• Home page of novelist William S. Frankl, M.D.
  • About author William S. Frankl, M.D.
  • Books by novelist William S. Frankl, M.D.
  • Reviews of the writing of author William S. Frankl, M.D.
  • Blog of author William (Bill) S. Frankl, M.D.
  • Contact author William S. Frankl, M.D.
Title: Blog by Novelist William S. Frankl, MD

Travel Ban is Revealing ––––but Does Not Threaten American Medicine

February 12th, 2017

This essay is a response to the hand wringing of many academic and corporate medical workers lamenting the potential effect of the recent travel ban, which was blocked in a most absurd and unconstitutional manner by           a 3-judge panel of the 9th circuit court of appeals.

 

Travel Ban is Revealing ––––but Does Not Threaten American Medicine

 

Jane Orient, M.D.

2/9/2017

 

A 90-day ban on travel from seven countries has sparked tremendous outpourings of “worry” or outright opposition by some 33 medical organizations.

 

“The community is reeling over the order, fearing that it will have devastating repercussions for research and advances in science and medicine,” states an article in Modern Healthcare.

 

Certainly the order is disrupting the lives of individual physicians who have won coveted positions in American medical institutions and were not already in the U.S. when the order was issued. Also their employers have a gap in the work schedule to fill. War tears people’s lives apart, however innocent they may be. And countries that sponsor terrorism have effectively declared war on the U.S.

 

But is American medicine so fragile that it can’t survive a 90-day delay in the arrival of physicians, most of them trainees, from Iran, Iraq, Libya, Syria, Yemen, Somalia, and Sudan? After all, every year more than a thousand seniors in U.S. medical schools do not land a position in a post-graduate training program through the annual computerized “Match” of graduates with internships. After another chance through the Supplemental Offer and Acceptance Program, or SOAP, hundreds of seniors are still without a job. This means that they cannot get a license to practice in the U.S., however desperate rural communities or inner-city hospitals are to find a physician, and their four years of rigorous, costly post-college education are wasted. Yet James Madara, CEO of the American Medical Association (AMA), is worried about vacant residency slots, according to a Feb 3 article in MedScape by Robert Lowes.

Entry to medical school is highly competitive, so presumably all the students are well-qualified. Can it be that graduates from Sudan are better trained? Does the U.S. have so few young people capable of and interested in a medical career that we have to depend on a brain drain from countries that are themselves desperately short of physicians?

 

For all the emphasis on “cultural competence” in American medical schools, and onerous regulations regarding interpreters for non-English speakers, what about familiarity with American culture and ability to communicate effectively with American English speakers? Some foreign-born graduates are doubtless excellent, but many American patients do complain about a communication gap. So why do some big institutions seem to prefer foreigners? Could it be that they want cheap, and above all compliant labor? Physicians here on an employment-related visa dare not object to hospital policy.

 

Whatever the reasons for them, here are some facts about the American medical work force:

  • One-fourth of practicing physicians in this country are international medical graduates (IMGs), who are more likely to work in underserved areas, especially in primary care, according to Madara.
  • According to the Accreditation Council for Graduate Medical Education (ACGME), 10,000 IMGs licensed in the United States graduated from medical schools in the seven countries affected by the ban.
  • Immigrants account for 28% of U.S. physicians and surgeons, 40% of medical scientists in manufacturing research and development, and 15% of registered nurses, according to the Institute for Immigration Research at George Mason University. More than 60,000 of the 14 million workers in health-related fields were from the seven countries affected by the ban.

Is medicine, like agriculture, now filled with “jobs that Americans won’t do”? Actually, we have more than enough Americans who love medical work. But some of best doctors are being driven out by endless bureaucratic requirements, including costly “Maintenance of Certification™” programs that line the pockets of self-accredited “experts” but contribute nothing to patient care. They are being replaced (substituted for) by “mid-levels” with far less training. Then there are thousands of independent physicians having to retire or become employees because they can’t afford the regulatory requirements—soon to be greatly worsened by MACRA, the new Medicare payment system. Physician “burnout” is becoming so bad that we lose up to 400 physicians—the equivalent of a large medical school class—to suicide every year.

