Category: Health

Fauci’s Office Rejected Protocol for a Voluntary COVID Human Challenge Trial That Could Have Tested Therapies and Vaccines Faster

(p. 2) . . . the first Covid-19 human challenge study [was] just completed in Britain, where young, healthy and unvaccinated volunteers were infected with the coronavirus that causes Covid while researchers carefully monitored how their bodies responded.

. . ., there were those who decried deliberately infecting or “challenging” healthy volunteers with disease-causing pathogens. It violates the medical principle of “do no harm.” The trade-off is a unique opportunity to discover the causes, transmission and progression of an illness, as well as the ability to more rapidly test the effectiveness of proposed treatments.

. . .

Dr. [Matthew] Memoli [the director of the Laboratory of Infectious Diseases Clinical Studies Unit at the National Institute of Allergy and Infectious Diseases] has conducted numerous influenza challenge studies, and he prepared a protocol for a Covid challenge trial that the National Institute of Allergy and Infectious Diseases rejected last year because it was felt that not enough was known about the virus and that there were no effective rescue therapies, according to a statement from the office of the director, Dr. Anthony Fauci.

The consortium formed to run Britain’s Covid challenge trial, which included scientists who trained at the Common Cold Unit, had access to the British National Health Service’s robust, real-time data on Covid hospitalizations and deaths. The researchers designing the study said they felt confident that there was little risk to the healthy unvaccinated 18-to-30-year-old volunteers they recruited for the trial. There were no severe adverse events in the 36 people who participated, and they will continue to be monitored over the next year.

The aim of the study was to identify the lowest amount of virus to safely and reliably infect someone, so researchers can later easily test the efficacy of vaccines or antivirals on future challenge trial volunteers.

. . .

Dr. Fauci’s office said the institute has no plans to fund Covid-19 human challenge trials in the future. Many bioethicists support that decision. “We don’t ask people to sacrifice themselves for the good of society,” said Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics. “In the U.S., we are very much about protecting individual rights and individual life and health and liberty, while in more communal societies it’s about the greater good.”

But Josh Morrison, a co-founder of 1Day Sooner, which advocates on behalf of more than 40,000 would-be human challenge volunteers, argues it should be his and other people’s right to take risks for the greater good. “Most people aren’t going to want to be in a Covid challenge study, and that’s totally fine, but they shouldn’t project their own choices on other people,” he said.

. . .

As one participant in Britain’s Covid human challenge trial put it: “You know the phrase ‘one interesting fact about yourself’ that strikes terror into everyone? That’s now solved forever. I did something that made a difference.”

For the full commentary, see:

Kate Murphy. “Are Human Challenge Trials Ethical?” The New York Times, SundayReview Section (Sunday, October 17, 2021 [sic]): 2.

(Note: ellipses, and bracketed words, added.)

(Note: the online version of the commentary has the date Oct. 14, 2021 [sic], and has the title “Britain Infected Volunteers With the Coronavirus. Why Won’t the U.S.?”)

The “Rules of Desperation Oncology” Allow Oncologists to Throw Dying Patients a Hail Mary Immunotherapy Drug

(p. D1) Dr. Oliver Sartor has a provocative question for patients who are running out of time.

Most are dying of prostate cancer. They have tried every standard treatment, to no avail. New immunotherapy drugs, which can work miracles against a few types of cancer, are not known to work for this kind.

Still, Dr. Sartor, assistant dean for oncology at Tulane Medical School, asks a diplomatic version of this: Do you want to try an immunotherapy drug before you die?

The chance such a drug will help is vanishingly small — but not zero. “Under rules of desperation oncology, you engage in a different kind of oncology than the rational guideline thought,” Dr. Sartor said.

The promise of immunotherapy has drawn cancer specialists into a conundrum. When the drugs work, a cancer may seem to melt away overnight. But little is known about which patients might benefit, and from which drugs.

Some oncologists choose not to mention immunotherapy to dying patients, arguing that scientists first must gather rigorous evidence about the benefits and pitfalls, and that treating patients experimentally outside a clinical trial is perilous business.

But others, like Dr. Sartor, are offering the drugs to some terminal patients as a roll of the dice. If the patient is dying and there’s a remote chance the drug will help, then why not?

