From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.cardiology
Subject: Re: Statin drugs lower heart attack death-study
Date: 30 Aug 2005 18:11:15 -0700
Message-ID: <1125450675.086757.154960@o13g2000cwo.googlegroups.com>

listener wrote:
> Maybe the surgeon's having a shot of wiskey before he operates...or a
> toot of coke...but taking a statin?!!! Ohmygod, NO! What about all those
> nurses and security people and interns and ambulance drivers and
> receptionists, and...what about THEM! [cue ominous B-movie music here].
>
> L.


COMMENT:

This historically funny thing is that there've been more than a few
druggie surgeons who did some of their best work while high on
narcotics. Halsted famously on morphine for years and years.

Remember that 60 Minutes episode with Leslie Stahl about the doc who
specialized in pediatric brain surgery, and kept operating even though
riddled with bone mets from multiple myeloma? Great guy, but no doubt
narced into Xanadu on every procedure. "A miracle of rare device!"

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.cardiology,sci.med
Subject: Re: Statin drugs lower heart attack death-study
Date: 2 Sep 2005 13:17:07 -0700
Message-ID: <1125692227.566261.208420@g47g2000cwa.googlegroups.com>

fresh~horses@despammed.com wrote:
> Now that's something I can believe. You are referring to Halstead, the
> cancer surgeon who butchered women's breasts?


No, I'm refering to the one who saved a lot of women's lives (untreated
breast cancer mortality is 75% in 5 years, and that's what it was in
Halstead's day). Today we've improved the procedure, but we've improved
on the Wright brother's flyer, too. No reason to ridicule them.


> "The Halstead radical mastectomy, which became the accepted mode of
> management for breast cancer for many years, consisted of removing the
> entire breast parenchyma together with the pectoralis major, the
> pectoralis minor, the axillary contents, previous biopsy site, and
> breast skin."
>
> Today, surgeons do a lumpectomy, but it was women demandin sparing
> surgeries that had this changed.


COMMENT:

Indeed, but so what?  *All* improvements in medicine are due to
patients "demanding" (this can be a loaded word) treatments which are
less severe, less painful, less costly, and more simple and reliable.
And doctors and scientists struggling to find them and provide them
(and patients and laymen sometimes come up with improvements, too). In
general, you're describing the mechanism of progress in every technical
field known to humankind.

In the case of mastectomy, Halstead's initial "radical" procedure lost
favor as the statistics came in from women who'd refused it and chosen
less invasive procedures. the simple mastectomy. Finally, the
quadrantectomy and simple lumpectomy were tried in randomized studies
in the 70's, but the local recurance rates were 4 times what they were
from the Halstead prodedure. Halstead could have told you that-- that's
WHY he invented the radical in the first place (it wasn't out of some
need or joy in butchering women). When focused radiation beam treatment
(not available to Halstead!) was added back in to suppress local
recurances, the local recurance figure went down to Halstead's numbers,
or chose to it. What nobody could have predicted THEN, was that none of
this (so long as SOME surgery is done) would make any difference in 20
year survival. Halstead assumed that local recurance was a failure, and
being a non-cure, was worse than it turned out to be. So would anybody
now familiar with the century of survival statistics that Halstead
didn't have access to. For MOST cancers (breast cancer is an odd one)
Halstead's assumpion is correct--- once you lose local control once,
you've had it. It is NOT fair to judge the man by a century's worth of
hindsight.

And no, it's not like the feminists knew the truth all along. Carrie
Nation's axe wasn't for surgeons, but for the bars getting women's
husbands drunk and taking their money. I've looked at the Votes For
Women banners in the 1919 marches, and I don't see any saying "The
Radical Mastectomy Procedure Doesn't Improve 20-Year MORTALITY!" ANd I
think Gloria Steinem forgot to discuss it in the 60's, too.

The 2 pivotal randomized studies done in the 1970's which finally
killed the Halstead procedure, were conducted by men.

> This too may happen with unnecessary castrations as women demand their
> healthy organs be left, and that sparing surgeries to fascilitate this
> be developed.


COMMENT:

Again, so what? Your point being? The nerve-sparing prostatectomy was
developed by men "demanding" a less radical procedure which would be
less likely to leave them impotent (which had been the standard for
decades). The cordless telephone and the cell phone were developed by
consumers "demanding" that somebody get rid of the stupid trailing
wires...   And so on

What the devil makes you think ANY of the process you're taking about
is SPECIAL, or that it particularly applies in some way specially to
*women*, or (for that matter) even specifically to *medicine*?

Shaking my Head at Your Historical Ignorance,

SBH

From: "Howard McCollister" <nospam@nospam.net>
Newsgroups: sci.med.cardiology,sci.med
Subject: Re: Statin drugs lower heart attack death-study
Date: 2 Sep 2005 19:37:04 -0500
Message-ID: <4318efc9$0$244$bb4e3ad8@newscene.com>

"Don Kirkman" <donkirk@covad.net> wrote in message
news:ckhhh1t4spgrv1u7npoq8c4k6rsqvgk5tu@4ax.com...
>
> But you one-sidedly leave out his development of inguinal hernia
> surgery, far more common with men.  :)
>
> http://www.surgical-tutor.org.uk/default-home.htm?surgeons/halstead.htm~right
> --

The Halstead Repair for inguinal hernia is ALSO never done these days, as
men everywhere have DEMANDED an outpatient hernia repair that is less
painful and has a lower recurrence rate. Man, Halstead just hated everybody,
didn't he?

