CHEMICAL FROM PLASTIC WATER BOTTLES FOUND THROUGHOUT OCEANS


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Although plastic has long been considered indestructible, some scientists say toxic chemicals from decomposing plastics may be leaching into the sea and harming marine ecosystems.

Contrary to the commonly held belief that plastic takes 500 to 1,000 years to decompose, researchers now report that some types of plastic begin to break down in the ocean within one year, releasing potentially toxic bisphenol A (BPA) and other chemicals into the water.

“Plastics in daily use are generally assumed to be quite stable,” chemist Katsuhiko Saido of Nihon University in Japan said in a press release. “We found that plastic in the ocean actually decomposes as it is exposed to the rain and sun and other environmental conditions, giving rise to yet another source of global contamination that will continue into the future.” Saido presented the work Wednesday at the American Chemical Society meeting in Washington, D.C.

Several noxious plastic byproducts, including BPA and a substance called styrene trimer, have been detected in small quantities in the ocean, but Saido says this is the first time anyone has shown a direct connection between decomposing plastic and the hazardous chemicals. Both BPA and components of styrene trimer have been shown to disrupt hormone function and cause reproductive problems in animals.

 The Japanese researchers devised a method to simulate the breakdown of a hard plastic called polystyrene at 30 degrees Celsius (86 degrees Fahrenheit) in the lab, and they compared the chemical byproducts from their experiment with what they found in water and sand from the Pacific Ocean. Based on the speed of plastic decomposition and the amount of drift plastic found along the coasts of Japan, the scientists concluded that noxious chemicals in the water are probably coming from the breakdown of polystyrene, which is used to make Styrofoam.
 But not all researchers are convinced the lab experiment accurately reflects what’s going on in the ocean. “Polystyrene is actually heavier than seawater, so before it ever chemically breaks down or degrades, it may be sinking to the bottom,” said ocean researcher Charles Moore of the Algalita Marine Research Foundation, who was not involved in the study. Because temperatures are much lower at the bottom of the ocean and there’s very little light to cause photodegredation, Moore said it’s unlikely that the plastic would break down once it sunk.

“Food doesn’t even biodegrade at the bottom of the ocean,” he said. “There is so little activity going on down there.” In addition, Moore said ocean temperatures across most of the world are much lower than the 30 degrees Celsius the researchers used in their lab simulation.

Even if polystyrene breaks down in some regions of the ocean, pollution expert Joel Baker of the University of Washington questions whether the amount of chemicals released would be significant compared to the vast size of the ocean itself. “There’s a little bit of hyperbole going on here,” Baker said. “There’s no question that there’s too much plastic in the ocean, and we should try to reduce that. But whether it’s an important source of chemicals for the ocean is much less clear.”

But regardless of whether its chemicals leach into the water, the sheer volume of plastic floating in the sea makes it a major polluter, Moore said. Discarded plastic junk makes its way from gutters and storm drains into rivers and streams, and eventually flows into the ocean, where it gets trapped by currents and creates vast regions of plastic soup. On a voyage back from Hawaii in 1997, Moore discovered a floating island of garbage larger than the state of Texas, which has since been dubbed “The Great Garbage Patch.”

Plastic poses the biggest threat to marine animals that confuse garbage with dinner and end up digesting large quantities of polystyrene. Even if polystyrene isn’t decomposing in the water, Moore said it could be breaking down in the digestive tracts of fish and marine mammals. “Every size of organism,” he said, “every creature in the food web in the ocean, from the smallest filter feeders to the largest whales, is consuming plastic.”

Inside a Killer Drug Epidemic: A Look at America’s Opioid Crisis


The opioid epidemic killed more than 33,000 people in 2015. What follows are stories of a national affliction that has swept the country, from cities on the West Coast to bedroom communities in the Northeast.

Opioid addiction is America’s 50-state epidemic. It courses along Interstate highways in the form of cheap smuggled heroin, and flows out of “pill mill” clinics where pain medicine is handed out like candy. It has ripped through New England towns, where people overdose in the aisles of dollar stores, and it has ravaged coal country, where addicts speed-dial the sole doctor in town licensed to prescribe a medication.

Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone surpassed gun homicides.

And there’s no sign it’s letting up, a team of New York Times reporters found as they examined the epidemic on the ground in states across the country. From New England to “safe injection” areas in the Pacific Northwest, communities are searching for a way out of a problem that can feel inescapable.