. . .

(p. D6) . . . there is Clark Gordin, 67, who lives in Ocean Springs, Miss. He had metastatic prostate cancer, “a bad deck of cards,” he said in an interview.

Dr. Sartor tried conventional treatments, but they didn’t work for Mr. Gordin. Finally, the doctor suggested immunotherapy.

Mr. Gordin’s insurer refused. But then the lab that had analyzed his tumor discovered it had made a mistake.

There was a chance Mr. Gordin might respond to immunotherapy, because he had a rare mutation. So his insurer agreed to pay.

Immediately after taking the drugs, Mr. Gordin’s PSA level — an indicator of the cancer’s presence — went down to nearly zero.

“Makes my heart nearly stop every time I think about it,” Dr. Sartor said. “Life sometimes hangs on a thin thread.”

For the full story see:

Gina Kolata. “A Life’s One Last Chance.” The New York Times (Tuesday, May 1, 2018 [sic]): D1 & D6.

(Note: ellipses added.)

(Note: the online version of the story has the date April 26, 2018 [sic], and has the title “‘Desperation Oncology’: When Patients Are Dying, Some Cancer Doctors Turn to Immunotherapy.”)

Dogs Can Alert Owners to Epileptic or Diabetic Emergencies

(p. B1) Rosebud is a service dog trained at a nonprofit called Canine Partners for Life in Cochraneville, Pa. The dog can detect when Ms. Vible will have a seizure about 15 minutes before it happens. She lets Ms. Vible know with a whine or a bark and then lies down with her owner until the seizure is over.

Seizure-alert dogs are part of a growing class of service animals that can detect warning signs of epileptic seizures and diabetic emergencies and identify other medical conditions. Demand has surged, according to trainers and training centers—some of which now have long wait lists—as recent scientific studies have started to confirm the dogs’ efficacy in helping their owners.

. . .

Their acute sense of smell helps the dogs detect low and high blood-sugar levels and epileptic seizures before they happen. Researchers haven’t yet identified the specific compounds that the dogs are smelling. But once the dogs recognize the smell, they are trained to respond with a specific action such as barking or pawing at their owners. Depending on the owner’s state and the animal’s training, some dogs also might alert another adult, bring a juice box or press a button that sends a phone text to a caregiver.

The University of Bristol in England this year produced a study of dogs’ ability to detect hypoglycemia, which occurs when a diabetic’s blood sugar drops dangerously. If left untreated, this can lead to unconsciousness or death. In assessing the effectiveness of 27 glycemia-alert dogs, the Bristol study found that the dogs alerted their owners to 83% of hypoglycemic episodes in more than 4,000 hypo- and hyperglycemic episodes.

The findings of another study released this year showed promise for people suffering from epilepsy. Researchers from the University of Rennes in Normandy, France, presented dogs with samples of breath and sweat odors obtained from epileptic patients having seizures, not having seizures and exercising (to determine whether the dogs were just detecting sweat). All of the dogs succeeded in identifying the epileptic-seizure-odor sample, and the dogs spent about 23 seconds investigating the seizure smell, compared with about five seconds spent on the other samples.

The lead researcher of the study, Amelie Catala, a Ph.D. candidate at the University of Rennes, says the research could help in the development of electronic noses, devices that can detect and analyze odors and flavors.

“If there is an organic compound related to these diseases that we can detect and identify, it could help develop electronic noses,” she says.

Medical-alert dogs are being trained by for-profit and nonprofit centers, by individual trainers and at times by individual pet owners themselves. In addition to those skills already mentioned, some have been trained to warn patients about abnormal heart rhythms, and to detect allergens. Dogs also have been trained to help identify certain cancers in laboratory settings.

For the full story, see:

Aili McConnon. “Dogs That Can Read Warning Signs Progress Before Explosion.” The Wall Street Journal (Monday, Sept. 16, 2019 [sic]): R9.

(Note: ellipsis added.)

(Note: the online version of the story has the date Sept. 12, 2019 [sic], and has the title “A Growing Role for Medical-Alert Dogs.” The last four paragraphs quoted above appear in the online, but not in the print, version of the article.)

