By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 12/23/2012
On December 14, a 20-year-old gunman walked into Sandy Hook Elementary School on an otherwise unremarkable day in pastoral Newtown, CT. But when his gunfire ceased, we would learn that he had brutally shot and killed twenty young schoolchildren and six of their teachers before taking his own life as well.
At the time of this writing, children are still being buried in Newtown. We're hearing the usual media rhetoric -- about our country's appalling gun violence, our stunned witness of yet another mass domestic killing, the need for stricter gun control laws and greater access to mental health services. . .
This time, however, the rhetoric may compel actual change. President Barack Obama promised to submit new gun control proposals to Congress by January.
'Obamacare' survives – Twice!
The Patient Protection and Affordable Care Act -- also known as "Obamacare" -- survived two major challenges last year. First, an attempt to overturn it by 27 states who claimed it violated constitutional law -- chiefly because it required all Americans to obtain health insurance or pay a fine (the "individual mandate"). But in June the U.S. Supreme Court ruled otherwise.
Later, its fate rested on the outcome of the presidential election, with Republican candidate Mitt Romney vowing to begin repealing it on his first day in office. Obama's re-election ensured the act's viability, and, consequently, many of its major provisions -- including the individual mandate -- will take effect as planned in 2014.
The patients had nagging pain -- in the back, the neck, or a joint -- that would not go away. All 14,000 of them had hoped that "the steroid shot" would finally give them relief. Instead, they incurred additional suffering when subsequently notified that the injected steroid may have been contaminated by a fungus that could cause devastating and sometimes lethal infections. A least 620 have suffered an infectious complication, and 39 have died.
Public health investigators quickly tracked the outbreak's origin to the New England Compounding Center. They also identified "serious deficiencies and significant violations of pharmacy law and regulations that clearly placed the public's health and safety at risk." The news rekindled public concern about inadequate regulatory oversight of compounding pharmacies throughout the US.
A buggy year
Other microbial illnesses plagued 2012. A Hantavirus outbreak in Yosemite killed three hikers. About 5,000 cases of mosquito-borne West Nile virus infection were reported to the CDC, including 228 deaths. And 34,000 cases of whooping cough (pertussis) occurred, resulting in 16 deaths. The resurgence of whooping cough – a vaccine-preventable infection -- was attributed to inadequate population vaccination rates and the declining effectiveness of the vaccine over time.
Not 'all about the bike'
In October, cycling legend and anti-cancer crusader Lance Armstrong was stripped of his seven Tour de France titles and banned from future Olympic competition after the U.S. Anti-Doping Agency released its claims about his illicit use of performance-enhancing drugs. In the shadow of the agency's report, we also glimpsed a dark picture of professional cycling where rules of fair play were regularly bent, and illicit drug use was rampant.
Pink ribbons, red faces
In January, the Susan G. Komen for the Cure Foundation -- perhaps the most influential breast cancer charity -- created public furor when it decided to stop funding Planned Parenthood, which provides breast cancer screening for low-income women. Critics charged that the foundation had surrendered to anti-abortion rhetoric, dumping Planned Parenthood for political show during an election year.
Red-faced, the foundation -- known for its iconic pink ribbon -- apologized and reversed its position within days.
Can't sit on this
It was a stand-alone year for bad news about sitting. In the summer, a British Medical Journal study warned about the dangers of prolonged sitting. Reportedly, American adults spent, on average, about 55 percent of their time being inactive or sedentary.
Researchers claimed we could add two years to our lives by simply limiting sitting to a maximum of three hours a day. The conclusions add weight to an already massive body of literature that links our exercise-deficiency epidemic with our epidemic obesity. So one has to ask: Will this new study (finally) move us?
High-profile food fights
New York Mayor Michael Bloomberg defeated the food and beverage industry and implemented the country's first soda ban. The ban prohibits most of the city's public establishments from selling sugary drinks in volumes exceeding 16 ounces.
First lady Michelle Obama hoped to counter the typical lunch counter at public schools by unveiling new standards for the National School Lunch Program. On the revised menu: less fat and sodium, but more vegetables, fruits, skim milk, and whole grains. Some dissident students protested the new down-sized food portions, vowing"Fat chance!" about accepting them.
Meanwhile, the CDC released a report estimating that the number of children and teenagers with diabetes would catastrophically quadruple over the next four decades.
Mind me! Or maybe not
We heard that the pending 5th edition of the Diagnostic and Statistical Manual -- the definitive diagnostic text for U.S. psychiatrists -- had changed its mind again. For example, Asperger's will disappear as a unique diagnostic entity, and "gender identity disorder" will, itself, no longer be identifiable.
The manual also will include several newly recognized mental disorders like hoarding, binge-eating and skin-picking.
But so far, the most disputed new entry seems to be "disruptive mood dysregulation disorder" -- or, as some cynics claim, childhood tantrums gone bad. The new diagnosis has put some critics in . . . well, a disruptive mood of their own; they claim the manual overly-pathologizes normal human behaviors.
The manual’s ongoing revisions over time also remind us about the influence of culture and politics in shaping our beliefs about what constitutes a mental disorder.
Minding the pharm
In related and troubling news, in July pharmaceutical giant GlaxoSmithKline agreed to pay an unprecedented fine of $3 billion to settle allegations of fraud. Among those allegations, the U.S. Department of Justice accused Glaxo of marketing its antidepressant Paxil for use by children without FDA approval.
Kate Scannell is a Bay Area physician and syndicated columnist. She is the author of "Flood Stage" and "Death of the Good Doctor."
Copyright 2012, Kate Scannell
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December 25, 2012
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Death of the Good Doctor--Lessons from the Heart of the AIDS Epidemic
A physician's memoir about the early AIDS epidemic (1985-1990) in the US. Originally published in by Cleis Press, 1999. Brought back into print in 2012, and reissued with photographs in 2018. Click here for its paperback purchase.
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