 

Drug Deaths in America Are Rising Faster Than Ever


The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50.

Although the data is preliminary, the Times’s best estimate is that deaths rose 19 percent over the 52,404 recorded in 2015. And all evidence suggests the problem has continued to worsen in 2017.

 

Drug overdose deaths, 1980 to 2016
59,000 to65,000 peopledied from drugoverdoses in theU.S. in 2016*59,000 to65,000 peopledied from drugoverdoses in theU.S. in 2016*1980’85’90’95’00’05’10’1520,00030,00040,00050,00060,000Peak car crashdeaths (1972)Peak gundeaths (1993)Peak H.I.V.deaths (1995)10,000 deathsper year10,000 deathsper year
*Estimate based on preliminary data

Because drug deaths take a long time to certify, the Centers for DiseaseControl and Prevention will not be able to calculate final numbers until December. The Times compiled estimates for 2016 from hundreds of state health departments and county coroners and medical examiners. Together they represent data from states and counties that accounted for 76 percent of overdose deaths in 2015. They are a first look at the extent of the drug overdose epidemic last year, a detailed accounting of a modern plague.

The initial data points to large increases in drug overdose deaths in states along the East Coast, particularly Maryland, Florida, Pennsylvania and Maine. In Ohio, which filed a lawsuit last week accusing five drug companies of abetting the opioid epidemic, we estimate overdose deaths increased by more than 25 percent in 2016.

“Heroin is the devil’s drug, man. It is,” Cliff Parker said, sitting on a bench in Grace Park in Akron. Mr. Parker, 24, graduated from high school not too far from here, in nearby Copley, where he was a multisport athlete. In his senior year, he was a varsity wrestler and earned a scholarship to the University of Akron. Like his friends and teammates, he started using prescription painkillers at parties. It was fun, he said. By the time it stopped being fun, it was too late. Pills soon turned to heroin, and his life began slipping away from him.

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Mr. Parker’s story is familiar in the Akron area. From a distance, it would be easy to paint Akron — “Rubber Capital of the World” — as a stereotypical example of Rust Belt decay. But that’s far from a complete picture. While manufacturing jobs have declined and the recovery from the 2008 recession has been slow, unemployment in Summit County, where Akron sits, is roughly in line with the United States as a whole. The Goodyear factories have been retooled into technology centers for research and polymer science. The city has begun to rebuild. But deaths from drug overdose here have skyrocketed.

In 2016, Summit County had 312 drug deaths, according to Gary Guenther, the county medical examiner’s chief investigator — a 46 percent increase from 2015 and more than triple the 99 cases that went through the medical examiner’s office just two years before. There were so many last year, Mr. Guenther said, that on three separate occasions the county had to request refrigerated trailers to store the bodies because they’d run out of space in the morgue.

It’s not unique to Akron. Coroners’ offices throughout the state are being overwhelmed.

 

Drug overdose deaths in six Ohio counties, 2010 to 2017
’10’1720040060011130Warren Co.Warren Co.
’10’1761268ButlerButler
’10’1775290SummitSummit
’10’17154543HamiltonHamilton
’10’17267775CuyahogaCuyahoga
’10’17127800MontgomeryMontgomery
Totals for 2017 assume that overdose deaths continue at the same rate through the remainder of the year.Source: Butler County Coroner’s Office; Cuyahoga County Medical Examiner’s Office; Hamilton County Coroner; Montgomery County Alcohol, Drug Addiction & Mental Health Service; Montgomery County Sheriff’s Office; Summit County Department of the Medical Examiner

In some Ohio counties, deaths from heroin have virtually disappeared. Instead, the culprit is fentanyl or one of its many analogues. In Montgomery County, home to Dayton, of the 100 drug overdose deaths recorded in January and February, only three people tested positive for heroin; 99 tested positive for fentanyl or an analogue.

Fentanyl isn’t new. But over the past three years, it has been popping up in drug seizures across the country.

Drug seizures containing fentanyl
’01’02’03’04’05’06’07’08’09’10’11’12’13’14’15’165,00010,00015,00020,00025,00030,000A 2006 spike was tracedto a single lab in MexicoFentanyl reportsdoubled in 2016
Source: D.E.A. National Forensic Laboratory Information System

Most of the time, it’s sold on the street as heroin, or drug traffickers use it to make cheap counterfeit prescription opioids. Fentanyls are showing up in cocaine as well, contributing to an increase in cocaine-related overdoses.