The University of Bristol academic paper mentioned above is:

Rooney, Nicola J., Claire M. Guest, Lydia C. M. Swanson, and Steve V. Morant. “How Effective Are Trained Dogs at Alerting Their Owners to Changes in Blood Glycaemic Levels?: Variations in Performance of Glycaemia Alert Dogs.” PLOS ONE 14, no. 1 (2019): e0210092.

The University of Rennes academic paper mentioned above is:

Catala, Amélie, Marine Grandgeorge, Jean-Luc Schaff, Hugo Cousillas, Martine Hausberger, and Jennifer Cattet. “Dogs Demonstrate the Existence of an Epileptic Seizure Odour in Humans.” Scientific Reports 9, no. 1 (2019): article #4103.

Allowing the Sale of Hearing Aids Over-the-Counter (O.T.C.) Results in “Increased Innovation and Lower Prices”

(p. D3) A year ago, the Food and Drug Administration announced new regulations allowing the sale of over-the-counter hearing aids and setting standards for their safety and effectiveness.

. . .

Some background: In 2020, the influential Lancet Commission on Dementia Prevention, Intervention and Care identified hearing loss as the greatest potentially modifiable risk factor for dementia.

Previous studies had demonstrated a link between hearing loss and cognitive decline, said Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins and lead author of the new research.

“What remained unanswered was, If we treat hearing loss, does it actually reduce cognitive loss?” he said. The ACHIEVE study (for Aging and Cognitive Health Evaluation in Elders) showed that, at least for a particular group of older adults, it could.

. . .

A small study recently published in JAMA Otolaryngology found that patients who were given a commercially available, self-fitting hearing aid in a clinical trial could, after six weeks, hear as well as patients fitted with the same device by audiologists.

. . .

The United States is the first country to develop a regulated O.T.C. hearing aid market, and “the tech companies and the retailers are still experimenting,” Dr. Lin pointed out. He predicts increased innovation and lower prices ahead.

For the full commentary, see:

Paula Span. “THE NEW OLD AGE; A Challenging Over-the-Counter Market for Hearing Aids.” The New York Times (Tuesday, October 31, 2023): D3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Oct. 30, 2023, and has the title “THE NEW OLD AGE; Hearing Aids Are More Affordable, and Perhaps More Needed, Than Ever.”)

The “small study” mentioned above is:

De Sousa, Karina C., Vinaya Manchaiah, David R. Moore, Marien A. Graham, and De Wet Swanepoel. “Effectiveness of an over-the-Counter Self-Fitting Hearing Aid Compared with an Audiologist-Fitted Hearing Aid: A Randomized Clinical Trial.” JAMA Otolaryngology–Head & Neck Surgery 149, no. 6 (2023): 522-30.

Surgeons Often Excise Useful Appendix Even When Antibiotics Would Have Cured–“Surgeons Who Don’t Operate Miss Out on a Hefty Fee”

(p. D7) The appendix is a finger-shaped pouch attached to the large intestine (colon), usually on the lower right side of the abdomen. Long considered a vestigial organ with no known function, many people, young and old, have theirs removed in the course of another operation.

However, there are now indications that the appendix serves as a repository of healthy bacteria that can replenish the gut after an extreme attack of diarrhea. People who have had appendectomies, for example, are more likely to experience recurrent infections with the bacterium Clostridium difficile, a debilitating intestinal infection that causes severe, difficult-to-treat diarrhea.

. . .

Acute appendicitis is the nation’s most common surgical emergency.  . . .  Some 300,000 people in the United States undergo an appendectomy each year, but sometimes, the appendix turns out not to have been inflamed, meaning the operation was not necessary.

The results of several recent studies suggest that patients with uncomplicated appendicitis should not be rushed into surgery and instead should be offered the option of a trial of antibiotics.

In a controlled study among 540 adult patients, 72.7 percent of 257 patients randomly assigned to take antibiotics in lieu of an operation did not require subsequent surgery a year later, and those who did need surgery had no bad effects from the delay.

In another nonrandomized study of 3,236 patients who were not operated on initially, the nonsurgical treatment failed to cure the appendicitis in 5.9 percent of cases, and the inflammation recurred in 4.4 percent.

