Category: Health

Increasing Tax Rates Will Reduce Venture Funding for Cancer Research

(p. A17) In his last year as vice president, Joe Biden launched a “cancer moonshot” to accelerate cures for the disease. It was short-lived, but he did help negotiate an agreement in Congress easing regulation of breakthrough drugs and medical devices.

In February [2022], President Biden revived the initiative, setting a goal of reducing cancer death rates by at least 50% over the next 25 years. It’s ambitious but may be achievable given how rapidly scientific knowledge and treatments are advancing. Other Biden policies, however, are at odds with the goals of this one.

Two pharmaceutical breakthroughs were announced only last week that could save tens of thousands of lives each year and redefine cancer care. Yet the tax hikes and drug-price controls that the Biden administration is pitching would discourage the private investment that has delivered these potential cures.

. . .

Oncologists were blown away by the results reported last week in the New England Journal of Medicine: All 12 patients receiving the drug achieved complete remission after six months of treatment. None needed surgery, chemotherapy or radiation. Although some may relapse, the 100% success rate is unprecedented even for a small trial.

. . .

Last week AstraZeneca in partnership with Daiichi Sankyo reported that Enhertu reduced the risk of death by 36% in patients with metastatic breast cancer with low HER2 and by half for the subset who were hormone-receptor negative. These results blow the outcomes for other metastatic breast-cancer therapies out of the water.

. . .

These treatment breakthroughs aren’t happening because of government programs. They’re happening because pharmaceutical companies have invested decades and hundreds of billions of dollars in drug research and development. It typically takes 10.5 years and $1.3 billion to bring a new drug to market. About 95% of cancer drugs fail.

This is important to keep in mind as Mr. Biden and Democrats in Congress push for Medicare to “negotiate”—i.e., cap—drug prices and raise taxes on corporations and investors. The large profits that drugmakers notch from successful drugs are needed to reward shareholders for their investment risk and encourage future investment. Capital is mobile.

Mr. Biden’s proposal to increase the top marginal individual income-tax rates, including on capital gains, would punish venture capitalists who seed biotech startups, which do most early-stage research on cancer drugs and are often acquired by large drugmakers. At the same time, his proposed corporate global minimum tax would raise costs of intellectual property, which is often taxed at lower rates abroad.

There aren’t many things to celebrate nowadays, but biotech innovation is one. Let’s hope the president doesn’t kill his own cancer moonshot.

For the full commentary see:

Allysia Finley. “Biden May Stop His Cancer Moonshot’s Launch.” The Wall Street Journal (Thursday, June 16, 2022): A17.

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

(Note: the online version of the commentary has the date June 15, 2022, and has the same title as the print version.)

Corrupt Crony “Emergent” Firm Emerges as Incompetent Too

Emergent’s role in crony capitalism was documented in an earlier entry, that documented the donations and lobbying gifts they bestowed on congress and regulators in order to fill the emergency health stockpile with dubious anthrax vaccine instead of the masks and ventilators that were in demand during the Covid-19 pandemic.

(p. A7) WASHINGTON — Workers at a plant in Baltimore manufacturing two coronavirus vaccines accidentally conflated the ingredients several weeks ago, contaminating up to 15 million doses of Johnson & Johnson’s vaccine and forcing regulators to delay authorization of the plant’s production lines.

The plant is run by Emergent BioSolutions, a manufacturing partner to both Johnson & Johnson and AstraZeneca, the British-Swedish company whose vaccine has yet to be authorized for use in the United States. Federal officials attributed the mistake to human error.

. . .

The mistake is a major embarrassment both for Johnson & Johnson, whose one-dose vaccine has been credited with speeding up the national immunization program, and for Emergent, its subcontractor, which has faced fierce criticism for its heavy lobbying for federal contracts, especially for the government’s emergency health stockpile.

For the full story see:

Sharon LaFraniere and Noah Weiland. “Factory Mix-Up Ruins 15 Million Doses Of Vaccine From Johnson & Johnson.” The New York Times (Thursday, April 1, 2021): A7.

(Note: ellipsis added.)

(Note: the online version of the article was updated Aug. [sic] 1, 2021, and has the title “Factory Mix-Up Ruins Up to 15 Million Vaccine Doses From Johnson & Johnson.”