The most deadly of the fentanyl analogues is carfentanil, an elephant tranquilizer 5,000 times stronger than heroin. An amount smaller than a few grains of salt can be a lethal dose.

“July 5th, 2016 — that’s the day carfentanilhit the streets of Akron,” said Capt. Michael Shearer, the commander of the Narcotics Unit for the Akron Police Department. On that day, 17 people overdosed and one person died in a span of nine hours. Over the next six months, the county medical examiner recorded 140 overdose deaths of people testing positive for carfentanil. Just three years earlier, there were fewer than a hundred drug overdose deaths of any kind for the entire year.

This exponential growth in overdose deaths in 2016 didn’t extend to all parts of the country. In some states in the western half of the U.S., our data suggests deaths may have leveled off or even declined. According to Dr. Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, and an expert in heroin use in the United States, this geographic variation may reflect a historical divide in the nation’s heroin market between the powdered heroin generally found east of the Mississippi River and the Mexican black tar heroin found to the west.

This divide may have kept deaths down in the West for now, but according to Dr. Ciccarone, there is little evidence of differences in the severity of opioid addiction or heroin use. If drug traffickers begin to shift production and distribution in the West from black tar to powdered heroin in large quantities, fentanyl will most likely come along with it, and deaths will rise.

 

Drug overdose deaths in Philadelphia and San Francisco
Drug overdose deaths since 1980 have surged in Philadelphia despite a shrinking population; most heroin there is powdered. They have remained relatively flat in San Francisco, where most heroin is black tar.
1980’85’90’95’00’05’10’15100200300400500San FranciscoSan FranciscoPhiladelphiaPhiladelphia
Source: C.D.C. WONDER

First responders are finding that, with fentanyl and carfentanil, the overdoses can be so severe that multiple doses of naloxone — the anti-overdose medication that often goes by the brand name Narcan — are needed to pull people out. In Warren County in Ohio, Doyle Burke, the chief investigator at the county coroner’s office, has been watching the number of drug deaths rise as the effectiveness of Narcan falls. “E.M.S. crews are hitting them with 12, 13, 14 hits of Narcan with no effect,” said Mr. Burke, likening a shot of Narcan to “a squirt gun in a house fire.”

Early data from 2017 suggests that drug overdose deaths will continue to rise this year. It’s the only aspect of American health, said Dr. Tom Frieden, the former director of the C.D.C., that is getting significantly worse. Over two million Americans are estimated to be dependent on opioids, and an additional 95 million used prescription painkillers in the past year — more than used tobacco. “This epidemic, it’s got no face,” said Chris Eisele, the president of the Warren County Fire Chiefs’ Association and fire chief of Deerfield Township. The Narcotics Anonymous meetings here are populated by lawyers, accountants, young adults and teenagers who described comfortable middle-class upbringings.

Back in Akron, Mr. Parker has been clean for seven months, though he is still living on the streets. The ground of the park is littered with discarded needles, and many among the homeless here are current or former heroin users. Like most recovering from addiction, Mr. Parker needed several tries to get clean — six, by his count. The severity of opioid withdrawal means users rarely get clean unless they are determined and have treatment readily available. “No one wants their family to find them face down with a needle in their arm,” Mr. Parker said. “But no one stops until they’re ready.”

About the data

Our count of drug overdoses for 2016 is an estimate. A precise number of drug overdose deaths will not be available until December.

As the chief of the Mortality Statistics Branch of the National Center for Health Statistics at the C.D.C., Robert Anderson oversees the collection and codification of the nation’s mortality data. He noted that toxicology results, which are necessary to assign a cause of death, can take three to six months or longer. “It’s frustrating, because we really do want to track this stuff,” he said, describing how timely data on cause of death would let public health workers allocate resources in the right places.

 

To come up with our count, we contacted state health departments in all 50 states, in addition to the District of Columbia, asking for their statistics on drug overdose deaths among residents. In states that didn’t have numbers available, we turned to county medical examiners and coroners’ offices. In some cases, partial results were extrapolated through the end of the year to get estimates for 2016.