Some patients may choose an operation so they won’t have to worry about developing another attack of appendicitis, but if they aren’t told they have a choice, they can hardly make one.

Writing in JAMA [in February 2016] . . ., Dr. Dana A. Telem, a surgeon at Stony Brook University Medical Center, noted that “the notion of nonoperative treatment of appendicitis has not been well-received by the majority of the surgical community.” This is hardly surprising, because doctors, like many of us, are creatures of habit, and surgeons who don’t operate miss out on a hefty fee.

For the full story see:

JANE E. BRODY. “PERSONAL HEALTH; A Choice for Treating Appendicitis.” The New York Times (Tuesday, March 22, 2016 [sic]): D7.

(Note: ellipses, and bracketed words, added.)

(Note: the online version of the story has the date March 21, 2016 [sic], and has the title “PERSONAL HEALTH; A New View of Appendicitis.”)

The controlled randomized study mentioned above is:

Salminen, Paulina, Hannu Paajanen, Tero Rautio, Pia Nordström, Markku Aarnio, Tuomo Rantanen, Risto Tuominen, Saija Hurme, Johanna Virtanen, Jukka-Pekka Mecklin, Juhani Sand, Airi Jartti, Irina Rinta-Kiikka, and Juha M. Grönroos. “Antibiotic Therapy Vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The Appac Randomized Clinical Trial.” JAMA 313, no. 23 (2015): 2340-48.

The nonrandomized study mentioned above is:

McCutcheon, Brandom A., David C. Chang, Logan P. Marcus, Tazo Inui, Abraham Noorbakhsh, Craig Schallhorn, Ralitza Parina, Francesca R. Salazar, and Mark A. Talamini. “Long-Term Outcomes of Patients with Nonsurgically Managed Uncomplicated Appendicitis.” Journal of the American College of Surgeons 218, no. 5 (May 2014): 905-13.

Mandated Fukushima Evacuations Killed 1,600; Radiation Killed 0

Berkeley scientist Noah Whiteman’s Most Delicious Poison argues that often chemicals that are therapeutic at low doses are poisons at high doses. The commentary quoted below provides evidence that what Whiteman argues is true of many chemicals, is also true of radiation.

(p. D3) This spring [2015], four years after the nuclear accident at Fukushima, a small group of scientists met in Tokyo to evaluate the deadly aftermath.

No one has been killed or sickened by the radiation — a point confirmed last month by the International Atomic Energy Agency. Even among Fukushima workers, the number of additional cancer cases in coming years is expected to be so low as to be undetectable, a blip impossible to discern against the statistical background noise.

But about 1,600 people died from the stress of the evacuation — one that some scientists believe was not justified by the relatively moderate radiation levels at the Japanese nuclear plant.

. . .

“The government basically panicked,” said Dr. Mohan Doss, a medical physicist who spoke at the Tokyo meeting, when I called him at his office at Fox Chase Cancer Center in Philadelphia. “When you evacuate a hospital intensive care unit, you cannot take patients to a high school and expect them to survive.”

Among other victims were residents of nursing homes. And there were the suicides. “It was the fear of radiation that ended up killing people,” he said.

Most of the fallout was swept out to sea by easterly winds, and the rest was dispersed and diluted over the land. Had the evacuees stayed home, their cumulative exposure over four years, in the most intensely radioactive locations, would have been about 70 millisieverts — roughly comparable to receiving a high-resolution whole-body diagnostic scan each year. But those hot spots were anomalies.

By Dr. Doss’s calculations, most residents would have received much less, about 4 millisieverts a year. The average annual exposure from the natural background radiation of the earth is 2.4 millisieverts.

How the added effect of the fallout would have compared with that of the evacuation depends on the validity of the “linear no-threshold model,” which assumes that any amount of radiation, no matter how small, causes some harm.

Dr. Doss is among scientists who question that supposition, one built into the world’s radiation standards. Below a certain threshold, they argue, low doses are harmless and possibly even beneficial — a long-debated phenomenon called radiation hormesis.

. . .

Life evolved in a mildly radioactive environment, and some laboratory experiments and animal studies indicate that low exposures unleash protective antioxidants and stimulate the immune system, conceivably protecting against cancers of all kinds.

. . .