 

The U.S. should be a beacon to attract the best and brightest, and it should welcome those who want to become Americans. Unfortunately, the lives of Americans, as well as the opportunities of aspiring foreign-born doctors, are threatened by those who desire to kill Americans and destroy our culture. These must be screened out.

Meanwhile, the reaction of organized medical groups to the travel ban is spotlighting serious problems in American medicine.

 

 

Jane M. Orient, M.D.obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989.  Dr. Orient is the 2017 recipient of The Edward Annis award for medical leadership.

Angle for Anglo-Saxon, or Enlighten with Latin?

February 6th, 2017

For those who read my blog and who are writers, this short article should be quite helpful. Sent to me by my good friend, Stephen Dubel.

http://www.dailywritingtips.com/should-you-angle-for-anglo-saxon-or-enlighten-with-latin/

Should You Angle for Anglo-Saxon, or Enlighten with Latin?

By Mark Nichol

Arguments for and against favoring Latinate words over Germanic ones, or vice versa (or, if you prefer a non-Latinate phrase, the other way around), have been heard over the years. What’s best? How about the status quo?

The vocabulary of Modern English is the result of a unique admixture of words (and phrases) from a variety of languages. But only about one-fourth derive directly from Old English, or Anglo-Saxon, and other Germanic languages. More than that come from Latin — and Latin’s progeny (mostly Spanish and French) account for as many more words. Admittedly, many Latin words are used primarily in legal, scientific, and medical contexts, whereas Germanic words tend to be more practical for everyday life, but the Latinate contribution is still predominant over native words, and the language is richer for the widespread borrowings.

Given the choice between words from the Germanic root and those of Latin origin, which should one choose? How about one or the other, on an ad hoc basis, or as your mood strikes you? Various movements have attempted to eradicate non-Germanic vocabulary from the English word-hoard, or at least minimize it, but these absurd endeavors, which have sometimes included efforts to create or calque (translate) new words, have been prompted by nationalism, not by any sensible motive.

To communicate plainly, Germanic words, which tend to be shorter, are often preferable, but the Latinate pain, for example, is as simple as the Germanic ache, and Germanic anger and wrath are slightly more complicated than ire and rage, both of which are of Latin provenance but could easily be misidentified as Germanic words.

If you do want to introduce more Germanic words into your writing, it’s easy, for instance, to target classes of words with specific suffixes: For example, words that end in the Latinate suffix -age have more concise synonyms: Think of advantage (gain), marriage (wedlock), savage (wild), and voyage (trip). But where would we be without parentage? “Mother and father” may be more concrete, but the Latinate term is more concise, more precise, and more flexible when it comes to nontraditional families.

For another example, words ending in -ity are often more complicated; why not, for example, write selfhood instead of identity? Unfortunately, identity often refers to a collective, rather than individual, impression. (And often, when one considers alternatives for Latinate words, the first synonym that comes to mind is non-Germanic, too: Quick, what’s another word for fidelity? Loyalty? That’s from French. Allegiance? French.) For yet another example, though words ending in -ology are of Latin origin, there’s no suitable Germanic equivalent for the suffix.

Ultimately, word choice depends on various factors, but the ground a word sprang up in shouldn’t be one of them.


You received this message because you are subscribed to the Google Groups “SJDubelGroup” group.

EXTINCTION

January 27th, 2017

A most interesting article attempting to explain the destruction of the dinosaurs. If correct, we better hurry up and build all those space ships necessary to get us out of here soon, or in the far future, when the next asteroid comes our way.

Lights Out:Asteroid Triggered Freezing Darkness That Killed       Dinos
By:Laura Geggel, Senior Writer
1/20/17
The study was published online Jan. 13 in the journal Geophysical Research Letters. Original article on Live Science.
When a giant asteroid careened into Earth about 66 million years ago, the enormous collision led to the formation of an airborne “curtain” of sulfate molecules that blocked the sun’s light and led to years of freezing cold and darkness, a new study finds.