Drug Extending Life of Breast Cancer Patients by Six Months Is “Unheard-Of”

(p. A16) The patients had metastatic breast cancer that had been progressing despite rounds of harsh chemotherapy. But a treatment with a drug that targeted cancer cells with laserlike precision was stunningly successful, slowing tumor growth and extending life to an extent rarely seen with advanced cancers.

The new study, presented at the annual meeting of the American Society of Clinical Oncology and published on Sunday [June 5, 2022] in the New England Journal of Medicine, would change how medicine was practiced, cancer specialists said.

. . .

The clinical trial, sponsored by the pharmaceutical companies Daiichi Sankyo and AstraZeneca and led by Dr. Shanu Modi of Memorial Sloan Kettering Cancer Center, involved 557 patients with metastatic breast cancer who were HER2-low. Two-thirds took the experimental drug, trastuzumab deruxtecan, sold as Enhertu; the rest underwent standard chemotherapy.

. . .

“It is unheard-of for chemotherapy trials in metastatic breast cancer to improve survival in patients by six months,” said Dr. Moore, who enrolled some patients in the study. Usually, she says, success in a clinical trial is an extra few weeks of life or no survival benefit at all but an improved quality of life.

The results were so impressive that the researchers received a standing ovation when they presented their data at the oncology conference in Chicago on Sunday.

. . .

“This strategy is the real breakthrough,” he said, explaining that it would enable researchers to zoom in on molecular targets on tumor cells that were only sparsely present.

“This is about more than just this drug or even breast cancer,” Dr. Winer said. “Its real advantage is that it enables us to take potent therapies directly to cancer cells.”

For the full story see:

Gina Kolata. “Trial of New Breast Cancer Drug Results in ‘Unheard-Of’ Survival Rates.” The New York Times (Wednesday, June 8, 2022): A16.

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

(Note: the online version of the story has the date June 7, 2022, and has the title “Breast Cancer Drug Trial Results in ‘Unheard-Of’ Survival.” Where there are minor differences in wording between the versions, the passages quoted above follow the online version.)

The academic NEJM article reporting the results summarized in the passages quoted above is:

Modi, Shanu, William Jacot, Toshinari Yamashita, Joohyuk Sohn, Maria Vidal, Eriko Tokunaga, Junji Tsurutani, Naoto T. Ueno, Aleix Prat, Yee Soo Chae, Keun Seok Lee, Naoki Niikura, Yeon Hee Park, Binghe Xu, Xiaojia Wang, Miguel Gil-Gil, Wei Li, Jean-Yves Pierga, Seock-Ah Im, Halle C.F. Moore, Hope S. Rugo, Rinat Yerushalmi, Flora Zagouri, Andrea Gombos, Sung-Bae Kim, Qiang Liu, Ting Luo, Cristina Saura, Peter Schmid, Tao Sun, Dhiraj Gambhire, Lotus Yung, Yibin Wang, Jasmeet Singh, Patrik Vitazka, Gerold Meinhardt, Nadia Harbeck, and David A. Cameron. “Trastuzumab Deruxtecan in Previously Treated Her2-Low Advanced Breast Cancer.” New England Journal of Medicine 387, no. 1 (July 7, 2022): 9-20.

Three Cups of Coffee a Day Lowers Risk of Death

(p. D6) That morning cup of coffee may be linked to a lower risk of dying, researchers from a study published Monday [June 6, 2022] in The Annals of Internal Medicine concluded. Those who drank 1.5 to 3.5 cups of coffee per day, even with a teaspoon of sugar, were up to 30 percent less likely to die during the study period than those who didn’t drink coffee. Those who drank unsweetened coffee were 16 to 21 percent less likely to die during the study period, with those drinking about three cups per day having the lowest risk of death when compared with noncoffee drinkers.

Researchers analyzed coffee consumption data collected from the U.K. Biobank, a large medical database with health information from people across Britain. They analyzed demographic, lifestyle and dietary information collected from more than 170,000 people between the ages of 37 and 73 over a median follow-up period of seven years. The mortality risk remained lower for people who drank both decaffeinated and caffeinated coffee. The data was inconclusive for those who drank coffee with artificial sweeteners.

