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Kandahar Journal: Canadian doctors helping the Afghans lead
In an intensive care unit in Afghanistan’s Armed Forces Academy of Medical Sciences in Kabul lie 10 mangled men.
This is the end of the journey for many ANA soldiers. They arrive here after having stepped in the wrong place or having finally run out of luck at bullet dodging. For most of these young men — in truth, they are barely more than boys — their luck ran out in the last 10 days.
Many are missing limbs, others have been filled by shrapnel. Some have bullet wounds to the head, or other massive concussion trauma. The very fact that they are in ICU means that they are on the edge of death or — with a little help — on the edge of life.
“My role here is what my [Canadian military] mission is, but I am here ‘personally’ because I want to help,” says Lieutenant Commander Vincent Trottier. The same thing could be said of every member of Canada’s Medical contingent here in Afghanistan. They are not here for the money, or the prospects of promotion. They are here because they want to help.
(Illustrations: Richard Johnson/National Post)
Death of the eponym: Naming diseases after doctors is a practice in decline
Alzheimer. Parkinson. Hodgkin. The doctors themselves may have drifted into mainstream obscurity, but their names live on in medical textbooks, journals and obituaries around the world. Nevertheless, amid charges that medical eponyms are stodgy and outdated, there is a movement among modern doctors to eliminate eponyms from medical literature. But as doctors eschew the clunky and confusing names of the past in favour of more descriptive nomenclature, they may be taking some of medicine’s mystique with it.
There are definitely problems with eponyms. Look no further than Down syndrome. The 19th-century doctor John Langdon Down did not discover the famed genetic disorder, but he did assign it the name “mongolism.” In the 1960s, to purge medical journals of what was now an embarrassingly racist term (Down thought sufferers bore some resemblance to Mongols), researchers instead opted for an eponym — and falsely gave credit to Down. “It’s an example of everything that’s wrong with eponyms,” said Canadian medical historian Dr. Jacalyn Duffin. Doctors were trying to avoid a pejorative term and credit a founder, but they ended up doing “none of the above,” she says.
The selling of OxyContin
While opioids had long been reserved primarily for terminal cancer patients, ads in medical journals touted OxyContin — with up to twice the potency of morphine — as a safer alternative to even Aspirin and Tylenol and good for anyone who needed pain relief for “several days” or more.
It was not long before OxyContin was being widely prescribed in the Vancouver area, notes Dr. Thomas Perry, a local physician-pharmacologist, in an affidavit filed in a Nova Scoita class-action lawsuit against Purdue. Sales accelerated across the country, soaring from $3-million in 1998 to $243-million last year, according to IMS-Brogan, which tracks drug trends.
“The biggest surprise for us in Canada at the time was how fast it took off,” said Dwain May, a former Purdue executive in Alberta.
“This campaign was amazingly successful,” said Dr. Mel Kahan, a University of Toronto addiction expert. “It was probably the most successful marketing campaign in history as far as I know for any class of drug.”
What happened next is now common knowledge, though the full extent of the “Hillbilly heroin’s” dark side has only recently become apparent. Addiction to the “low-abuse” drug — and other, similar opioid painkillers — has reached near-epidemic proportions, with 140 people a year in Ontario alone dying from overdoses related to the drug, more than are killed in drowning mishaps, according to the province’s coroner. Victims include street users, people taking what their doctor prescribed and those getting OxyContin from both legal and underground sources. (Photo: Jeff Siner/Chartlotte Observer)
More doctors prescribing placebos to unwitting patients
The practice is discouraged by major medical groups, considered unethical by many doctors and with uncertain benefit, but one in five Canadian physicians prescribes or hands out some kind of placebo to their often-unknowing patients, a new study suggests.
The seemingly widespread use of sugar pills and other inactive treatments identified by the survey highlights a mounting debate over the issue, with some experts arguing that placebos should be accepted as a legitimate — and side-effect-free — alternative to drugs.
Others say giving patients harmless but chemically inert treatments — especially when disguised as something else — cannot be justified until there is better-quality research proving they actually help.
“Doctors went to medical school to give out pills, to do procedures, to do surgeries,” said Dr. Kaptchuk. “Telling them to actually show their colours — to admit that a lot of what they do is actually what a shaman does — is very disconcerting.” (Photo illustration by Steve Murray)
