medicine – Bad Reputation A feminist pop culture adventure Tue, 02 Aug 2011 08:00:35 +0000 en-US hourly 1 https://wordpress.org/?v=5.6 37601771 Unsung Heroes: Mae Jemison /2011/08/02/unsung-heroes-mae-jemison/ /2011/08/02/unsung-heroes-mae-jemison/#comments Tue, 02 Aug 2011 08:00:35 +0000 http://www.badreputation.org.uk/?p=6080 At some point in their childhood, most people want to be astronauts when they grow up. A member of an elite few, taking huge risks in the name of science and getting to see a view of the Earth no one else will. A lot of children probably also want to grow up to be doctors; intelligent, prestigious, and well paid. Mae Jemison wasn’t content to just aspire to one or the other. Oh no. Mae Jemison grew up, as she was confident she would, to be a doctor in space. How much ass does that kick? All of it.

Born in Alabama in 1956, Jemison’s family moved to Chicago in 1959 to take advantage of the better educational opportunities there. Jemison took to the sciences with ease, doing well enough in her studies that she was able to enrol at Stanford University aged just 16.

In kindergarten, my teacher asked me what I wanted to be when I grew up, and I told her a scientist. She said, ‘Don’t you mean a nurse?’ Now, there’s nothing wrong with being a nurse, but that’s not what I wanted to be.

Mae Jemison

Jemison faced barriers due to both racism and sexism at Stanford, particularly in the engineering department, a place that was (and unfortunately to some extent still is) the domain of well off white males. She describes, looking back, occasions where professors would ignore her input while congratulating her male classmates for the exact same comments, and credits her success in part to the youthful arrogance of a teen allowing her to push on through.

NASA photo of African-American astronaut Mae Jemison in her orange flight-suit. Image via Wikimedia Commons, shared under a Creative Commons license.

After getting her chemical engineering degree Jemison went on to study medicine at Cornell, graduating in 1981. She did extensive work abroad during her time there, ranging from Thailand to Kenya as a primary care provider, and eventually joining the Peace Corps in 1983. With the Peace Corps she served in Sierra Leone, acting both as a medical doctor and a writer of guidelines, care manuals, and research proposals.

So, we’ve established she’s pretty goddamn awesome as both a doctor and a scientist. But I promised you a doctor in space, and so far it’s all been ground bound1. So, onto her career with NASA.

Rejected on her first try, Jemison was accepted into the program in 1987, the first class of astronauts to be enrolled after the 1986 Challenger disaster. She worked in launch support at the Kennedy Space Centre while training for her launch, helping to send other shuttle flights up into orbit. Her own turn came in 1992, when she became the first black woman to go into space, flying aboard the shuttle Endeavour with the six other astronauts of STS-47.

I wouldn’t have cared less if 2,000 people had gone up before me … I would still have had my hand up, ‘I want to do this.’

– Mae Jemison, speaking to the Des Moines Register in 2008

For the next 190 hours Jemison would orbit the Earth, one of the select few to see the planet from above for themselves.2 She conducted a series of life science experiments on how living organisms responded to the microgravity of space. This included one of her own devising, to study the effects of orbital conditions on bone cells. On September 20th 1992, Jemison and the rest of the mission’s crew returned safely to Earth, having spent the last eight days being awesome enough to risk death in the name of science.

STS-47 was to be Jemison’s only space mission, as she retired from NASA shortly after her return. She wanted to focus on social issues surrounding technology, its impact in developing nations, and means of mitigating future-shock. To this end she founded two rather cool organisations. First up, doing applied research, there’s the Jemison Group, set up to develop technology for daily life, which has worked on projects including thermal energy generation for developing countries, and satellite communications for facilitating health care in West Africa.

Her second project was the Dorothy Jemison Foundation for Excellence, named for her mother. The foundation runs international science camps for students in their teens, aimed at encouraging people to think globally about how technology can deal with problems. The group works to build critical thinking skills and scientific literacy, which is a pretty damn solid aim.

Oh, and a last point of geeky coolness (which obviously is the most important kind), Jemison appeared in an episode of Star Trek: The Next Generation after LeVar Burton discovered she was a fan and invited her to take part. That makes her the first real life astronaut to have featured on the show. It’s a neat bit of circularity, given that Jemison cites Nichelle Nichols’s performance as Lt. Uhura as one of her motivations for joining NASA.

So, doctor, astronaut, advocate for science education, and she even got to hang out on the bridge of the Enterprise. That’s a pretty good definition for a badass life right there.