“It’s huge. There are very few things that reduce your mortality by 30 percent,” said Dr. Christina Wee, an associate professor of medicine at Harvard Medical School and a deputy editor of the scientific journal where the study was published. Dr. Wee edited the study and published a corresponding editorial in the same journal.

. . .

The study showed that the benefits of coffee tapered off for people who drank more than 4.5 cups of coffee each day.

For the full story see:

Dani Blum. “Have a Cup of Coffee. It Could Extend Your Life.” The New York Times (Tuesday, June 7, 2022): D6.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story has the date June 1, 2022, and has the title “Coffee Drinking Linked to Lower Mortality Risk, New Study Finds.” Where there are minor differences in wording between the versions, the passages quoted above follow the online version.)

The academic article summarized in the passages quoted above is:

Liu, Dan, Zhi-Hao Li, Dong Shen, Pei-Dong Zhang, Wei-Qi Song, Wen-Ting Zhang, Qing-Mei Huang, Pei-Liang Chen, Xi-Ru Zhang, and Chen Mao. “Association of Sugar-Sweetened, Artificially Sweetened, and Unsweetened Coffee Consumption with All-Cause and Cause-Specific Mortality.” Annals of Internal Medicine 175, no. 7 (July 2022): 909-17.

CDC’s “Rigid Checklist” Leads Doctors to Misdiagnose Atypical Cases

(p. A17) In his “memoir of illness and discovery,” Mr. Douthat tells us of his descent into a netherworld of consternation, paranoia and despair after contracting a chronic form of Lyme disease six years ago. Although he experienced physical pain that was often unbearable, he was stonewalled and scoffed at by skeptical doctors who refused to accept the existence of a long-lingering form of Lyme.

. . .

Lyme—a debilitating bacterial disease acquired from deer-tick bites—was ruled out because many of his symptoms didn’t match a rigid checklist drawn up for the ailment by the Centers for Disease Control and Prevention. This “diagnostic standardization,” Mr. Douthat writes, was “supposed to establish a consistent baseline for national case reporting, not rule out the possibility of atypical cases or constrain doctors from diagnosing them.” As a result of such inflexibility, he tells us, doctors miss “anywhere from a third to half of early Lyme cases.”

For the full review, see:

Tunku Varadarajan. “BOOKSHELF; Patient, Heal Thyself.” The Wall Street Journal (Saturday, Oct. 14, 2021): A17.

(Note: ellipsis added.)

(Note: the online version of the review has the date October 13, 2021, and has the title “BOOKSHELF; ‘The Deep Places’ Review: Patient, Heal Thyself.”)

The book under review is:

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

Sri Lankan Ban on Synthetic Fertilizer Causes Soaring Food Prices and Hunger

(p. A17) The Green Revolution of Norman Borlaug, the American agronomist who did more to feed the world than any man before or since, set Sri Lanka on the path to agricultural abundance in 1970. It was built around chemical fertilizers and crops bred to be disease-resistant. Fifty-two years later, Sri Lanka has pulled off a revolution that is “antigreen” in the modern sense, toppling its president, Gotabaya Rajapaksa. In an uprising that has its roots in Mr. Rajapaksa’s imperious decision to impose organic farming on the entire country—which led to widespread hunger after the agricultural economy collapsed—Sri Lanka’s people have wrought the first contra-organic national uprising in history.

. . .

. . ., Mr. Rajapaksa was driven from office in part because he was an overzealous green warrior, who imposed on his countrymen a policy that the American environmental left holds sacred.

. . .

. . ., Mr. Rajapaksa took a step that poleaxed Sri Lanka. On April 27, 2021—with no warning, and with no attempt to teach farmers how to cope with the change—he announced a ban on all synthetic fertilizers and pesticides. Henceforth, he decreed, Sri Lankan agriculture would be 100% organic. Agronomists and other scientists warned loudly of the catastrophe that would ensue, but they were ignored. This Sri Lankan Nero listened to no one.

. . .