The finding shows how these droplets, or aerosols, of sulfuric acid formed high in the atmosphere, and likely contributed to the deaths of 75 percent of all animals on Earth, including nonavian dinosaurs such as Tyrannosaurus rex and long-necked sauropods, the researchers said.
Earlier studies suggested that the dino-killing asteroid kicked up dust and debris that hung in the air and blocked sunlight in the short term. But by using computer simulations, the researchers of the new study showed how droplets of sulfuric acid contributed to long-term cooling. [Wipe Out: History’s Most Mysterious Extinctions]

Moreover, the sudden, drastic drop in temperature likely caused the surface of the oceans to cool, which would have massively disturbed the marine ecosystems, the researchers said.
“The big chill following the impact of the asteroid that formed the Chicxulub crater in Mexico is a turning point in Earth history,” the study’s lead researcher Julia Brugger, a climate scientist at the Potsdam Institute for Climate Impact Research (PIK) in Germany, said in a statement. “We can now contribute new insights for understanding the much debated ultimate cause for the demise of the dinosaurs at the end of the Cretaceous era.”
Brugger and her colleagues employed a type of computer simulation typically used for climate modeling. The model showed that gases containing sulfur evaporated during the violent impact. These sulfuric molecules were the main ingredients that blocked the sun’s light on Earth and led to plummeting temperatures, they said.

For instance, before the asteroid hit, the tropics were an average temperature of 81 degrees Fahrenheit (27 degrees Celsius). But after the massive impact, the average temperature was 41 F (5 C), the researchers said,”It became cold, I mean, really cold,” Brugger said. Globally, temperatures fell at least 47 F (26 C). For at least three years following the asteroid’s crash, the average annual temperature fell below freezing, and the polar ice caps grew in size.

“The long-term cooling caused by the sulfate aerosols was much more important for the mass extinction than the dust that stays in the atmosphere for only a relatively short time,” study co-researcher Georg Feulner, a climate scientist at PIK, said in the statement. “It was also more important than local events like the extreme heat close to the impact, wildfires or tsunamis.”

In all, it took 30 years for Earth’s climate to recover, the researchers said.
As the air cooled, so did the ocean’s surface waters. This cold water became denser and thus heavier, and sank into the depths of the ocean. Meanwhile, warmer water from the deeper ocean rose, bringing up nutrients that likely led to giant algal blooms, the researchers said.
It’s possible these algal blooms produced toxic substances that affected life along the coasts, the researchers said. But regardless of whether they were toxic or not, the ocean’s massive mixing would have disrupted the marine ecosystem, and likely contributed to the extinction of its species, including the ammonites and the reptilian sea beasts known as plesiosaurs.

The new research illustrates what might happen to Earth if another asteroid were to cross its path, the researchers said.“It is fascinating to see how evolution is partly driven by an accident like an asteroid’s impact — mass extinctions show that life on Earth is vulnerable,” Feulner said. “It also illustrates how important the climate is for all life-forms on our planet. Ironically today, the most immediate threat is not from natural cooling but from human-made global warming.”

Starr/Hayflick/ImmortalityorDeath

January 17th, 2017

The following is a most interesting article about aging, immortality, and what the future might hold for humanity. It’s a must read.

THE HUFFINGTON POST

01/13/2017

On the Verge of Immortality, Or Are We Stuck with Death? A New Direction For Research Could Provide the Answers—and More

Bernard Starr, PhD
LeonardHayflick, PhD

How long can human beings live? Is there an outside limit? Do we know enough about aging to break through possible biological barriers? Is the current approach to curing “age associated diseases” like Alzheimer’s flawed? Experts are sharply divided.

In 1962 eminent biologist Leonard Hayflick discovered that normal human fetal cells replicate a limited number of times. This phenomenon promptly acquired the moniker the “Hayflick Limit.” Later, biologists Calvin Harley and Carol Greider provided the molecular explanation for the Hayflick limit with their discovery that telomeres, the DNA biological material in every cell of our bodies, diminish each time cells divide.

