Part the First: Financing Professional Education in the United States.<\/strong>\u00a0 College costs too much in the United States.\u00a0 Professional School costs way to much.\u00a0 Up until the present \u2013 who knows what will happen next as the broad attacks on American universities continue \u2013 graduate education at the PhD level in traditional disciplines in the natural sciences, social sciences, and humanities has been funded at the student level by teaching and research assistantships in which those programs worth the effort will graduate PhD candidates who will not have accumulated large debts as a consequence of getting their doctorates.\u00a0 The overhang from undergraduate debt can be large, however.<\/p>\n We can and we should and we must do better.\u00a0 However, that we have not is not<\/strong> the point right now.\u00a0 A fair and just solution will have to await a political revolution, which is coming. \u00a0The proposed changes in federal student loan programs that allow students from families without generational wealth to attend medical school will prevent these students from becoming doctors.<\/strong>\u00a0 This is not acceptable.<\/p>\n The Association of American Medical Colleges is not one of my usual sources, to say the least, but this covers the current situation on the ground fairly well: Proposed changes to federal student loans could worsen the doctor shortage<\/strong><\/a>. \u00a0I am particularly concerned because my day job is devoted increasing the number of rural medical students who will become primary care physicians (Internal Medicine, Family Medicine, General Surgery, Pediatrics, Obstetrics & Gynecology and Psychiatry) and then return home to practice medicine.\u00a0 Most of these students do not have generational wealth.\u00a0 Many are first-generation college students who persevered by working their way through college to get to medical school. \u00a0Pulling the rug out from under them will do nothing but keep them from going to medical school.<\/p>\n This proposal in bad faith will not decrease the number of students going to medical school.\u00a0 But those students will be among those who got to medical school in the first place because college was a matter of course for them and they never had to concern themselves with paying their own bills \u2013 rent, living expenses, tuition and otherwise.<\/p>\n When I began my current position it became clear that the easiest path to medical school was to choose one\u2019s parents wisely, with the children of doctors (and other professionals) being overrepresented in our student population.\u00a0 A recent look at our admissions data showed that students in the so-called \u201cTop-20\u201d based on scores on the Medical College Admission Test had 13 parents with an MD or PhD and average family income three times the median for the state.\u00a0 None was a first-generation college student.\u00a0 The so-called \u201cBottom-20\u201d had three MD or PhD parents and a family income below the average.\u00a0 Most of them were first-generation college students.\u00a0 In the end, however, there was no difference in how these two groups performed in medical school, and the residency programs each group joined were equivalent.<\/p>\n We can return to the first group as the primary source of our future doctors, but somehow I do not believe that rich, urban America needs more \u201caesthetic dermatologists.\u201d\u00a0 On the other hand, a dermatologist who treats farmers and farm workers for skin cancer in rural America and an OB-GYN who cares for women and mothers and delivers babies where prenatal care has been unknown for years will be doing God\u2019s work on Earth.<\/p>\n And yes, I know that urban America has a population of medically underserved that is obscenely large.\u00a0 I can see that from my window.\u00a0 That is the fault of how we (fail to) provide healthcare in America and is not due to a local shortage of physicians, which has become the default state in much of rural America.\u00a0 Oh, and medical school indebtedness is real, but doctors in America are members of the one profession that can afford it, for now.\u00a0 That is, as long as they begin with a Honda instead of the Range Rover and a house instead of the McMansion.<\/p>\n Part the Second. Science Is Cool<\/strong>.\u00a0 Our Denisovan<\/a> ancestor, Dragon Man, was one interesting looking fellow<\/a>.\u00a0 But we could have guessed that, even if the illustrator has a somewhat fanciful view of the subject.\u00a0 And he came to science in an interesting way:<\/p>\n Qiang Ji, a palaeontologist at Hebei GEO University in Shijiazhuang, China, obtained the specimen from an unnamed man in 2018. The man \u2013 who Ji suspects discovered the artefact himself but failed to report it to authorities \u2013 claimed that his grandfather unearthed the fossil in 1933 during bridge-construction work over Long Jiang (which means dragon river), and buried it in an abandoned well, where it remained until a deathbed confession\u2026 In 2021, Ji and his colleagues determined that the \u2018Dragon Man\u2019 fossil represented a new archaic human species, which they crowned Homo longi<\/em>.