What happened next? Rice production fell by 20% in the first 180 days of the ban on synthetic fertilizer. Tea, Sri Lanka’s main cash crop, has been hit hard, with exports at their lowest level in nearly a quarter-century. Whether from indignation over the new laws or an inability to go organic, farmers left a third of all farmland fallow. Food prices soared as a result of scarcity and Sri Lanka’s people, their pockets already hit by the pandemic, began to go hungry. To add to the stench of failure, a shipload of manure from China had to be turned back after samples revealed dangerous levels of bacteria. The farmers had no synthetic fertilizer, and hardly any of the organic kind.

For the full commentary see:

Tunku Varadarajan. “Sri Lanka’s Green New Deal Was a Human Disaster.” The Wall Street Journal (Friday, July 15, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 14, 2022, and has the same title as the print version.

Insurers Claim Curing Obesity Is “Vanity”

(p. A17) Maya Cohen’s entree into the world of obesity medicine came as a shock.

In despair over her weight, she saw Dr. Caroline Apovian, an obesity specialist at Brigham and Women’s Hospital, who prescribed Saxenda, a recently approved weight-loss drug. Ms. Cohen, who is 55 and lives in Cape Elizabeth, Maine, hastened to get it filled.

Then she saw the price her pharmacy was charging: $1,500 a month. Her insurer classified it as a “vanity drug” and would not cover it.

“I’m being treated for obesity,” she complained to her insurer, but to no avail.

. . .

More than 40 percent of Americans have obesity, and most have tried repeatedly to lose weight and keep it off, only to fail. Many suffer from medical conditions that are linked to obesity, including diabetes, joint and back pain and heart disease, and those conditions often improve with weight loss.

“The evidence is now overwhelming that there are physical changes in weight regulating pathways that make it difficult for people to lose weight and maintain their weight loss,” said Dr. Louis Aronne, an obesity medicine specialist who directs the comprehensive weight control center at Weill Cornell Medicine. “It’s not that they don’t have willpower. Something physical is holding them back.”

. . .

“Access to medicines for the treatment of obesity is dismal in this country,” said Dr. Fatima Cody Stanford, an obesity medicine specialist at Massachusetts General Hospital and Harvard Medical School.

. . .

Douglas Langa, an executive vice president at Novo Nordisk, . . . said that diabetes and obesity were “separate categories, separate marketplaces” to explain the difference in price between the companies’ two drugs that were based on the same medicine, semaglutide. He said Wegovy’s price “reflects efficacy and clinical value in this area of unmet need.”

Dr. Stanford was appalled.

“It’s unbelievable,” she said, adding that it was a gross inequity to charge people more for the same drug because of their obesity. She finds herself in an untenable situation: getting excited when her patients with obesity also have diabetes because their insurers pay for the drug.

For the full story, see:

Gina Kolata. “Many Insurers Won’t Cover New Weight Loss Drugs.” The New York Times (Wednesday, June 1, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the story has the date May 31, 2022, and has the title “The Doctor Prescribed an Obesity Drug. Her Insurer Called It ‘Vanity.’.”)

Cerebrospinal Fluid From Young Mice Improves the Memories of Old Mice

(p. D3) Five years ago, Tal Iram, a young neuroscientist at Stanford University, approached her supervisor with a daring proposal: She wanted to extract fluid from the brain cavities of young mice and to infuse it into the brains of older mice, testing whether the transfers could rejuvenate the aging rodents.

. . .

Dr. Iram persevered, working for a year just to figure out how to collect the colorless liquid from mice. On Wednesday [May 11, 2022], she reported the tantalizing results in the journal Nature: A week of infusions of young cerebrospinal fluid improved the memories of older mice.

. . .

Cerebrospinal fluid made for a logical target for researchers interested in aging. It nourishes brain cells, and its composition changes with age. Unlike blood, the fluid sits close to the brain.

But for years, scientists saw the fluid largely as a way of recording changes associated with aging, rather than countering its effects. Tests of cerebrospinal fluid, for example, have helped to identify levels of abnormal proteins in patients with significant memory loss who went on to develop Alzheimer’s disease.

. . .

“This is a very cool study that looks scientifically solid to me,” said Matt Kaeberlein, a biologist who studies aging at the University of Washington and was not involved in the research. “This adds to the growing body of evidence that it’s possible, perhaps surprisingly easy, to restore function in aged tissues by targeting the mechanisms of biological aging.”