While noting the difficulty of making predictions, Mr. Anderson reviewed The Times’s estimates and said they seemed reasonable. The overdose death rate reported by the N.C.H.S. provisional estimates for the first half of 2016 would imply a total of 59,779 overdose deaths, if the death rate remains flat through the second half of the year. Based on our reporting, we believe this rate increased.

 

While the process in each state varies slightly, death certificates are usually first filled out by a coroner, medical examiner or attending physician. These death certificates are then collected by state health departments and sent to the N.C.H.S., which assigns what’s called an ICD-10 code to each death. This code specifies the underlying cause of death, and it’s what determines whether a death is classified as a drug overdose.

Sometimes, the cases are straightforward; other times, it’s not so easy. The people in charge of coding each death — called nosologists — have to differentiate between deaths due to drug overdose and those due to the long-term effects of drug abuse, which get a different code. (There were 2,573 such deaths in 2015.) When alcohol and drugs are both present, they must specify which of the two was the underlying cause. If it’s alcohol, it’s not a “drug overdose” under the commonly used definition. Ideally, every medical examiner, coroner and attending physician would fill out death certificates with perfect consistency, but there are often variations from jurisdiction to jurisdiction that can introduce inconsistencies to the data.

These inconsistencies are part of the reason there is a delay in drug death reporting, and among the reasons we can still only estimate the number of drug overdoses in 2016. Since we compiled our data from state health departments and county coroners and medical examiners directly, the deaths have not yet been assigned ICD-10 codes by the N.C.H.S. — that is, the official underlying cause of death has not yet been categorized. In addition, the mortality data in official statistics focuses on deaths among residents. But county coroners typically count up whichever deaths come through their office, regardless of residency. When there were large discrepancies between the 2015 counts from the C.D.C. and the state or county, we used the percent change from 2015 to calculate our 2016 estimate.

We can say with confidence that drug deaths rose a great deal in 2016, but it is hard to say precisely how many died or in which places drug deaths rose most steeply. Because of the delay associated with toxicology reports and inconsistencies in the reported data, our exact estimate — 62,497 total drug overdose deaths — could vary from the true number by several thousand.

Prescription painkiller tramadol ‘claiming more lives than any other drug’


For many, when given a prescription the assumption is that the drug they’re taking is safe. In the case of prescription painkiller Tramadol, however, that could hardly be further from the truth.

In fact, according to some experts, it may be claiming more lives than any other drug – including cocaine and heroine.

For instance, last year Tramadol was responsible for 33 deaths in Northern Ireland – including both a 16-year-old girl and a pensioner in his 70’s.

Tramadol is just one of many opiate-based painkillers on the market, and is illegal without a prescription. Like many other opiates, however, it’s easy for people to get hooked, and it’s becoming more widely available on the black market.

Rule-makers around the world are worried about what may happen as Tramadol becomes more widely available. Having seen the opiate crisis in the United States and elsewhere, it seems with good reason.

“I don’t think that people realise how potentially risky taking tramadol is.

I think it’s because it’s a prescription drug – people assume it’s safe.” – PROFESSOR JACK CRANE, STATE PATHOLOGIST FOR NI

The opiate-based drug used to treat moderate or severe pain should only be available on prescription – it was reclassified in 2014 making it an illegal Class C drug without prescription.

But anti-drug campaigners say more and more people are turning to the black market.

Professor Jack Crane has spoken out to say he fears more people will die unless urgent action is taken and he is calling for a crackdown on the illegal market.

He wants tramadol to be upgraded again, this time to Class A.

Professor Crane is now set to meet Northern Ireland’s Chief Medical Officer later this month to push for change.

 

Mobile phone addiction ruining relationships


Not for nothing is a popular mobile phone brand nicknamed the Crackberry.

Andy Puddicombe, founder of meditation app Headspace says: 'The constant demands of alerts, notifications and social networks can leave us feeling worn out'.

Andy Puddicombe, founder of meditation app Headspace says: ‘The constant demands of alerts, notifications and social networks can leave us feeling worn out’

Researchers have found that constantly checking for messages is an addiction which like other drugs can ruin your personal relationships.

 

The survey shows that young adults spend up to seven hours a day interacting with communication technology and their behaviour can spill over into a problem.