. . ., a study of radon by a Johns Hopkins scientist suggested that people living with higher concentrations of the radioactive gas had correspondingly lower rates of lung cancer. If so, then homeowners investing in radon mitigation to meet federal safety standards may be slightly increasing their cancer risk. These and similar findings have also been disputed.

. . .

There is more here at stake than agonizing over irreversible acts, like the evacuation of Fukushima. Fear of radiation, even when diluted to homeopathic portions, compels people to forgo lifesaving diagnostic tests and radiotherapies.

We’re bad at balancing risks, we humans, and we live in a world of continual uncertainty. Trying to avoid the horrors we imagine, we risk creating ones that are real.

For the full commentary, see:

George Johnson. “RAW DATA; When Radiation Isn’t the Risk.” The New York Times (Tuesday, Sept. 22, 2015 [sic]): D3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Sept. 21, 2015 [sic], and has the title “RAW DATA; When Radiation Isn’t the Real Risk.”)

The recent book by Whiteman mentioned above is:

Whiteman, Noah. Most Delicious Poison: The Story of Nature’s Toxins―from Spices to Vices. New York: Little, Brown Spark, 2023.

The study of radon mentioned above is:

Thompson, Richard E. “Epidemiological Evidence for Possible Radiation Hormesis from Radon Exposure: A Case-Control Study Conducted in Worcester, Ma.” Dose-Response 9, no. 1 (2011): 59-75.

Isaacson Reprises His Themes of “Science, Genius, Experiment, Code, Thinking Different” in Book on CRISPR

(p. 12) The landmark research that brought Doudna and Charpentier to the pinnacle of global acclaim has the potential to control future pandemics — either by outwitting the next viral plague through better screening and treatment or by engineering human beings with better disease resistance programmed into their cells. The technique of gene editing that they patented, which goes by the unwieldy acronym of CRISPR-Cas9, makes it possible to selectively snip and alter bits of DNA as though they were so many hems to take up or waistbands to let out. The method is based on defenses pioneered by bacteria in their ages-old battle against viruses.

. . .

The CRISPR history holds obvious appeal for Walter Isaacson, a biographer of Albert Einstein, Benjamin Franklin, Steve Jobs and Leonardo da Vinci. In “The Code Breaker” he reprises several of his previous themes — science, genius, experiment, code, thinking different — and devotes a full length book to a female subject for the first time.

. . .

Isaacson keeps a firm, experienced hand on the scientific explanations, which he mastered through extensive readings and interviews, all of which are footnoted.

For the full review, see:

Dava Sobel. “Deus Ex Machina.” The New York Times Book Review (Sunday, March 21, 2021 [sic]): 12.

(Note: ellipses added.)

(Note: the online version of the review has the date March 8, 2021 [sic], and has the title “A Biography of the Woman Who Will Re-Engineer Humans.”)

The book under review is:

Isaacson, Walter. The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race. New York: Simon & Schuster, 2021.

Risk of Bat Disease Spillover to Humans Is Small and Decreasing

(p. A15) The World Health Assembly in May is poised to divert $10.5 billion of aid away from tackling diseases such as malaria and tuberculosis. Instead, that money will go toward combating the threat of viruses newly caught from wildlife. The assumption behind this initiative, endorsed by the Group of 20 summit in Bali in 2022, is that the threat of pandemics from spillovers of animal viruses is dramatically increasing.

That assumption is almost certainly false. A new report from the University of Leeds, prepared in part by former World Health Organization executives, finds that the claims made by the G-20 in support of this agenda either are unsupported by evidence, contradict their own cited sources, or fail to correct for improved detection of pathogens. Over the past decade the burden and risk of spillover has been relatively small and probably decreasing. The Leeds authors conclude: “The implication is that the largest investment in international public health in history is based on misinterpretations of key evidence as well as a failure to thoroughly analyze existing data.”

. . .

It is a misconception that population growth or prosperity leads humanity to encroach on wildlife habitats. The poorest people in Africa encroach on forest wildlife by hunting for bush meat; when they grow richer, they shop for chicken or pork instead. Humans visited bat caves more frequently in the distant past.

. . .