  • Unsung Heroes: spotlighting fascinating people we never learned about at school. Rob Mulligan also blogs at Stuttering Demagogue. Stay tuned for future Heroes, or send your own in to [email protected]!
  1. Well, excepting an incident in Sierra Leone where Jemison commandeered a hospital plane to evacuate a volunteer with meningitis and worked throughout the flight to keep them alive, racking up an eventual total of 56 hours solid work.
  2. As of today only around 500 people have been up there, depending on exactly what you define as “in space”.
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Unsung Heroes: Helen Taussig /2011/05/13/unsung-heroes-helen-taussig/ /2011/05/13/unsung-heroes-helen-taussig/#respond Fri, 13 May 2011 08:00:14 +0000 http://www.badreputation.org.uk/?p=3880 You know you’re pretty awesome when you’re credited with founding a field of medicine. Not just a particular technique or methodology, which is impressive enough in itself, but a whole field of practice. It’s the sort of achievement that you drop into conversation and then everyone else feels a little bit bad, because they will never do anything quite as cool. One person who can claim such an achievement is Dr Helen Taussig, pioneer of paediatric cardiology.

A black and white portrait photo of Dr. Helen Taussig. Image via Wikimedia Commons.

Helen Taussig, taken during her time as a professor at Johns Hopkins University.

Prior to 1944, children born with a condition known as Tetralogy of Fallot – or more commonly “blue baby syndrome” – could expect poor physical development, difficulty feeding, and an early death (untreated cases saw only 30% survive to the age of 10). Tetralogy of Fallot was the most common (400 cases out of every million live births) of complex heart defects and considered at the time to be surgically irreparable.

Taussig (b. 1898) had other ideas. Having studied at a series of prestigious schools, including Harvard, Taussig graduated from Johns Hopkins University Medical School in 1927, moving to Johns Hopkins Hospital to spend several years specialising in cardiology and paediatrics. In 1930 she was appointed head of the Children’s Heart Clinic, making her one of the highest ranking women in American medicine at the time. She noted that infants with another particular heart deformity (patent ductus arteriosus, which allows blood to flow between the aorta and the pulmonary artery) who suffered from Tetralogy of Fallot tended to have better survivability than those with Tetralogy of Fallot alone.

Based on this, Taussig came to a conclusion that had evaded everyone else up until then: by creating an artificial hole, or shunt, between the two arteries it might be possible to overcome most of the problems caused by Tetralogy of Fallot. She took her ideas to Robert Gross, a surgeon at Boston who had pioneered patent ductus arteriosus ligation (the tying off of the hole between the arteries to stop the flow between them). Gross dismissed the idea, acting on the accepted wisdom of the time that stated the condition to be impossible to fix surgically. Without the help of an experienced cardiac surgeon, there would be no way to actually test Taussig’s ideas.

In addition to the resistance from established surgeons, Taussig faced another obstacle to developing her idea: Around the time of graduating from Johns Hopkins she had become profoundly deaf, something which seemed, at the time, like it might put an end to her career. How could one practise cardiology without being able to hear heart rhythms through a stethoscope? Taussig was not one to be stopped by such trifling matters though, and developed an exceptional proficiency for feeling the rhythms by hand instead of listening to them, later crediting some of her discoveries to this talent.

You must learn to listen with your fingers.

– Dr Helen Taussig

This might be the point where a less awesome individual might give up, might let their idea drop and become just another footnote in medical history. Instead, Taussig approached Alfred Blalock, a recent appointment at Johns Hopkins Hospital. Together with his surgical technician, Vivien Thomas, they began to develop the idea, and by 1944 were ready to perform their first operation on a person.

The first operation was a qualified success – the initial surgery went well, but the patient didn’t survive a follow up surgery the following year. The following two attempts were wholly successful, and by 1952 over 1,000 patients had undergone the Blalock-Taussig Shunt procedure, as it became known, with around 85% survival rates. Taussig and Blalock lectured on their technique in Paris and London, where surgeons experienced similar success rates.

But pioneering a new field of medicine and improving the life expectancy and quality of life for countless infants wasn’t enough for Taussig – she had more awesome achievements still to go. In 1957 the sedative drug Thalidomide was distributed to thousands of clinicians in the US for testing, proposed as a safe drug for a variety of conditions. We now know, of course, that the drug was far from safe for this, having massively teratogenic properties. Taussig was one of the doctors, along with the FDA inspector Frances Oldham Kelsey, who provided evidence for the dangers of the drug. This lead to its being refused approval for sale in the US, and eventually removed from other markets once its dangers had been exposed.

So that’s twice that Taussig was a key figure in improving the quality of life of infants, thus arguably making the world a better place through her actions. In addition to this she campaigned for the legalisation of abortion and became one of the first women to be appointed to a full professorship at Johns Hopkins University in 1959, and the first to serve as president of the American Heart Association. One of the four colleges of the Johns Hopkins medical school still bears her name.