For some it can become a compulsion and others feel feelings of withdrawal when they are not with their phone.

 

It is also extremely annoying to those around them.

Is your phone ruining your relationships?
Yes, I’m hopelessly addicted and I know it annoys my friends and familyNo, as long as you have manners this isn’t a problem
 Dr James Roberts, of Baylor’s Hankamer School of Business, in Texas, said that the “instant messaging” addiction was driven by “materialism and impulsiveness”.

“Mobile phones are a part of our consumer culture,” Dr Roberts said.

“They are not just a consumer tool, but are used as a status symbol. They’re also eroding our personal relationships.”

He said getting hooked on a mobile is similar to other addictions, such as compulsive buying and credit card misuse.

The study is the first to investigate the role materialism plays in mobile phone addiction and the researchers say it is an important consumer value that impacts many decisions shoppers make.

The researchers believe mobile phone use has become so common, it is important to have a better understanding of what drives these types of technological addictions.

Previous studies have revealed young adults, aged 18 to 29, send on average 109.5 texts a day, or approximately 3,200 messages a month.

They receive an additional 113 texts and check their phones 60 times in a typical day and students spend about seven hours a day interacting with information and communication technology.

The study for the Journal of Behavioural Addictions used data from 191 business students and two universities, as mobiles are used by about 90 per cent of students – “serving more than just a utilitarian purpose”, Dr Roberts said.

Mobiles are accessible at any time – including during class – and their functions are forever expanding, making their use or overuse more likely.

And the, researchers say a majority of youngsters claim losing their phone would be “disastrous to their social lives”.

Dr Roberts said: “At first glance, one might have the tendency to dismiss such aberrant mobile phone use as merely youthful nonsense – a passing fad.

“But an emerging body of literature has given increasing credence to cell phone addiction and similar behavioural addictions.”

The addiction has even been given a name – Nomophobia is the term created by British researchers in 2008 to identify people who experience anxiety when they have no access to mobile technology.

A previous study showed that young people are now so addicted to their mobile phones it feels like they have lost a limb when they are without them.

Some said they felt so bereft without their iPhone or Blackberry that it evokes similar feelings to the “phantom limb” syndrome suffered by amputees.

The findings, by the University of Maryland, show the growing reliance that the younger generation has on technology and how it has become central to their lives.

Mobile addict parents guilty of child ‘neglect’ warns psychologist


Parents who constantly fiddle with mobile phones or iPads in front of their children are guilty of “benign neglect” and risk driving them to a lifelong dependency on screens, a leading psychologist has warned.

Limiting your child’s screen use

A generation of young people is growing up with a virtual addiction to computers, televisions and smartphones with striking similarities to alcoholism, according to Dr Aric Sigman.

By the time they turn seven, children born today will have spent the equivalent of an entire year of their lives watching some form of small screen, he told an audience of doctors.

The effect could be long-term changes to children’s brain circuitry similar to those in other forms of dependency, he said.

He told the Royal College of Paediatrics and Child Health annual conference in Glasgow that parents need to “regain control” of their households.

He said: “Passive parenting’ in the face of the new media environment is a form of benign neglect and not in the best interests of children. Parents must regain control of their own households.

Last month a Europe-wide report called for nurseries to ban televisions and called for parents to resist pleas to let children have them in their bedrooms, in a bid to fight obesity among young people.

Dr Sigman, who is both a biologist and an Associate Fellow of the British Psychological Society, drew on research which suggests an association between high levels of screen use and both type two diabetes and cardiovascular disease.

In a presentation on the parallels between screen dependency and alcoholism, he said that on-screen novelty and stimulation caused the release of dopamine, a chemical which plays an important role in the brain’s “reward” system and may be linked to the formation of addictions.

It is estimated that teenagers now spend up to six hours a day in front of some form of small screen.

Children as young as 10 now have access to as many as five different screens at home, often watching two or more at a time, he said in a presentation to the conference and screen dependency.

But parents’ behaviour can play a key role in determining how children will treat technology, he said.

Boys whose parents watch more than four hours a day of television are more than 10 times more likely to develop the same habit as those whose parents do not, he said.

He also singled out parents who maintain high levels of “eye-to-screen contact” at home warning that they are likely to instill similar behaviour in their children

“Technology should be a tool, not a burden or a health risk,” he said.