The prospect of spending $31 billion a year on pandemic prevention, a third of which would be new money and a third diverted from other programs, provides an incentive for international bureaucrats to ignore or misrepresent evidence that the problem is small.

But a dollar spent on spillover can’t be spent on something else, and the evidence is clear that sanitation, nutrition and vitamins are more cost-effective ways to save lives in poor countries—from infectious diseases as well as other causes.

For the full commentary, see:

Matt Ridley. “Why Scientists Love Chasing Bats.” The Wall Street Journal (Thursday, March 7, 2024): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date March 6, 2024, and has the same title as the print version.)

The University of Leeds report mentioned above is:

Bell, David, Garrett Brown, Blagovesta Tacheva, and Jean von Agris. “Rational Policy over Panic: Re-Evaluating Pandemic Risk within the Global Pandemic Prevention, Preparedness and Response Agenda.” REPPARE Report. University of Leeds, UK, Feb. 2024, URL: https://essl.leeds.ac.uk/downloads/download/228/rational-policy-over-panic.

By Serendipity and Persistence, Epstein Found the Epstein-Barr Virus That Can Cause a Cancer

(p. A23) In March 1961, Dr. Anthony Epstein, a pathologist at Middlesex Hospital in London, almost skipped a visiting physician’s afternoon lecture about children with exceptionally large facial tumors in Uganda.

. . .

Despite Dr. Epstein’s initial reluctance to attend the talk — he sat in the rear so he could make a quick escape — his excitement grew the longer Dr. Burkitt spoke. By the time the lecture was over, he knew that he would drop all of his ongoing projects to find the cause of that unusual malignancy.

. . .

“To have the insight and to be able to follow his hypothesis, with a little acknowledged serendipity, and identify the novel virus was pioneering,” Dr. Darryl Hill, who heads the University of Bristol’s School of Cellular and Molecular Medicine in England, said in an email.

. . .

When the 50th anniversary of E.B.V.’s discovery was celebrated in 2014, Dr. Epstein told an interviewer with the BBC what he had been thinking as he listened to Dr. Burkitt speak in 1961.

“I thought there must be some biological agent involved,” Dr. Epstein said. “I was working on chicken viruses which cause cancer. I had virus-inducing tumors at the front of my head.”

. . .

The discovery of the virus was not quick. Dr. Burkitt sent tumor biopsies to London from Kampala, Uganda, but Dr. Epstein couldn’t find viruses in the early specimens, according to Dr. Hill, who wrote a remembrance of Dr. Epstein for the University of Bristol.

When another biopsy shipment was diverted from Heathrow Airport to another airport, in Manchester, England, because of fog, the sample seemed doomed, Dr. Hill said.

“By the time the sample reached Tony, it had gone cloudy — usually a sign of bacterial contamination that would consign it to the bin,” Dr. Hill wrote in his tribute. “Tony did not throw it away but examined it carefully.”

“He discovered, to his surprise, that the cloudiness was due to lymphoid tumor cells that had been shaken off the biopsy in transit and were now floating merrily in suspension.” He continued, “Tony exploited this chance finding to grow cell lines, derived from the tumor, in culture. He showed that these stayed alive indefinitely.”

Studying his new sample with a powerful electron microscope, Dr. Epstein was able to spot the distinct viral signature of a herpes virus. Dr. Hill called the discovery a eureka moment.

For the full obituary, see:

Delthia Ricks. “Dr. Anthony Epstein, 102, Who Discovered Epstein-Barr Virus, Dies.” The New York Times (Friday, March 8, 2024): A23.

(Note: ellipses added.)

(Note: the online version of the obituary was updated March 11 [sic], 2024, and has the title “Dr. Anthony Epstein, Pathologist Who Discovered Epstein-Barr Virus, Dies at 102.” Where there are minor differences in wording between versions, the passages quoted above follow the online version.)

If Your Disease Has No “F.D.A.-Stamped” Cure, Try Rational Experiments Rather Than Give Up

(p. 9) My whole family was sick in March with Covid-like symptoms, and though the one test we obtained was negative, I’m pretty sure we had the thing itself — and my own symptoms took months rather than weeks to disappear.