Her 1947 textbook, Congenital Malformations of the Heart, is worth reading whether or not one has a medical background, as it stands as an example of a very well written work by one of the field’s most incisive minds.

[Taussig] was truly a remarkably notable woman in health care.

– Harold Ellis, Journal of Perioperative Practice

  • Unsung Heroes: spotlighting fascinating people we never learned about at school. Rob Mulligan also blogs at Stuttering Demagogue. Stay tuned for future Heroes, or send your own in to [email protected]!
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HPV Vaccines: Cervarix vs Gardasil /2011/03/17/hpv-vaccines-cervarix-vs-gardasil/ /2011/03/17/hpv-vaccines-cervarix-vs-gardasil/#comments Thu, 17 Mar 2011 09:00:49 +0000 http://www.badreputation.org.uk/?p=3923 Before launching into this I want to preface what I say with this: Public health is a complex issue; there is a finite amount of money to be allocated and the long term cost/benefit analyses are by no means straightforward. Organisations like NICE have to make some occasionally very tough decisions, and sometimes good treatments have to be left out of guidelines because they would deprive other areas of resources judged to have a greater beneficial impact. With that said, on to an issue of current importance, in which NHS guidelines may well be letting a lot of people down.

Photo showing a small glass vial with a green plastic lid on a grey table surface. The yellow and black label on the vial reads

Gardasil vial, via Wikimedia Commons. This is what we

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections. HPV symptoms include outbreaks of genital warts, and several of the strains (primarily types 16 and 18, which account for roughly 1 in 20 infections according to CDC statistic) are responsible for the majority of cervical cancer cases. Cervical cancer is the second leading cause of cancer deaths amongst women worldwide, particularly in developing nations.

So when vaccines that protect against the high-risk strains of HPV became available in 2008 it was a good thing, yes? A concerted vaccination program would reduce new infections, see a decrease in cervical cancer diagnoses over the next 15-20 years, and save millions of pounds in public health spending on pap smears, right? Well, sort of. The issue here is that there are two vaccines available, Gardasil from Merck and Cervarix from GlaxoSmithKline. Whilst both protect against strains 16 and 18, Cervarix does not provide any protection against the non-cancerous strains responsible for genital warts. Gardasil, by contrast, also protects against strains 6 and 11, which cause 90% of genital wart cases. Gardasil also has a rather high list price of £240 per person, whereas the makers of Cervarix have significantly undercut their list price in an unreleased contract with the NHS.

In countries such as Australia, that have taken up Gardasil, there has been a 75% decrease in new cases of genital warts over the last three years; the UK, over the same period, has seen no difference in the number of new cases. Whilst women aged 16-19 are the group most affected by this, the issue is one that matters to everybody: greater uptake of the vaccine increases herd immunity, protecting those who haven’t been vaccinated as well (for the same time period cases in unvaccinated heterosexual males fell by one third in countries using Gardasil).

So, and this is the problem, we’re now offered a vaccine that provides no protection against genital warts, and almost no information about the alternative (I could find just one mention of Gardasil on the NHS’s HPV vaccination page here ). Those in the know are seeking out Gardasil through private clinics, whilst the majority, arguably including those most at risk of infection, are left in the dark.

“We, as consultants in sexual health, have been told to say nothing publicly that would damage the current vaccine programme, as the Cervarix vaccine has already been purchased. We have had to be circumspect in public but in private we have all purchased Gardasil for our own children and advised colleagues to do the same.” – Dr. Colm O’Mahony and Dr. Steve Taylor

This is leading us into a split system whereby those who can are taking the greater protection of Gardasil, and everyone else is getting Cervarix. This is, I think, neither a reasonable nor efficient use of NHS funding, and somewhat gives the lie to health secretary Andrew Lansley’s promise of “no decision about you without you.”

Treatment of genital warts costs the NHS £31 million annually and takes trained staff away from time that could be spent on other serious conditions. It is difficult to gauge how this balances against the savings from sticking with the cheaper Cervarix, because the NHS will not release the details of their contract with GSK. With the contract coming up for renewal now is the time when Lansley needs to reveal the details of the contract, involve the public in the decision, and provide more accessible information regarding Gardasil.

Why is this relevant on a feminist blog? Fair access to this information (and related sexual health matters) is vitally important to women (and indeed to men). We all need to be equipped to not only make the best decisions for our own sexual health but also to campaign for those in the most at risk groups — who are currently being let down by the lack of information provided by the NHS. The choice of vaccine is an important issue that will effect tens of thousands of lives every year, and it is one the public needs to be involved in.

(Here’s the British Association for Sexual Health and HIV’s press release on the issue, which has links to some relevant papers.)

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