“Whether children or adults are formally ‘addicted’ to screen technology or not, many of them overuse technology and have developed an unhealthy dependency on it.

“While there are obviously a variety of different factors which may contribute to the development of a dependency – whether it involves substances or activities – the age, frequency, amount of exposure along with the ease of access and the

effects of role modelling and social learning, all strongly increase the risk.

“All of these contribute to a total daily exposure to, or ‘consumption of’, an activity.

“And all are prerequisite factors that contribute to the risk of dependent overuse of technology.”

He called for children under three to have no screen time at all, and no more than an hour a day outside school for those under seven.

Sue Palmer, author of the book Toxic Childhood, said that screens were altering the way children develop basic communication skills.

“Learning to read people’s faces and expressions and body language is absolutely essential in order to develop empathy,” she said.

“The children are simply not getting enough experience of them.”

She said that one midwife had recently told her that it is becoming common for mothers delivering babies to text or post updates to their friends from the delivery room.

“They are not even really present at their children’s births any more,” she said.

The Number of Deadly Heatwaves Will Only Keep Rising, Experts Warn


Majority of the world population could be exposed by 2100.

One of the consequences of a warming planet is more heatwaves, and more heatwaves that are hot enough to kill. Those deadly heatwaves are set to keep growing in number, according to a new study.

Researchers compared projected temperatures with data from past heatwaves and found that a massive 74 percent of the world’s population could be exposed to potentially deadly heatwaves by 2100, if carbon gas emissions continue to rise at the current rates.

If the nations of the world successfully cut back on the amount of carbon getting into the atmosphere, we’re still looking at 48 percent of the people on the planet dealing with heatwaves that can kill in the next 80 years or so, according to the team from the University of Hawaii.

They also put together a web app showing how the situation could get worse as temperatures rise across the globe.

“We are running out of choices for the future,” says lead researcher, Camilo Mora. “For heatwaves, our options are now between bad or terrible.”

“Many people around the world are already paying the ultimate price of heatwaves, and while models suggest that this is likely to continue, it could be much worse if emissions are not considerably reduced.”

For the study, the team combed through 30,000 relevant references in publications from 1980 to 2014 to find information about deadly heatwaves of the past, including the 2003 European heatwave that claimed 70,000 lives and the 2010 Moscow heatwaveresponsible for around 10,000 deaths.

From their data the researchers picked out 783 deadly heatwaves covering 164 cities and 36 countries, using them to identify a temperature and humidity threshold beyond which heatwaves start to become killers.

The threshold varies from place to place, and depends on the way temperature combines with humidity and other factors like wind speeds, but the experts say people have died in temperatures as low as 23°C (73.4°F).

At the moment, about 30 percent of the world’s population gets exposed to heatwaves beyond this threshold for 20 days or more every year, the researchers say, but much worse could be to come.

For humans, our core body temperature needs to be around 37°C (98.6°F), otherwise problems start happening – problems that can be fatal if the body temperature goes much higher.

And it’s the most vulnerable people on the planet who don’t have the shelter or the technology to protect themselves from the heat.

Atmospheric scientist Daniel Mitchell, from the University of Oxford in the UK, wasn’t involved in the research but thinks it leaves out some relevant factors that contribute to mortality rates, such as city design and available medical support.

“There are lots of things that can lead to mortality that have nothing to do with the climate,” he told Kendra Pierre-Louis at Popular Science.

However, Mitchell does agree that the study brings up some necessary points and is “a good step in the right direction”.

According to Camilo Mora we’re going down a path “that will become increasingly dangerous and difficult to reverse” if we don’t start making serious cuts in our production of greenhouse gases.

“Actions like the withdrawal from the Paris agreement is a step in the wrong direction that will inevitably delay fixing a problem for which there is simply no time to waste,” he says.

Source: Nature Climate Change.

With doctors losing respect, perhaps it’s time to expose medicine’s dark side


The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER:

1 a.m.: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s good, he’ll get a cut.”

1:40 a.m.: Patient is making inappropriate sexual comments and is verbally aggressive with medical staff. He is advised to stay in bed.

2:02 a.m.: Patient (who had been sleeping comfortably) wakes up and begins screaming obscenities at everyone. When a nurse asks why he was angry, he says, “What do you think, mother f*****? I will wipe your a**.” Multiple attempts to calm patient fail.

