(Roughly) Daily

Posts Tagged ‘medical school

“Long life is welcome, agreeable, pleasant, and hard to obtain in the world”*…

… maybe, as recent research from Saul Justin Newman explains, even harder than we thought…

The observation of individuals attaining remarkable ages, and their concentration into geographic sub-regions or ‘blue zones’, has generated considerable scientific interest. Proposed drivers of remarkable longevity include high vegetable intake, strong social connections, and genetic markers. Here, we reveal new predictors of remarkable longevity and ‘supercentenarian’ status. In the United States supercentenarian status is predicted by the absence of vital registration. In the UK, Italy, Japan, and France remarkable longevity is instead predicted by regional poverty, old-age poverty, material deprivation, low incomes, high crime rates, a remote region of birth, worse health, and fewer 90+ year old people. In addition, supercentenarian birthdates are concentrated on the first of the month and days divisible by five: patterns indicative of widespread fraud and error. As such, relative poverty and missing vital documents constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records…

The paper in full: “Supercentenarian and remarkable age records exhibit patterns indicative of clerical errors and pension fraud,” at @biorxivpreprint.

(Image above: source)

* Buddha

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As we long for longevity, we might send healthy birthday greetings to William H. Welch; he was born on this date in 1850. A physician, pathologist, bacteriologist, and medical educator, He was one of the “Big Four” founding professors at the Johns Hopkins Hospital, the first dean of the Johns Hopkins School of Medicine, and the founder of the Johns Hopkins School of Hygiene and Public Health, the first school of public health in the country.

Welch revolutionized American medicine by demanding of its students a rigorous study of physical sciences and an active involvement in clinical duties and laboratory work. His students included Walter Reed, James Carroll and Simon Flexner.

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“‘Life’ is of course a misnomer, since viruses, lacking the ability to eat or respire, are officially dead”*…

The human genome contains billions of pieces of information and around 22,000 genes, but not all of it is, strictly speaking, human. Eight percent of our DNA consists of remnants of ancient viruses, and another 40 percent is made up of repetitive strings of genetic letters that is also thought to have a viral origin. Those extensive viral regions are much more than evolutionary relics: They may be deeply involved with a wide range of diseases including multiple sclerosis, hemophilia, and amyotrophic lateral sclerosis (ALS), along with certain types of dementia and cancer.

For many years, biologists had little understanding of how that connection worked—so little that they came to refer to the viral part of our DNA as dark matter within the genome. “They just meant they didn’t know what it was or what it did,” explains Molly Gale Hammell, an associate professor at Cold Spring Harbor Laboratory. It became evident that the virus-related sections of the genetic code do not participate in the normal construction and regulation of the body. But in that case, how do they contribute to disease?

An early clue came from the pioneering geneticist Barbara McClintock, who spent much of her career at CSHL. In the 1940s, long before the decoding of the human genome, she realized that some stretches of our DNA behave like infectious invaders. These DNA chunks can move around through the genome, copying and pasting themselves wherever they see fit, which inspired McClintock to call them “jumping genes.” Her once-controversial idea earned her a Nobel Prize in 1983.

Geneticists have since determined that jumping genes originate in the viral portion of the genome. Many of these genes turn out to be benign or even helpful. “But some of the things are full-on parasites,” Hammell says, like infections embedded within our own DNA. All it takes to set these bad actors loose, she is finding, is a slip-up in the body’s mechanisms that normally prevent the genes from jumping around and causing harm…

Half of your genome started out as an infection; if left unchecked, some parts of it can turn deadly all over again: “The Non-Human Living Inside of You.”

See also: “The Wisdom of Pandemics– viruses are active agents, existing within rich lifeworlds. A safe future depends on understanding this evolutionary story.”

* “‘Life’ is of course a misnomer, since viruses, lacking the ability to eat or respire, are officially dead, which is in itself intriguing, showing as it does that the habit of predation can be taken up by clusters of molecules that are in no way alive.” – Barbara Ehrenreich, Living with a Wild God: A Nonbeliever’s Search for the Truth about Everything

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As we check our baggage, we might send reforming birthday greetings to Abraham Flexner; he was born on this date in 1866.  The founding director of Princeton’s Institute for Advanced Studies, Flexner is best remembered for his pioneering work as a reformer of American higher education, especially medical education.  On the heels of his 1908 study, The American College, in which he effectively critiqued the university lecture as a method of instruction, he published the Flexner Report, which examined the state of American medical education and led to far-reaching reform in the training of doctors.  The report called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research.  While one unintended consequence of Flexner’s impactful advocacy was the reversion of American universities to male-only admittance programs to accommodate a smaller admission pool (female admissions picked up again only later the century), most historians agree with his biographer, Thomas Bonner, that Flexner was “the severest critic and the best friend American medicine ever had.”

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“I just saw some idiot at the gym put a water bottle in the Pringles holder on the treadmill”*…

 

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Like millions of other people, I put a fair amount of effort into “being healthy.”  I don’t smoke, try to eat a reasonable diet, and so forth.  I do all of this with the backing of a strong scientific consensus that such behaviors are likely to be very good for my health and longevity.  None of this makes me special in any way; I am trying to follow what one might call the medical truth of health.