In contrast, cancer cells, which are immortal, produce an enzyme called telomerase that maintains the length of telomeres and enables cancer cells to replicate without limit. The strategy of extending the life of normal cells by injecting telomerase has proven thorny, as reported by Dr. Elizabeth Blackburn, co-discoverer of telomerase: “too much telomerase can help confer immortality onto cancer cells and actually increase the likelihood of cancer, whereas too little telomerase can also increase cancer by depleting the healthy regenerative potential of the body..telomerase shots are not the magical anti-aging potion….”

The finite capacity of normal human fetal cells to divide (on average about 50 times) suggested to Hayflick that aging is responsible for the end of normal cell replication and eventually death. Other researchers translated Hayflick’s findings into a maximum human lifespan of 120 years.

A 2016 study at the Albert Einstein School of Medicine came up with a similar human lifespan limit of 115 years. The investigators drew their conclusion from surveys of longevity and mortality records in more than forty countries since 1900. While their findings showed an impressive increase in the number of people living beyond age 100 in recent decades, rarely did centenarians live longer than 115 years. One exception, Frenchwoman Jeanne Calment, died at age 122. She was a media sensation because she exceeded the traditional limit for longevity.

The dramatic increase in life expectancy from 18 years (at birth) in prehistoric times to an average of 79 in the U.S. today (and 1-4 years longer in more than 25 other countries) is not due to breakthroughs in our understanding of the biology of aging. Rather, it’s been achieved through the reduction in infant mortality, public health measures such as clean water, improved sanitation, better nutrition, healthy life styles, and the remarkable boost when antibiotics and vaccines were introduced.

But is the Hayflick Limit fixed, or is it a biological barrier that can be penetrated? Opinions vary.

At one extreme, Cambridge University trained Dr. Aubrey de Grey, Chief Science Officer of the SENS Research Foundation for the study of aging claims that emerging breakthroughs in the biology of aging have brought human lifespan to the verge of vastly extended longevity—and perhaps immortality. The first person to live to 1,000 years is likely walking the earth right now, he declares.

I met Aubrey de Grey several years ago at a screening of the film To Age or Not To Age, sponsored by the International Longevity Center. He was one of the researchers featured in the documentary. Afterwards I approached him with a question.

“Do you think civilization is ready for immortality?” I asked, since immortality has obvious implications for the social, economic, and political functioning of society.

De Grey didn’t like my question. He immediately launched into a lengthy rant. “Do you know how many people die each day and that it’s not necessary,” he remarked. “We have the means and knowledge…” I quickly realized that de Grey champions another version of right to life. So sure is he that death is not inevitable that he recoils at the idea that we dare think otherwise.

Dr. Leonard Hayflick takes a strong stand against De Grey’s position on life extension. And he has little respect for those touting “cures for aging.” The “fountain of youth” business, he says, is the first or second oldest profession.

What does Hayflick think of the work of MIT biologist Dr. Leonard Guarente I wanted to know. In 2016 Guarente generated a lot of fanfare when his newly formed company, Elysium, introduced a nutritional supplement called Basis. The main ingredient of Basis, nicotinamide riboside (NR), raises the body’s levels of nicotinamide adenine dinucleotide (NAD), which in turn, Guarente claims, can slow the aging process by boosting mitochondria, the energy dynamo of cells that diminishes with age. While Guarente’s Basis and anti-aging products of other companies may improve some aspects of bodily functioning, do they put the brakes on aging? Hayflick is doubtful if not dismissive of that notion.

I interviewed Dr. Hayflick on the telephone on October 27th and 29th 2016. He spoke from his home in Northern California. The strength of his voice, not to mention his convictions, belie his eighty-eight years. And he anticipates many productive years ahead, based on the principle that the best way to insure longevity is to pick your parents carefully. His mother lived to 106.

While he agrees that biology plays a role in longevity, Hayflick rejects claims that a genetic aging code is about to be broken, thus opening the floodgates for unlimited lifespans. In stark contrast to those who argue that researchers have accumulated a trove of knowledge about aging, Hayflick insists that “We know very little if not zero about the fundamental cause of aging.”