I will stop here, because the insulting language, obscene physical gestures, and eventual threats of physical abuse only become more vulgar and inappropriate. The attending recorded in the chart, word for word, the things that spewed from the patient’s mouth and, eventually, when he became physically aggressive, called the crisis team who came and restrained the patient.  The story was shared with me by one of the residents who had witnessed the entire discourse, and we laughed about the absurdity of some of the drunken babble. We also smiled in speaking about the state of mind of the doc who documented the conversation so meticulously in the chart. She must have just had it with the abuse and decided she was going to permanently record all the nonsense in the EMR.

Photo published for With doctors losing respect, perhaps it's time to expose medicine's dark side

As I sat by myself, thinking about the somewhat comical story, I realized that it really was not funny at all. This is the status quo. Health care professionals deal with patients like the one above every day. The verbal abuse and physical threats are so common that we have settled in to just trying to find some humor in them. This type of abuse is not unique to the health care field, but the difference is that you cannot just stop treating your abuser. You have to make sure he or she gets better. You cannot fire a patient in an ER who would die in the street if you kicked him out. Every doc or nurse has an anecdote in which they have been spit on, urinated on, cursed at, assaulted, or threatened.

In the medical world, we do not talk a lot about this aspect of our training and experience. Incoming residents have no idea that, along with their medical education, they will be getting a pedagogy in dealing with some seriously aggressive personalities. Whether it is a drunk patient in the ED, an angry family member, or the overtly psychotic patient on the psych ward, being on guard becomes second nature.

I remember one resident laughing hysterically as he described an enraged patient using the TV remote as weapon against his caretakers, swinging it in circles like a lasso. Or the time a family member broke into the medical lounge and attempted to physically intimidate a resident into changing a medical plan for a dying patient in the ICU. I have seen female trainees and attendings cat-called, harassed (both physically and verbally), and made to feel unsafe by the people they care for. It is tough to diagnose and treat someone when you cannot put your hands on them without fear of a violation of personal space.

This is medicine. There is so much beauty in the patient-doctor relationship and so much that I could say about the wonderful people whom I have learned from and loved while they were under my care. But, like anything else in life, medicine has a dark side that we rarely discuss with people outside of the field. With an increasing percentage of doctors feeling unappreciated, abused, and depressed, maybe it is time to share the whole story.

Source:http://www.kevinmd.com

Haemophilia and the Contaminated Blood Scandal. 


Following disclosure on Panorama last week of his intention to take legal action against the Department of Health, Jason Evans has been joined immediately by over 120 people who wish to join the proposed group action. They also wish to join with him in his call for a full Public Inquiry into the scandal.

Speaking today Jason Evans said “It is a scandal that whilst it was at David Cameron’s direction that the Leveson Inquiry was put in place to examine the culture, practice and ethics of the press, now in the face of overwhelming evidence presented to Parliament by Andy Burnham last month, Theresa May has still not seen fit to order an Inquiry into the culture, practice and ethics of the Department of Health in dealing with this human tragedy in which many 1000s of people including 100s of children were infected, many fatally, with HIV and Hep C through Factor conentrates”

Des Collins of Collins Solicitors said “The public response has been unprecedented. It is widely thought that the campaign for a Public Inquiry, already supported by Andy Burnham, Dr David Owen, Bianca Jagger and others, will shortly receive the support of all the main opposition parties when manifestos are published over the next few days. This is a wrong which must now be put right. It is essential that lessons are learned from this tragedy so that such disastrous mistakes are not repeated in the future.”

Des Collins
Senior Partner
Collins Solicitors
T) 01923 223 324
dcollins@collinslaw.co.uk

Danielle Holliday
Partner
Collins Solicitors
T) 01923 223 324
dholliday@collinslaw.co.uk

This Toothpaste Can Cause Cancer, Disrupt Thyroid Hormones and Affect Heart Function.


Are you brushing your teeth with poison? Conventional toothpaste is loaded with toxins. Even the warning label on any conventional toothpaste states, “Do not swallow,” and “in case of accidental ingestion, contact the poison control center.” Your mouth is  one of the most absorbent places in your entire body. While you are brushing, the ingredients enter your mouth and gums and making their way into your bloodstream.

10 Reasons to Never Use Conventional Toothpaste Again