<\/p>\n<\/blockquote>\n Does the identification of Homo longi <\/em>and other Denisovans mean anything?\u00a0 That depends on one\u2019s view of science.\u00a0 We can never know too much of the natural world, and often the most obscure research leads to a revolution in science or the practice of science.\u00a0 Is there something in the genome of Homo longi<\/em> that could explain resistance to disease, for example?\u00a0 Perhaps. As we have discussed before, research on how jellyfish glow in the dark<\/a> (GFP) has revolutionized cell biology.\u00a0 And now those who work on pluripotent stem cells, which will eventually provide the means to fight any number of conditions and diseases, are now able to track the cells in a living organism.\u00a0 Without the label, the stem cell would look like any and all others.\u00a0 A big thank you to the late Paul Allen<\/a>.<\/p>\n Part the Third: Science is Really Cool<\/strong>.\u00a0 Ever since I had a (now retired) colleague who kept an aquarium full of water bears who happily lived in the mosses at the bottom of the tank I have been fascinated by tardigrades<\/a>.\u00a0 They are absolutely adorable and practically indestructible.\u00a0 And they have much to teach us, if we will pay attention.<\/p>\n Having previously gone through seven weeks of radiation and chemotherapy for a tonsil tumor, I am paying attention to recent results of research on tardigrades that may lead to practices that will reduce radiation damage to healthy tissue during the course of treatment using modern radiation oncology.\u00a0 From a short news item from the National Institutes of Health<\/a>, which still exists according to my email:<\/p>\n Modern medical and radiation oncology \u201cresolved\u201d my tumor but three years later, but some things linger:<\/p>\n High doses of radiation can damage the DNA inside cancer cells, which destroys the cells and shrinks tumors. But radiation treatments can harm healthy cells as well, which can lead to severe side effects. These effects can be especially challenging for patients with head and neck cancer\u2026 Oral tissues can become inflamed after radiation therapy for head and neck cancer, making eating difficult.<\/p>\n<\/blockquote>\n The first thing to go (within a few days) during even highly focused radiation of the oropharyngeal space is the sense of taste, which makes eating a difficult and unnatural chore.\u00a0 The salivary glands are also damaged by radiation and \u201cdry mouth\u201d can follow.\u00a0 This can lead to dental problems such as cavities long after one\u2019s \u201ccavity prone\u201d years.\u00a0 My sense of taste returned, except that chocolate is not the same as before (no great loss and probably a healthy outcome).\u00a0 Dry mouth, especially at night, remains uncomfortable, and a few months ago I had two cavities filled for the first time in about thirty years.\u00a0 And eating bread and cheese without something to drink is an iffy proposition. But overall, no complaints thanks to modern clinical oncology!\u00a0 And now on to tardigrades, who apparently have no kryptonite and make Superman look weak:<\/p>\n In the hope of protecting healthy tissue during radiation therapy, an NIH-supported research team took inspiration from miniature creatures called tardigrades, or water bears. These tiny eight-legged animals are less than a millimeter in size, barely visible to the naked eye. They can survive in a wide range of extreme environments, from the ocean\u2019s depths to the vacuum of outer space. They also can endure high doses of radiation that would kill most other organisms<\/strong>.<\/p>\n The scientists focused on a damage-suppressing protein found in tardigrades called Dsup. Dsup interacts with DNA strands and keeps them from breaking. The researchers envisioned a novel approach in which Dsup could be precisely delivered to healthy tissues before radiation treatment to curtail radiation damage.<\/p>\n<\/blockquote>\n And how did these NIH-supported scientists deliver Dsup to cells?<\/p>\n The researchers created nanoparticles that encased messenger RNA (mRNA) with instructions for making the Dsup protein. They showed that the nanoparticles could ferry the mRNA into mouse or human cells and trigger broad production of Dsup<\/strong> (thank you Dr. Robert Malone<\/a>). To see how long Dsup production would last in the body, the scientists injected the nanoparticles into the oral or rectal tissues of mice. The protein\u2019s production peaked about 6 hours after injection, then declined. Four days after the injection, little or no Dsup could be detected.