What I want to suggest here is that there is a dark underside to all that healthy behavior. The underside is that the healthy behavior encourages the view that individuals are largely responsible for their own health outcomes, and that if people end up unhealthy or diseased, it’s their fault for not having engaged in sufficiently healthy behaviors.  Call this a “social truth” of health.  This social truth has real consequences. On the one hand, if individuals are to blame for their poor health, then they should bear a lot of the cost of their disease.  After all, there is a sense in which they “chose” to be sick because of their unhealthy lifestyle.  On the other hand, policies designed to create healthier environments or at reducing structural factors associated with poor health outcomes, like poverty, start to seem less important.

“Healthism,” as a prescient article from 1980 called it, has been a growing part of the American social landscape since the 1970’s, when jogging emerged as a fitness trend.  The rise of healthism coincides with the rise of neoliberalism, a loosely-grouped set of policies that aim at analyzing all parts of society in economic terms, expanding the reach of actual markets, encouraging competitive behavior between individuals, and encouraging people to view their lives in entrepreneurial terms (for example, treating education as an investment the value of which is measured in terms of its probable future returns in the form of higher income). Because of the focus on individuals and market behaviors, neoliberal governance tends not to see systemic or public problems except insofar as they can be reduced to the problems of individuals…

It is in this context that we need to see our healthy lifestyles and the dilemma they pose.  It is obvious that those who have the good fortune and the means can and should want to be healthy, for its own sake.  On the other hand, the effort to be healthy directly feeds a narrative that says that poor health is the product of poor management, in the way that poor returns on financial investments might be.  No one is ever simply “healthy;” even health today may hide illness to come, future illness that must be detected and prevented.

The problem is that the wellness narrative causes us to over-estimate the degree to which it is fair to blame individuals for their health outcomes…

The importance of separating what is an individually-healthy behavior from good health policy: “Is Your Healthy Lifestyle Bad For You?

* meme

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As we emphasize empathy, we might recall that it was on this date in 1850 that the first classes were held at The Female Medical College of Pennsylvania, the second medical school in the U.S. exclusively for women.  (The New England Female Medical College had been established two years earlier.)  It soon changed its name to The Woman’s Medical College of Pennsylvania, then much later was renamed as The Medical College of Pennsylvania after opening its doors to men in 1970.

The school’s first building

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Written by (Roughly) Daily

October 12, 2017 at 1:01 am

“There wasn’t an anhydrous lacrimal gland in the room”*…

 

For more than 100 years after the founding of America’s first medical school at the University of Pennsylvania in 1765, faculty members personally peddled tickets to their classes in order to fill lecture halls. So if a prospective surgeon, like Samuel Gartley, whose name appears on this delightfully morbid ticket featuring dancing skeletons, wanted to study anatomy under W.S. Jacobs at the University of Pennsylvania around 1800, he would seek out Jacobs and buy a ticket to attend his “dissecting class.”

“With roughly 10 to 15 dollars in hand, anybody could purchase admission to a course of lectures directly from the professor, who profited directly from the students’ fees,” write Carol Benenson Perloff and Dr. Daniel M. Albert, the authors of a new book, Tickets to the Healing Arts: Medical Lecture Tickets of the 18th and 19thCenturies. Customers included not only matriculated medical students but also practicing physicians and “apprentices” laboring within the older, informal system of medical education. This proprietary enrollment system was upheld by unsalaried professors who worked like independent contractors, paying rent and overhead to the school’s dean out of ticket sales while pocketing the proceeds…

* Mary Roach, Stiff: The Curious Lives of Human Cadavers

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As we take our seats, we might spare a colorful thought for Phineas Taylor (“P.T.”) Barnum; he died on this date in 1891.  Barnum founded and ran a small business, then a weekly newspaper in his native Connecticut before leaving for New York City and the entertainment business.  He parlayed a variety troop and a “curiosities” museum (featuring the “‘Feejee’ mermaid” and “General Tom Thumb,” but also serious scientific exhibits, for which he actively collected natural history specimens.) into a fortune…  which he lost in a series of legal setbacks.  He replenished his stores by touring as a temperance speaker, then served as a Connecticut State legislator and as Mayor of Bridgeport (a role in which he introduced gas lighting and founded the Bridgeport hospital)… It wasn’t until after his 60th birthday that he turned to endeavor for which he’s best remembered– the circus.

“I am a showman by profession…and all the gilding shall make nothing else of me.”

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Written by (Roughly) Daily

April 7, 2016 at 1:01 am

I’m looking through you…

It is perhaps a sign of the times?  In any case, Eizo (more specifically, the German medical imaging subsidiary of the Japanese company) has issued a pin-up calendar that cuts right to the bone:

Miss September

See them all at Advertolog.  (TotH to UFUNK)

As we think again about responding to the X-Ray Specs ad in the back of that comic book, we might recall that on this date in 1768, the first commencement of a U.S. medical college was held at the College of Philadelphia (now, The University of Pennsylvania.)  With the establishment of a the Department of Medicine in 1765, CoP had become the first medical school in the U.S.

The institution granted ten Bachelor of Medicine degrees at this first commencement. Being alphabetically at the head of the list, John Archer became the  first doctor in the U.S. to receive such a degree. Four of these ten also received a Doctor of Medicine degree from the college three years later, in 1771. (The first Doctor of Medicine degree was granted in 1770 at King’s College– now Columbia University– in New York.)

The University of Pennsylvania Medical School (Originally, instruction took place in a wooden building, Surgeon’s Hall)

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