By Chet Yarbrough
You Bet Your Life (From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation)
By: Paul A. Offit, MD
Narrated by: James Hoban
Paul Offit (Author, American pediatrician specializing in infectious diseases, vaccines, immunology, and virology.)
Like Siddhartha Mukherjee’s “The Emperor of All Maladies”, Paul Offit reflects on patients who risk their lives based on medical treatment and prescribed drugs by educated scientists, physicians, and drug manufacturers. Both Mukherjee and Offit write of the medical causes of death and attempts made by the medical profession to save lives. What both books have in common is that the medical industry, just as in all life’s work, is influenced by money, power, and prestige. Those influences carry risks and rewards.
Both Mukherjee and Offit are doctors with wide expertise in their respective fields. Offit’s book is shorter but equally important and impactful. Medical practice is just what the words mean.
Both physician/authors imply the word “practice” entails experiment on human beings. A physician can only be sure of successful medical procedures and treatment based on repeated healthful results for human beings.
Doctors, scientists, drug manufacturers, and medical employees make good and bad decisions based on educational achievement, hands-on medical experience, and personal motivation. That is true in all forms of work employment. The difference is we who are not part of the medical industry are intimately and mortally affected by its practice and advertisement.
Bad medical decisions can end a life; good medical decisions can save a life.
As a surgeon, Mukherjee reviews the history of cancer treatments and medical decisions that both killed and saved lives. Offit, a pediatrician, and member of the Centers for Disease Control (CDC), reviews the history of medical innovations and treatment of infectious diseases that killed and saved lives. In the age of Covid19, Offit’s history is enlightening and somewhat frightening.
The hard push (called “warp speed) for a vaccine that treated Covid required risks to be taken. Putting aside the politics enshrined in American freedom of choice, in 2020 nearly 700,000 Americans may not have died if the vaccine had been accepted more quickly by the public. On the other hand, Offit’s history shows errors have been made by both physicians and drug manufacturers that have killed Americans in search for cure. Even with the great success of polio elimination in America, some died from improperly manufactured vaccines.
Offit reminds listeners of the history of heart transplants, blood transfusions, and anesthesia that reminds one of the gruesome details reported by Mukherjee about cancer in the early days of a search for cure.
Louis Washkansky lived for 18 days after having his heart replaced by a human donor’s heart. Only after years of research on rejection, did heart transplants give years of life to recipients.
Ryan White, a teenage Indiana boy, is saved from hemophilia after being given a blood transfusion that infects him with HIV. He was diagnosed in 1984 and given six months to live. He lived until 1990 but was ostracized by schools and society because of American fear of the disease. Too little was known about how the Auto Immune Deficiency was transmitted.
The search for a way to conduct surgery without pain led to the use of chloroform in the 1800s. Hannah Greener, a 15-year-old, dies from application of chloroform for surgical removal of an infected toenail in 1848. Offit does go on to explain chloroform became notorious for criminal use in robberies. In any case, the principle of anesthesia made a great contribution to surgical practice.
Hannah Greener (1833-1848, dies from an overdose of chloroform when anesthetized.)
Contrary to Offit’s claim of an overdose, the cause of death may have been aspiration of fluids in trying to bring her back to consciousness.
There are many more interesting stories from Offit’s historical account of medical innovation. The fundamental point of both Offit and Mukherjee is that errors will be made by the medical industry. Risks are taken by patients who rely on the industry to cure or ameliorate the ravishes of ill health. Government oversight, like the FDA, CDC, USDA, and the World Health Organization, work on minimizing risk to society but risk reduction is a work in progress. Offit notes there are many ways for medical cures to go wrong. From misleading advertising to poor medical practice, to human greed for money-power-prestige, human risk abounds. Of course, the ultimate risk is the patients.
The lesson one draws from these two physicians is that the public has a right to be skeptical but there is no right to be stupid. Dying will always be a part of our lives, whether mistakes are made or not.
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