<\/p>\n To test protection against radiation, the nanoparticles were injected into healthy mice about 6 hours before exposure to a radiation dose that\u2019s similar to what cancer patients receive. A control group of mice received radiation but no nanoparticles. The nanoparticle-treated mice showed much less DNA breakage after radiation treatment than the non-treated mice<\/strong>. Additional experiments found evidence that the protective effects of nanoparticles remained limited to the injection site. As such, the particles are unlikely to have the unwanted effect of protecting nearby tumor cells.<\/p>\n<\/blockquote>\n Are these results ready for translation to the clinic?\u00a0 Certainly not yet.\u00a0 But radiation oncology has made immense progress over the past few years.\u00a0 Radiation (protons) from a mini-particle accelerator (I couldn\u2019t help but be fascinated by the process while bolted down to a table in a fitted mesh mask that prevented my head and neck from moving more than a millimeter) can be focused to a small area and tuned to a certain depth.<\/p>\n But collateral damage is inevitable.\u00a0 And it could be these little creatures will provide an answer to radiation side effects.\u00a0 Twenty years ago, I would have had surgery followed by cisplatin and relatively unfocused radiation.\u00a0 The side effects would have been grim, including likely structural damage due to the surgery and damage to my kidneys, hearing, and vision caused by the cisplatin.\u00a0 Twenty years from now, a patient in my predicament might retain his sense of taste during radiation and not have his salivary glands damaged irreversibly.\u00a0 And all because NIH funded the research on strange little animals.\u00a0 The paper<\/a> is here if you can get over the paywall.\u00a0 I do wonder, will NIH even fund mRNA research that leads to such an advance?<\/p>\n Another general article on tardigrades is here<\/a>, and it includes mention of how delivery of functional mRNA was tested using the jellyfish protein \u2013 GFP \u2013 mentioned in Part the Second.\u00a0 It is safe to say that without the tool that is GFP none of this research would have been feasible.<\/p>\n Part the Fourth: Another Episode in the Ongoing Series Called \u201cWe Are Not a Serious People.\u201d<\/strong>\u00a0 This time the culprit is \u201cFast Fashion\u201d, described in Fun Ways to Ditch Fast Fashion for a Sustainable Wardrobe<\/a>.<\/p>\n In Chile\u2019s Atacama Desert<\/a>, a mountain of more than 59,000 tons of clothing can now be seen from space. This so-called garment graveyard comprises fast-fashion discards inherited from the U.S., Europe and Asia. In 2024 activists, designers and NGOs organized Atacama Fashion Week\u2014with a fashion show atop the garment graveyard\u2014to draw attention to this growing problem.<\/p>\n<\/blockquote>\n The article is definite coffee break material, while it describes just another way we are trashing the planet for no reason other than it seems convenient and a good way for some to make a lot of money:<\/p>\n The HVTP (Hudson Valley Textile Project, a natural-textile supply chain that aims to break free from the global fashion industry) is one part of a growing effort to mitigate the harms of the global fashion industry, in which millions of low-paid garment workers around the world endure unsafe working conditions to churn out huge amounts of clothing and textiles year after year. The pull on the planet\u2019s natural resources is immense: Annual textile production uses up enough water to fill at least<\/strong> 37 million Olympic-size swimming pools<\/strong>. Cotton agriculture alone uses 2.1 percent of the world\u2019s arable land. And because roughly 60 percent of global textiles now contain plastic derived from fossil fuels, it is estimated that more than a third of the microplastics in the oceans today were shed from clothing<\/strong>.<\/p>\n The fashion industry is also responsible for up to 10 percent of global greenhouse gas emissions\u2014more than the aviation and shipping industries combined.<\/strong> If apparel consumption continues to grow at its current rate, by 2050 the industry will be using more than one quarter<\/a> (McKinsey) of the world\u2019s carbon budget. The problem becomes even worse when you consider that most clothes make a quick trip to the landfill, where they\u2019ll emit greenhouse gases such as methane.<\/p>\n These numbers reflect a growing appetite for fast fashion, a business model that brings trendy designs to the masses as quickly and cheaply as possible. As clothing consumption rises, the consumer tends to shoulder the blame. But what\u2019s enabled things to get this bad is a lack of regulation.<\/p>\n<\/blockquote>\n One is reminded of the late, great Herbert Stein of fifty years ago: \u201cIf Something Cannot Go on Forever, It Will Stop.\u201d<\/a>\u00a0 The coming world will get smaller whether we like it or not.\u00a0 We could go ahead and stop this nonsense now.<\/p>\n Part the Fifth. Measles, of All Things.<\/strong>\u00a0 This brings us to another coffee break article that can only make one want to scream.