoid mishaps and fatalities during the storm. I have no doubt that hundreds of lives were saved by these actions.

Secondly comes word that as far as first-responder communication, we still have a way to go to ensure that first responders have their own bandwidths on which to seamlessly communicate with one another.

NY and NJ first responders had success in communicating at the push of a button, but teams from outside the region that had come to provide extra help were left with dialing cell phone numbers on the usual 4G network–subject to the same dropped calls and network outages as the rest of us.

Haven’t we learned from 9/11 and Hurricane Katrina? The government has created FirstNet, an independent federal agency, to set up a national emergency responders network, in addition to setting aside a portion of the broadband spectrum to create such an entity. But the FCC isn’t planning on auctioning off this part of the spectrum until 2014 at the earliest due to resistance on the part of broadcast networks and other government agencies, according to a NYT piece by Edward Wyatt.

Hopefully with the election season out of the way, the President can prioritize full establishment of a secure and strong emergency communication network during his second term–and leave us all a little safer for it.


I’m offering a thought and prayer for the sixty million people coping with the effects of Hurricane Sandy.

Here’s just a brief list of the preparations that cities and states all along the eastern seaboard have taken:

  • Subways-CLOSED
  • Airports-CLOSED
  • Train depots-CLOSED
  • Tunnels-CLOSED
  • Marinas-CLOSED
  • Beaches-CLOSED
  • Parks-CLOSED
  • Stock exchanges-CLOSED
  • Many businesses-CLOSED

Anyone ever remember all of this happening at once? In advance? Over such an incredibly large area?

Obviously, it’s too early to say, but the advance preparations here will hopefully save lives.

Prevention is all about reducing risk. Staying inside and keeping people from using public transportation, going to and from work and school, and amping up the warnings to stock up on consumables will likely reduce death and injury in this situation by an order of magnitude. No small feat for a storm of this size.

Congratulations to officials in so many jurisdictions for being on point and providing a clear and uniform message.

Cataclysm or not, it’s a poetic break from election madness.

Hospital of Horror

photo credit: Times of India

Every once in a while, a tragic news story pierces though the emotional wall we set up to handle the endless torrent.

The news of a hospital fire in Kolkata [formerly Calcutta], India is one such story for me.

The name of the hospital is the “Advanced Medical Research Institute,” known locally as AMRI.

It seems that any place wanting to call itself advanced would consider basics like a fire safety plan and how to execute it.

I was particularly horrified by the utter abandonment of patients by the medical professionals. From a NY Times article on the blaze:

The doctors on duty fled the hospital almost immediately, leaving patients stuck in their wards and at the mercy of the billowing black smoke, witnesses and patients told reporters.

I was reminded of Hurricane Katrina and the brave docs who stuck around tending to those so critically ill that they couldn’t be moved out of the storm’s path.

The Kolkata fire tragedy was compounded by inept administration, security, and rescue response. From the same article:

Local people who tried to get inside the hospital to help rescue patients said they were turned away by security guards who assured them it was only a small kitchen fire.

Hospital officials were slow to call the Fire Department, and then fire trucks were slow to arrive, hospital officials said.

In fact, it took firefighters more than 12 hours to subdue the blaze, Fire Department officials said. The hospital’s fire detection and suppression system did not function…

Who bears responsibility for such a tragedy?

Six senior hospital officials were charged with culpable homicide in connection with the fire, according to government officials.


Thank you for Not Smoking

How well does e-smoking approximate the real thing?

Hope you had a pleasant Thanksgiving. GlassHospital was on the road again, taking the kids to visit the hometown of Cleveland, health mecca of the eastern Midwest.

E-cig smoked by a stunt double for my Uncle Ron.

Had Thanksgiving dinner at my aunt and uncle’s. My aunt is a culinary master; she loves to pull out all the stops, including the homemade apple pie that helped define my youth.

I came away feeling a bit gluttonous. Fitting, I suppose, for the holiday.

But gluttony is not the sin for today. No, today’s sin is smoking.

There has been a convergence of recent news stories regarding the nasty habit that have grabbed my attention:

First, a Lancet article (subscription required) claiming that secondhand smoke kills–to the tune of six hundred thousand lives per year worldwide. The study was done by the World Health Organization (WHO?), and compiled statistics from 192 countries. A data set that broad is not too shabby. [Readers from almost that many countries have enjoyed reading GlassHospital, if we’re to believe Google Analytics.]

Secondly, a recent commentary written under the heading “Ideas and Opinion” in the Annals of Internal Medicine introduced me to something that I’d never seen before Thanksgiving: the electronic cigarette (the “e-cig”).