He emphasizes that all the advances in average life expectancy that have been derived from prevention and cures for diseases have not told us anything about the fundamental etiology of aging. “We do not know why cells age,” Hayflick told me. And until we expand our knowledge of the fundamental cause of aging he does not foresee significantly extending average life expectancy; he is even less hopeful about extending human lifespan beyond the current limit.

Hayflick says that if cures are miraculously found for the leading causes of death, that will add about 13 years to average life expectancy. But, he points out, those cures will not increase the lifespan beyond the current limit. He warns: “People will continue to die as a result of aging.” The explanation for why they are dying, he insists, will only be found by unraveling the mystery of the cause of molecular and cellular aging.

“How likely is that to happen?” I asked him. “Very unlikely,” he admitted. Hayflick laments that two to three percent at most of the $1.27 billion that the National Institute of Aging (NIA) spends annually on aging research is allocated to fundamental biological research. That’s why “little work is being done on the basic understanding of aging—not only in this country but worldwide.”

According to Transparency Market Research, the anti-aging market is projected to reach $91.7 billion globally by 2019. Most of that money will be for anti-aging products and services with possibly only a tiny percentage for basic biological research.

Dr. Jan Vijg, Chair in Molecular Genetics at the Albert Einstein School of Medicine in New York City, and a lead researcher on the recent longevity study, confirmed in an interview on November 16, 2016, that a miniscule amount of funding goes to basic biological research, where many of the questions about aging are more likely to find answers. Vijg agrees with Hayflick about the dearth of knowledge about cellular aging. He says we know a lot about factors such as genomes (the DNA of genes) that affect cellular senescence but the question of why cells age remains largely unanswered.

On the positive side, Vijg notes that scientists in the field of aging are increasingly focusing on the biology of aging, not just the cure of diseases. He told me that he has recently applied for a large grant for the study of drugs that target aging rather than specific diseases. Hayflick, he acknowledges, “was the original defender of this position to study aging per se and now he’s been proven correct.”

If that direction is endorsed by a growing consensus of scientists, why the dearth of funding, I asked?

Dr. Vijg points to an entrenched establishment driven by the public, special interests, and lobbyists who want immediate results. People accept aging and death as natural facts of life, Vijg says, but they don’t accept diseases as natural and thus they want cures for them. Basic research may seem abstract and remote. Few laypeople grasp that unraveling the underlying biology of aging could produce faster and more successful results.

Token funding for basic research on the biology of aging makes no sense, Hayflick argues, when it’s clear that aging is the condition that increases vulnerability to age-associated diseases. Physicians and other experts on aging talk glibly, he says, about age-associated diseases such as cancer, cardiovascular, Alzheimer’s, and other illnesses for which the elderly are at greater risk. And then they immediately utter the mantra that the greatest risk factor for age-associated diseases is aging. “But,” he adds, “they never ask themselves why all these major causes of death are occurring in older people.” If you try to answer that question logically, he continues, “you come to the conclusion that there must be something in old cells that provides the milieu or the opportunity for age-associated diseases that does not occur in young cells.” Isn’t it therefore highly probable, he conjectures, that “old cells may provide the condition that allows for the emergence of all age-associated diseases?”

If Hayflick’s analysis is correct, shouldn’t a significant part of the fifty percent of the NIA budget for aging research, which Hayflick says is designated for the treatment and cure of Alzheimer’s (Vijg estimates an even higher percentage), be shifted to research on molecular and cellular aging, where a cure may be found?

Hayflick gets emotional in his frustration that researchers are not aggressively pursuing a strategy to understand why old cells are different from young cells: “Why in the hell aren’t we studying the fundamental biology of aging if that is the major risk factor for age-associated diseases? Why are we ignoring it almost 100 percent?”

While unlocking the keys to cellular aging might enable vast numbers of people to live closer to the limit of life expectancy, Hayflick still cautions that it will not extend lifespan beyond its current limit. What then does he say about the limit? Is it fixed or can it be extended. And if it is possible to increase it, by how much?