\u00a0 I had rubella (German measles) and rubeola (14-day measles) in the first grade.\u00a0 As far as I know these two unpleasant interludes caused no lasting damage to me.\u00a0 The same is not true of all of us, though, as recounted in this article from The New York Times<\/em>: \u201cI Feel Like I\u2019ve Been Lied To\u2019: When a Measles Outbreak Hits Home\u201d<\/a>.<\/p>\n This is particularly interesting as the story of one rural physician, Don Edwards, who is now practicing what can only be described as alternative medicine, including vitamin A (cod liver oil) as a treatment for measles:<\/p>\n Edwards had never seen a measles case until earlier this year, but he\u2019d helped vaccinate hundreds of children against the virus. He spent the first decade of his career as the only doctor in rural Garza County, Texas, practicing medicine in the same tradition as his grandfathers. \u201cI was 100 percent by the book, just following the company line,\u201d he said, which meant he saw patients in 10-minute blocks, recommended all vaccines on schedule and kept prescribing more medications to a population that seemed to only get sicker.<\/p>\n It wasn\u2019t until 2011 that Edwards experienced what he called a \u201cdivine appointment,\u201d and began questioning the core tenets of American medicine. He came to believe that his patients weren\u2019t suffering from diseases so much as experiencing symptoms of bad diets and societal rot, and that the human body was almost always capable of healing itself with hydration, movement, nutritious foods and spiritual peace. He moved to Lubbock and started his own practice, Veritas Medical, named after the Latin word for truth. He began selling supplements and started a weekly podcast, \u201cYou\u2019re the Cure,\u201d on which he often hosted guests who questioned the safety of vaccines.<\/p>\n Instead of seeing 50 patients a day, Edwards scheduled his intake appointments for up to two hours, so he could learn about the root causes of his patients\u2019 problems and offer dietary plans and what he called \u201cpeace consultations.\u201d His new practice filled with hundreds of patients who shared his disillusionment with mainstream medicine, including a few dozen Mennonites who lived an hour from Lubbock.<\/p>\n<\/blockquote>\n Thus, Dr. Edwards change in his medical practice to include the tropes of MAHA predates the damascene conversion of Casey Means MD<\/a> by about fifteen years, and more recently on the current absolutely unnecessary measles outbreak:<\/p>\n Most of Edwards\u2019s patients showed some initial improvement with supportive care \u2014 which is what he offered to Kiley and his family as they began to recover. He gave all four children intravenous fluids and vitamins to bolster their immune systems for the weeks and months ahead. Edwards also continued to prescribe breathing treatments for patients in more severe distress, which sometimes helped ease their symptoms.<\/p>\n And all the while, Edwards continued to release his weekly podcast, hosting a rotation of authors, doctors and activists who minimized the danger of measles and spoke instead about the benefits of being unvaccinated and the risks of rare vaccine injuries.<\/p>\n \u201cThe body\u2019s designed to kill measles,\u201d Edwards said, as it spread into New Mexico and Oklahoma.<\/p>\n \u201cI would encourage you to seek a higher authority, a spiritual authority, and let peace guide you,\u201d he said, as the disease stretched into Kansas and Nebraska.<\/p>\n \u201cDon\u2019t be scared of anything,\u201d he said, when the total number of reported measles cases rose above 1,000, almost all among people who were unvaccinated, as the virus continued to spread in Colorado, Pennsylvania and finally into the remote corners of North Dakota, arriving in the state for the first time in 14 years.<\/p>\n<\/blockquote>\n We have seen this show before.\u00a0 Dr. Edwards is not wrong that we are an unhealthy society in too many ways to count sometimes.\u00a0 But<\/strong> the body is not designed to kill measles<\/strong>.\u00a0 The immune system has evolved to combat infectious disease, but not for every disease every time.\u00a0 And unless this nonsense about the measles vaccine ends, the lives of thousands will end unnecessarily. \u00a0Herd immunity against measles<\/a> requires that >90% of the population be vaccinated, or like me and many others of a certain age, have had the measles and recovered.\u00a0 There is no treatment for measles aside from supportive care.<\/p>\n And the disease still kills.\u00a0 Mother Nature doesn\u2019t care about our beliefs, and this curve could reverse itself<\/a> if vaccination rates against measles and other diseases continue to decline below the threshold for herd immunity.<\/p>\n See you next week on Independence Day in America.\u00a0 Until then, stay safe.<\/p>\n\n
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