HMc

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.cardiology,sci.med
Subject: Re: Statin drugs lower heart attack death-study
Date: 2 Sep 2005 21:47:07 -0700
Message-ID: <1125722827.585772.86860@g14g2000cwa.googlegroups.com>

O'Hush wrote:
> Steve Harris <sbharris@ix.netcom.com> wrote in message
> news:1125692227.566261.208420@g47g2000cwa.googlegroups.com...
> > fresh~horses@despammed.com wrote:
> > > Now that's something I can believe. You are referring to Halstead, the
> > > cancer surgeon who butchered women's breasts?
> >
> >
> > No, I'm refering to the one who saved a lot of women's lives (untreated
> > breast cancer mortality is 75% in 5 years, and that's what it was in
> > Halstead's day). Today we've improved the procedure, but we've improved
> > on the Wright brother's flyer, too. No reason to ridicule them.
>
> It's Halsted (with no "a").  I know if you Google it, nearly everybody
> spells it Halstead, but they're all wrong.
> http://www.whonamedit.com/synd.cfm/3542.html
>
> ~~Patti


COMMENT:

Well, damn me. Thanks. That's the way I spelled it first and that's the
way I remembered it. I should know better than to trust Zee on
ANYTHING.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.cardiology,sci.med
Subject: Re: Statin drugs lower heart attack death-study
Date: 3 Sep 2005 20:55:04 -0700
Message-ID: <1125806104.358095.66620@g47g2000cwa.googlegroups.com>

Howard McCollister wrote:
> The Halstead Repair for inguinal hernia is ALSO never done these days, as
> men everywhere have DEMANDED an outpatient hernia repair that is less
> painful and has a lower recurrence rate. Man, Halstead just hated everybody,
> didn't he?
>
> HMc


COMMENT:

Halsted's also responsible for surgeons starting to wear rubber gloves.
Before that, they worked bare handed. Today we demand THINNER gloves;
who knows what thick dishwashing type stuff the old guy used, just to
increase his, er, insensitivity to patients.

Trivia: The man's name was pronounced with accent on first syllable:
HOL-stid. I'm unable to discover if it was HOLE-stid or HAWL-stid. I've
always heard HAWL STED, so HAWL-stid is probably it. But what do
doctors know about their own profession's history? More than the
general public, but still shockingly little, overall. No time for it.

Last time I was at Johns Hopkins I guess I could have gone to the
library and asked, but it's one of those things I didn't know I wanted
to know. They had their own problems at Hopkins. An armed camp in the
slums of Baltimore, it was. When I walked in the main doors, security
jumped on me like a duck on a junebug, and I went nowhere til I'd been
ID'd badged, and routed. I had gone to see the aether dome, but it was
closed. All in all, very depressing. The Baltimore slums looked like
they hadn't changed much since Poe slumped down in the gutter there and
died. And by the time I let, I felt like he must have.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.cardiology
Subject: Re: Statin drugs lower heart attack death-study
Date: 4 Sep 2005 19:56:25 -0700
Message-ID: <1125888985.508404.114940@z14g2000cwz.googlegroups.com>

Chris Malcolm wrote:
> Steve Harris <sbharris@ix.netcom.com> wrote:
> > listener wrote:
> >> Maybe the surgeon's having a shot of wiskey before he operates...or a
> >> toot of coke...but taking a statin?!!! Ohmygod, NO! What about all those
> >> nurses and security people and interns and ambulance drivers and
> >> receptionists, and...what about THEM! [cue ominous B-movie music here].
>
> > COMMENT:
>
> > This historically funny thing is that there've been more than a few
> > druggie surgeons who did some of their best work while high on
> > narcotics. Halsted famously on morphine for years and years.
>
> When Kay Redfield Jamison, the psychiatry prof who suffers pretty
> seriously from bipolar affective disorder, consulted her chiefs at
> Johns Hopkins about their attitude towards the idea of her coming out
> publicly about this condition, she was very surprised and encouraged
> by their attitude. I'm paraphrasing from memory of a radio interview
> of her paraphrase of what they said, but it was something along the
> following lines.
>
> "The best skills don't always come packaged in the best personalities.
> It's the duty of universities to foster the best academic skills and
> if necessary to help the possessor of the skills develop them despite
> personal problems. Sometimes this just involves us in some sympathetic
> coping. Sometimes we have to protect the person from an ignorant and
> hostile world. We had to go to great lengths to protect Halsted. If we
> can't protect you we no longer deserve the name of Johns Hopkins. If
> you want to go public about your mental illness that's fine with us,
> we'll back you all the way."


COMMENT:

That's an enlightened attitude. Doing the opposite shoots you in the
foot the same as any other employee prejudice. I've worked in several
big institutions which were full of smooth-smilers and glad-handers who
had GREAT people skills. But couldn't do more than smile and ask for
opinions when it came to creative thinking in any other category than
social. They were bureaucrats, and that's all. And they spread like
cancer, if you don't keep them down like crabgrass. That's what
happened to NASA--- the internal politiking took over and the actual
rocket scientists got booted or ignored. It has also happened to large
hunks of academia.

True, you may have to keep the worst nerds or socially odd in the back
room where the the public can't see them and get upset. But don't FIRE
them. You NEED them to think about everything else that doesn't involve
kissing somebody's ass! And that might be quite a lot of your business,
if you're NASA. But even if you're ENRON.  Microsoft, of course knew
this from the ground up, as most all computer related business do.  But
some others businesses never get it, and I can even think of one
computer business that, in its old age, got nailed: IBM. They used to
control the whole enchilada, but forgot that their white shirts and
neckties and nifty sales-and-support-force, weren't really ALL that
made it go.  In fact, when it came to the PC, people skills didn't help
them at all, and other companies ate their lunch there entirely. It
remains to be seen if they survive at all.

SBH