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Patterns
of the AIDS epidemic
With globalization
of the world’s economy making the transfer of money, people
and products easier, drugs and disease are also crossing international
borders, said Don Des Jarlais, Ph.D., director of research
at the Chemical Dependency Institute at Beth Israel Medical Center
in New York. In a talk to researchers at the Yale AIDS Colloquium
Series, Des Jarlais noted that an estimated 10 percent of all
international trade is in illicit psychoactive drugs. “We
are not going to be able to return to the ’50s, ’40s
or ’30s or some other age of innocence when illegal drugs
were hard to find,” he said. “We are clearly not moving
towards a drug-free world. We are clearly not moving towards
an AIDS-free world. Both of these are expanding rapidly.” |
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Cold
War qualms spawned bioethics
When Nazi war
criminals were put on trial in Nuremberg for performing medical
experiments on concentration camp prisoners, they pointed in
their defense to the United States, where prison inmates had
been exposed to mosquitoes to test antimalaria drugs. The Nazi
experiments had a military purpose—to gauge the effects
of low atmospheric pressure and freezing water on pilots. But
there was a moral difference, according to Jonathan D. Moreno,
Ph.D., director of the Center for Biomedical Ethics at the University
of Virginia. “Death was not an acceptable outcome in the
U.S. experiments,” Moreno said in an April talk titled “Secret
State Experiments on Humans” for the Bioethics and Public
Policy Seminar Series at Yale. Nevertheless, American officials
engaged in questionable practices following World War II. They
deliberately released radioactivity into the atmosphere, injected
plutonium into people and spiked the drinks of unsuspecting victims
with LSD, activities that caused unease among some Pentagon officials.
“The prehistory of bioethics is deeply related to activities
undertaken during the Cold War, often in secret,” Moreno
said. |
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Nimble
bugs outmaneuver slow-moving humans
In the battle
against infectious disease, microbes have the upper hand, said
Joshua Lederberg, Ph.D. ’47, who shared the 1958
Nobel Prize in Physiology or Medicine for his studies of bacterial
genetics. In an address to the Associates of the Cushing/Whitney
Medical Library in April, Lederberg noted that while the human
immune system was set in stone between 50 and 100 million years
ago, bacteria can evolve every few years. “The pace of microbial
evolution vastly outstrips that of large, ponderous, slow-reproducing
multicellular organisms like ourselves,” he said. Humans,
he continued, must find a way to coexist in “domesticated
equilibrium” with microbes. “We ought to be looking
at the world from the bug’s eye view if we want to figure
out how to live with them.” |
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When
physicians meet the press
“With added
[academic] degrees, something happens to one’s ability to
speak English,” said Nancy L. Snyderman, M.D., who,
as a practicing surgeon and medical correspondent for ABC News,
straddles the line between medicine and the media. Speaking to
doctors and residents at medical grand rounds in March, she offered
some basic advice for dealing with the press: “Keep it simple.”
On a video screen she showed a clip of an M.D./Ph.D. who was
unable to shed the jargon of her work throughout an hour-long
interview. “She’s brilliant,” Snyderman said.
“She never made it on television.” In our sound-bite
society, the average news piece is 90 seconds. Snyderman’s
recommendation: “You should know in your head the three
things you want to get out. If there are things that you really
have to explain for someone to get it, skip it. It is either
going to get reported incorrectly or it will take you down the
wrong path.” |
Originally published in Yale
Medicine, Summer 2001.