Here Hayflick’s analysis turns to an overarching law of nature. He explains that cells, like all things animate and inanimate, are subject to the second law of thermodynamics, which states that energy dissipates or spreads out when not constrained. Applied to aging, this means that entropy (energy dissipation) increases over time—and the increase in entropy forecasts the inevitability of death. Sounds pessimistic, but is that the end of the story? Maybe not.

Vijg acknowledges entropy as a limiting factor, but he believes it could be slowed if we had a better understanding of entropy at the cellular level. He also expresses great faith in science and therefore will not rule out future discoveries that could lead to a significant increase in human lifespan. Hayflick as well will not bet against science, but he adds this stern caveat: “First we must invest substantially in the study of the basic biology of aging.”

Note: The first and second laws of thermodynamics were introduced by Rudolf Clausius and William Thomson around 1850.

Bernard Starr,PhD, is Professor Emeritus at the City University of New York (Brooklyn College), where he directed a graduate program in gerontology. He is founder and editor of a number of publications in the field of aging: The Springer Publishing Company Series on Adulthood and Aging, the Springer Series on Lifestyles and Issues in Aging, and the cutting edge Annual Review of Gerontology and Geriatrics. For seven years he was writer, producer and host of an award winning radio commentary, The Longevity Report, on WEVD-AM Radio in NYC. During the same period— for three years—he wrote op-ed articles for the Scripps Howard News Service on healthcare, the “boomers,” and issues of an aging society.
Follow Bernard Starr on Twitter: www.twitter.com/starrprobe

Leonard Hayflick has studied the fundamental biology of aging for over 50 years. He discovered that cultured normal human cells are mortal and age and that only cancer cells are immortal thus upsetting a 60-year old dogma.

Hayflick is a Fellow of the American Association for the Advancement of Science, an Honorary Member of the Tissue Culture Association and, a Life Member of the British Society for Research on Ageing. According to the Institute of Scientific Information, he is one of the most cited contemporary scientists in the world “in the fields of biochemistry, biophysics, cell biology, enzymology, genetics and molecular biology.” Dr. Hayflick is the author of over 280 scientific papers, book chapters and edited books of which four papers are among the 100 most cited scientific papers of the two million papers published in the basic biomedical sciences from 1961 to 1978.

Dr. Hayflick is the author of the popular book, “How and Why We Age” published in August 1994 by Ballantine Books, NYC and available in 1996 as a paperback. This book has been translated into nine languages and is published in Japan, Brazil, Russia, Spain, Germany, the Czech Republic, Poland, Israel and Hungary. It was a selection of The Book-of-the-Month Club and has sold over 50,000 copies world-wide.

Obama’s Medal

January 15th, 2017

Another unforgettable moment in the almost 8 years of President Barack Hussain Obama

Vision to America News

Obama Awards Himself with Distinguished Public Service Medal

January 5, 2017

By: Joe Newby

On Wednesday, Warner Todd Huston reported at Breitbart.com that President Obama added another medal to his collection when he had Defense Secretary Ash Carter award him with the Department of Defense Medal for Distinguished Public Service.

According to Huston:

Secretary Carter awarded his boss with the medal on January 4 during the Armed Forces Full Honor Farewell Review for the President held at Conmy Hall, Joint Base Myer-Henderson Hall in Virginia.

Carter insisted that the medal was a token of appreciation for Obama’s service as commander in chief, the Associated Press reported.

After spending the last few weeks throwing roadblocks in the path of President-elect Donald Trump and his transition team, Obama nonetheless claimed in his remarks to the members of the military in attendance that “We’ve got to make sure that during this transition period that there is a seamless passing of the baton, that there’s continuity.”

“Thus, President Obama officially declares himself the greatest public servant during his own tenure,” a post at Conservative Treehouse said.

Defense Secy Carter presents Pres Obama with Dept of Defense Medal for Distinguished Public Service. — Mark Knoller (@markknoller) January 4, 2017


William S. Frankl, All Rights Reserved
Design by Yikes!