Military Medicine

February 21, 2018

FDA approves a blood test to diagnose severity of traumatic brain injury

Federal officials offer a glimmer of hope in caring for head injuries, especially the sharp, repeated, and often damaging blows that afflict athletes and which millions worldwide are witnessing, yes, as part of the Winter Olympic Games.

The federal Food and Drug Administration has announced that it has approved a long-awaited blood test that can help doctors determine the severity of traumatic brain injuries. This test will provide a cheaper, easier, more convenient, and likely faster way to handle the rising health bane of concussions, rather than relying on computed tomography or CT scans using big machines and a form of X-rays.

As the New York Times reported:

December 19, 2017

Seven words that federal scientists are no longer supposed to use (one is “science-based”)

by Patrick A. Malone

What’s going on at the Centers for Disease Control and Prevention?

It’s a federal agency with a $7 billion budget and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Its work and guidance on health matters long has been heeded and well respected.

But the Washington Post — in a story that sounds like it might have leaped from the satirical pages of The Onion or from a monologue by the late comedian George Carlin — has reported that CDC experts have been banned from using seven words in any upcoming communications with Congress about the 2019 budget.

November 13, 2017

First-responders, trauma response wins praise in Texas church shooting

by Patrick A. Malone

In the torrent of the relentless 24/7 news cycle, let’s not allow a new normal to prevail. We can’t forget that just days ago, a madman opened fire on a church in a small town south of San Antonio, Texas, killing at least 26 and wounding 20 or so. It was the worst mass shooting in the Lone Star State’s history, and it added to a horrific and growing toll for recent such gun-related outbreaks.

These incidents not only devastate the communities in which they occur. They also put giant strains of doctors, nurses, emergency medical technicians, and hospitals. All respond in ways that deserve a major salute, as well as empathy, compassion, and shared grief for the victims, their families, and those who seek to save and protect lives in chaotic situations.

The killing in Sutherland, Texas, posed its own unique stresses, with medical experts heaping praise on EMTs and first-responders for their heroic work at the scene, and then speeding those in need to care at hospitals at least 35 miles away.

October 9, 2017

Las Vegas tragedy helps highlight what’s right with nation’s health care system

by Patrick A. Malone

Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds. A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more.

August 25, 2017

Can VA’s struggles, successes help improve health care for us all?

by Patrick A. Malone

Despite the barrage of terrible headlines about reported problems in its care, the VA, aka Veterans Affairs, “continues to perform as well as, and often better than, the rest of the U.S. health-care system on key quality measures [including] patient safety, patient satisfaction, care coordination, and adherence to evidence-based medical practices,” a new study of the embattled agency concludes.

The work, issued by the American Legion and conducted by health care journalists with affiliations including Johns Hopkins University and the University of California, San Francisco, is part of a growing, continuing, and urgently needed re-examination of one of the nation’s major medical providers.

The VA’s struggles, past, present, and into the future, are driven in part by its size and the scope of its mission and commitment, as a recent, detailed article in Foreign Affairs points out:

April 18, 2017

Hospital safety and access are still big problems

by Patrick A. Malone

Hospitals can be risky, troubled, and even downright scary spots, as some recent news and other reports indicate:

Inspector general slams DC VA Medical Center

Almost 100,000 patients of the VA Medical Center in Washington, D.C., have been put at unnecessary risk because hospital staff and administrators, a government watchdog said, failed to “ensure that appropriate medical supplies and equipment were available to providers when needed; that recalled supplies or equipment were not used on patients; and that sterile supplies were stored appropriately.”

December 5, 2016

Psychedelic drugs gets serious clinical consideration in PTSD, cancer care

by Patrick A. Malone

Mental health experts aren’t suffering Sixties flashbacks. But they are seeing a new day for Molly (aka MDMA, Ecstasy, or 3,4-Methylenedioxymethamphetamine) and magic mushrooms (psilocybin). These hallucinogenic drugs are getting serious consideration in helping those with post-traumatic stress disorder (PTSD) and depression and anxiety due to cancer.

The federal Food and Drug Administration, which won’t comment on the matter, has approved Phase 3 clinical trials (large-scale human research) of MDMA for treatment of PTSD, according to Multidisciplinary Association for Psychedelic Studies (MAPS).

MAPS is a nonprofit research and educational organization that “develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.”

October 17, 2016

Baltimore confronts an epidemic of gun violence

by Patrick A. Malone

A lethal epidemic is sweeping Baltimore neighborhoods, costing taxpayers millions of dollars, as well as demoralizing caregivers who struggle with its casualties daily. Researchers, tragically, are barred from developing detailed data about this scourge to try to curb its increasingly deadly harm.

Kudos to the Baltimore Sun and reporter Justin George for investigating for a year the gun violence that torments the city, sending at least 200 patients to area hospitals already just in 2016. The Sun says hospitals in the poor city have spent in five years more than $80 million caring for patients involved in gun crimes. Hospitals have seen their gunshot caseload double, and the costs of this care increase by 30 percent. Taxpayers end up footing most of the bill under Medicaid, the federal-state insurance for the poor.

The Sun’s multi-part series looks at gun violence from many aspects but the violence’s effects on the city’s health care is tragic and distressing.

July 10, 2016

A little Rx for all the awful headlines: four stories of remarkable resilience

by Patrick A. Malone

The events of recent days ─in Texas, Louisiana, and Minnesota─ have been so tragic that it’s easy to despair. Here are four health-related people stories worth reading to remind us of humanity’s enduring better side:

In the horrors of Syrian combat, medical Samaritans strive to maintain some kind of care

First, let’s stipulate that there’s almost as much barbarous conduct as can be imagined in this recent New Yorker report about the struggle to maintain medical care in combat-ravaged Syria. President Assad’s predation on his own people has become an international abomination, including his forces unleashing snipers to maim emergency medical personnel, and their dropping barrel bombs, laden with lacerating shrapnel, on hospitals or known care-giving sites (February, 2016, photo of a bombed hospital from Doctors Without Borders/Medicins san Frontieres).

July 1, 2015

Waiting List for Vets Seeking Health Care Grows

by Patrick A. Malone

Last year the country was shocked to learn the extent of the systemic problems the Department of Veterans Affairs had in delivering adequate health care generally, and, specifically, the grossly long periods vets had to wait to get an appointment.

It’s not getting better.

Department officials told the New York Times that the number of vets on waiting lists of at least one month is 50% higher than it was during the height of last year’s problems.