But unlike many of the afflicted, I didn’t find the experience particularly shocking, because I have a prior long-haul experience of my own. In the spring of 2015, I was bitten by a deer tick, and the effects of the subsequent illness — a combination of Lyme disease and a more obscure tick-borne infection, Bartonella — have been with me ever since.

Lyme disease in its chronic form — or, per official medical parlance, “post-treatment Lyme disease syndrome” — is a fiendishly complicated and controversial subject, and what I learned from the experience would (and will, at some point) fill a book.

. . .

If you feel like you need something else to get better, some outside intervention, something more than just your own beleaguered body’s resources, be impatient — and find a way to go in search of it.

. . .

EXPERIMENT, EXPERIMENT, EXPERIMENT.

There is no treatment yet for “long haul” Covid that meets the standard of a randomized, double-blind, placebo-controlled trial, which means that the F.D.A.-stamped medical consensus can’t be your only guide if you’re trying to break a systemic, debilitating curse. The realm beyond that consensus has, yes, plenty of quacks, perils and overpriced placebos. But it also includes treatments that may help you — starting with the most basic herbs and vitamins, and expanding into things that, well, let’s just say I wouldn’t have ever imagined myself trying before I become ill myself.

So please don’t drink bleach, or believe everything you read on Goop.com. But if you find yourself decanting Chinese tinctures, or lying on a chiropractor’s table with magnets placed strategically around your body, or listening to an “Anti-Coronavirus Frequency” on Spotify, and you think, how did I end up here?, know that you aren’t alone, and you aren’t being irrational. The irrational thing is to be sick, to have no official treatment available, and to fear the outré or strange more than you fear the permanence of your disease.

. . .

. . . I believe that with enough time and experimentation, I will actually be well.

That belief is essential. Hold on to it. In the long haul, it may see you through.

For the full commentary, see:

Ross Douthat. “What to Do When Covid Doesn’t Go Away.” The New York Times, SundayReview Section (Sunday, August 9, 2020 [sic]): 9.

(Note: ellipses and bracketed year added. A few words in the original are italicized, but you cannot see that since my blog formatting has all quoted words italicized.)

(Note: the online version of the commentary has the date Aug. 8, 2020 [sic], and has the title “China Wants to Move Ahead, but Xi Jinping Is Looking to the Past.” The heading EXPERIMENT, EXPERIMENT, EXPERIMENT was in bold in both the online and print versions. In the print version it was all in caps. In the online version only the first letter of each word was capitalized.)

Douthat’s The Deep Places book can be viewed as a substantial elaboration of the commentary quoted above:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.

“If You Burn Out, Relight the Fire”

(p. A11) Dr. Gladys McGarey, 103, continues to consult, give talks and podcast interviews after nearly eight decades in the medical field. She started an Instagram account that has nearly 47,000 followers.

“If you burn out, relight the fire,” says McGarey. She ran a clinic while raising six children and had to start a new one when her husband and clinic partner left her when she was 69 and married one of their colleagues.

. . .

Not everyone wants to work in their later years, says Dr. Robert Waldinger, a professor of psychiatry at Harvard Medical School.

“It’s not burnout. It’s just ‘I don’t want to do this anymore,’ ” says Waldinger, director of the Harvard Study of Adult Development, a longitudinal study on how people thrive.

As people get older, they are better at discerning what really matters, he says, and what they can let go of. The goal isn’t necessarily an 80-year career, but finding purpose in whatever we chose to do in our 80s and beyond, whether that is taking care of a grandchild, playing the piano, or joining a community theater.

For many, there is passion, purpose and love in the work.

. . .

Like others who have remained engaged in their careers in their later years, she says the secret is to find things that make life important and our “hearts sing.”

For the full commentary, see:

Clare Ansberry. “At 103, Work Still Makes Heart Sing.” The Wall Street Journal (Wednesday, Jan. 3, 2024): A11.

(Note: ellipses added.)

(Note: the online version of the commentary has the date December 29, 2023, and has the title “TURNING POINTS; How to Work—and Love It—Into Your 80s and Beyond.”)

The memoir by McGarey mentioned above is:

McGarey, Gladys. The Well-Lived Life: A 102-Year-Old Doctor’s Six Secrets to Health and Happiness at Every Age. New York: Atria Books, 2023.