Dr. Iram tried to determine how the young cerebrospinal fluid was helping to preserve memory by analyzing the hippocampus, a portion of the brain dedicated to memory formation and storage. Treating the old mice with the fluid, she found, had a strong effect on cells that act as precursors to oligodendrocytes, which produce layers of fat known as myelin that insulate nerve fibers and ensure strong signal connections between neurons.

The authors of the study homed in on a particular protein in the young cerebrospinal fluid that appeared involved in setting off the chain of events that led to stronger nerve insulation. Known as fibroblast growth factor 17, or FGF17, the protein could be infused into older cerebrospinal fluid and could partially replicate the effects of young fluid, the study found.

Even more strikingly, blocking the protein in young mice appeared to impair their brain function, offering stronger evidence that FGF17 affects cognition and changes with age.

. . .

But Dr. Wyss-Coray said that the study filled a critical gap in the understanding of how the brain’s environment changes as people age.

“The question is, ‘How can you maintain cognitive health until you die? How can you make the brain resilient to this relentless degeneration of the body?’” he said, “and what a growing number of studies show is that as we learn more about the aging process itself, maybe we can slow down aspects of aging and maintain tissue integrity or even rejuvenate tissues.”

For the full story, see:

Benjamin Mueller. “A Step Toward Refreshing Memory.” The New York Times (Tuesday, May 17, 2022): D3.

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

(Note: the online version of the story has the date May 11, 2022, and has the title “Spinal Fluid From Young Mice Sharpened Memories of Older Rodents.”)

The academic article in Nature that reports the results discussed in the passages quoted above is:

Iram, Tal, Fabian Kern, Achint Kaur, Saket Myneni, Allison R. Morningstar, Heather Shin, Miguel A. Garcia, Lakshmi Yerra, Robert Palovics, Andrew C. Yang, Oliver Hahn, Nannan Lu, Steven R. Shuken, Michael S. Haney, Benoit Lehallier, Manasi Iyer, Jian Luo, Henrik Zetterberg, Andreas Keller, J. Bradley Zuchero, and Tony Wyss-Coray. “Young CSF Restores Oligodendrogenesis and Memory in Aged Mice Via Fgf17.” Nature 605, no. 7910 (May 19, 2022): 509-15.

Gillies Created Reconstructive Surgery “Through Trial and Error”

(p. C6) During World War I, a handful of soldiers who had suffered catastrophic facial wounds traveled to Paris on a journey of last resort.

. . .

Trench warfare produced a huge number of facial injuries, and bespoke masks could never keep up with the demand.

. . .

But masks were of limited value, because they could conceal, but never heal, grievous wounds. Disfigured men needed a medical breakthrough to help them. Ms. Fitzharris, the author of “The Butchering Art” (2017), a history of Victorian medicine, chronicles the life of the British plastic surgeon Harold Delf Gillies, whose innovations and operating-room magic saved thousands of warriors from their fates and allowed them to walk in the world again. Both heartbreaking and inspiring, “The Facemaker” tells a profound story of survival, resurrection and redemption.

Born in New Zealand and educated in England, Gillies entered the Royal Army Medical Corps early in the war, at age 32. A champion amateur golfer, he began his soldiering as a novice military doctor. The second Battle of Ypres, in May 1915, was his baptism by fire. It was there, Ms. Fitzharris says, that he “first stepped into a field hospital’s makeshift operating theater,” where he labored around the clock, standing on a floor awash with blood. A month later, he was assigned to the Allied Forces base hospital in Étaples, France. The dental surgeon Auguste Charles Valadier showed him how to use bone grafts to reconstruct faces without distorting the features and to restore a patient’s ability to speak and eat.

That summer, Gillies sought out Hippolyte Morestin, an eccentric French surgeon devoted to achieving high-quality aesthetic results. Gillies watched Morestin remove a large cancerous growth from a patient’s face and close the wound with a flap of skin from the patient’s neck. It was a turning point for Gillies, who would describe the moment as “the most thrilling thing I had ever seen. I fell in love with the work on the spot.”

. . .