Oddly enough, in our post-Thanksgiving stupor, what do you think I saw? My Uncle Ron, a longtime smoker, proceeded to sit in the comfy TV room chair and “light up” cigarette after cigarette.

I was surprised, because Uncle Ron’s smoking has been shunned by the rest of the family to the point where he’ll usually go outside or hide in his room if he’s going to light one up. I was also surprised since even though he’s an inveterate smoker, I’d never seen him chain smoke one after the other like that.

And with kids in the room!

Then I noticed the strange glow from the tip of the cigarette. Orange. Bright orange. Perfectly bright orange with a blue halo. And the way the smoke seemed to come out in a consistent volume whether he was puffing on it or not.

Uncle “Smoke” (as my niece and nephews affectionately used to refer to him) was smoking an e-cig!

Coincidence? I think not.

My cousin had introduced his Dad to the e-cig in the hope that he’d use the device(s) to help himself quit.

The e-cig is an aerosolized nicotine delivery device that uses a battery to deliver the “medicine” and create the “vapor” that emanates from the cigarette’s tip to simulate the controlled burn of tobacco and paper in a real cigarette.

As the title of the Annals piece states, e-cigarettes are “a rapidly growing internet phenomenon.” As such, it behooves us to treat this phenomenon with a healthy degree of skepticism. The Annals piece concludes by making the unsurprising claim that more research needs to be done into the products, their effects, and their unintended consequences. For example, just how “safe” is that vapor for non-users in the vicinity of an e-cigarette? And, is there any compelling evidence that absorbing nicotine in this way really helps hard core smokers to cut down or quit?

My first impression was that my uncle was actually “smoking” more, since he no longer was leaving the room to smoke.

After Thanksgiving, my curiosity about e-cigarettes grew. If they’re so “safe,” could they be smoked in hospitals so that addicts could get their fix of nicotine in a way non-harmful to others?

Indeed, a quick internet search turns up this. But take it with a boulder of salt, since it’s a press release from a manufacturer. They do not identify the Tampa hospital that purportedly permits this, nor do they give other examples of accommodating hospitals, even though the headline boasts of e-cigarettes being accepted in “many hospitals.”

For his part, Uncle Ron seems to like the products. He’s “present” more at work, since he now doesn’t need to go outside to smoke. As to whether the e-cigs are helping him quit his tobacco habit, he (and those around him) remain uncertain.

Ni hao from China

In our unremitting effort to make transparent all that is Medicine, GlassHospital has journeyed to China, home of the 2008 Summer Olympics.

The real reason we’re here is to facilitate dialogue and cultural exchange between two great medical schools, those being the one affiliated with GlassHospital and the one here at Wuhan University. Like many medical schools, Wuhan is looking to modernize its curriculum, emphasizing clinical reasoning and small group learning over the traditional large lecture format and rote memorization.

And, in an interesting twist, the central government has embarked on an ambitious health care reform agenda that among other goals seeks to produce more primary care doctors to serve the world’s largest population.

Hmmm, does this sound vaguely familiar? (Fodder for future posts?!?-ed.)

A couple of travel notes:

The GlassHospital family travelled to Beijing, China’s capital, on our way to Wuhan. There we saw incredible sites like the Olympic Park, Tiananmen Square and the Forbidden City.

At the Bird’s Nest stadium, famous architectural marvel and home to the track and field competition and opening ceremonies, we saw this interesting machine:

Health in a Box? (photo by SAH)

It wasn’t getting a lot of patronage, but still–we very much liked the idea of quitting smoking in a box.

Then, at the Beijing airport (a pretty fantastic architectural achievement in its own right), we were intrigued about the no smoking signs posted around. They had the usual circle-with-a-line-through-it around a cigarette, apparently sponsored by the “Beijing Patriotic Health Campaign Committee.”

That’s using civic pride to good public health effect.

A couple of other notes:

I’d heard about the internet filtering of sites like Facebook and Twitter. What I wasn’t prepared for was the blacklisting of many blogs that I regularly read. At first I thought that maybe folks like Dr. Grumpy had simply irritated the authorities with his clever and sometimes sophomoric humor. Then, when I also couldn’t find my favorite health policy blog, I thought they had my number. What had these medical bloggers done to be politically controversial?

Well, it turns out it’s a blanket proscription on all blogs Google; that is, if the blog is written on Google’s Blogger program, no dice being read in China. Apparently, it extends beyond Blogger blogs, too, but I’ll just leave it at that for now.

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