[Gillies’s] . . . key insight was that a multidisciplinary approach was needed: the combined work of plastic surgeons, dental surgeons, nurses, radiologists, artists, sculptors and photographers.

Gillies conceded it was “a strange new art,” without textbooks, precedent, or experience to guide its practice. Through trial and error, he re-created missing mouths and noses, filled in gaping voids of bone and flesh, restored obliterated jaws, treated horrific burns, and performed skin grafts. Until then, most surgeons had stitched together the edges of a gaping wound, a process that could cause necrosis and cellular destruction as well as further disfigurement. Among other things, Gillies learned that, to achieve the best results, he needed to perform surgery incrementally and space operations out over time, to allow patients to recover from one surgery to the next. Some men required 15 or 20 operations, occasionally as many as 40. “Never do today what can be put off till tomorrow” became his motto.

And Gillies mastered the use of the flaps, which are made to cover a wound and which have, as Ms. Fitzharris tells us, their “own blood supply in the form of a single large artery or multiple smaller blood vessels.” Gillies’s greatest invention was the tubed pedicle—a flap of skin attached to a “protective, infection-resistant cylinder,” which was itself attached to the injury site. It “dramatically reduced the chance for infection,” Ms. Fitzharris writes.

For the full review, see:

James L. Swanson. “Repairing the Wounds of War.” The Wall Street Journal (Saturday, May 28, 2022): C6.

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

(Note: the online version of the review has the date May 27, 2022, and has the title “‘The Facemaker’ Review: Repairing the Wounds of War.”)

The book under review is:

Fitzharris, Lindsey. The Facemaker: A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War. New York: Farrar, Straus and Giroux, 2022.

Lacking Government Approval During Pandemic, “State-of-the-Art Testing Machines . . . Weren’t Turned On”

(p. 12) The ethics manual of the American College of Physicians states that “the ethical imperative for physicians to provide care” overrides “the risk to the treating physician, even during epidemics.” Nevertheless, for most of human history, doctors often ran away in the face of widespread contagious disease.

. . .

When health workers stick around to treat patients, even at risk to their own lives, it is something to be celebrated, and the journalist Marie Brenner does just that in “The Desperate Hours,” an account of how workers at New York-Presbyterian, an academic health system, coped with the Covid surge in New York City beginning in the spring of 2020. The book details both medical heroism and corporate cowardice, prescient decisions and howling missteps, all against the backdrop of a swirling and mysterious pandemic that claimed the lives of more than 30,000 residents, not to mention 35 New York-Presbyterian employees.

Along the way we encounter some eye-opening anecdotes. Early on, New York City hospitals were faced with an alarming dearth of masks and a near rebellion by workers on the front lines. In response, New York-Presbyterian’s chief operating officer, Dr. Laura Forese, a pediatric orthopedic surgeon, assured staff members that “masks would not be necessary” unless workers were in direct contact with infected patients. Though she was working off mistaken C.D.C. guidelines, it was “advice and regulation that countermanded every bit of common sense understood by public health officials since the Black Plague,” Brenner writes.

. . .

Yet state-of-the-art testing machines at New York-Presbyterian weren’t turned on because the leadership was waiting for the government to approve their use. When doctors and nurses complained, the communications office attempted to throttle them and even threatened them with demotions or dismissal. It is part of what Dr. Steve Corwin, New York-Presbyterian’s chief executive, calls “a failure of imagination on our part.”

The book has its share of heroes who buck the strictures of the system to speak the truth about what was coming (or had already arrived). No one was more heroic than Dr. Nathaniel Hupert, an infectious-disease modeler at New York-Presbyterian who raised the alarm about the pandemic in February 2020 but was largely ignored.

“This is going to be historically bad, rivaling the medical consequences of 1918, but far exceeding it in terms of global financial impact,” he warned his colleagues. “If we get through this, it will be the sort of thing that we will tell our grandchildren about.” Yet when Hupert showed his projections at a planning meeting, the medical school dean told him, “I think we will be all right.”

. . .

Compounding the disaster was that little guidance was coming from executives on how to navigate the crisis, including how to potentially ration beds and ventilators (which fortunately did not come to pass). “The amount of moral damage they did to a lot of people while they get paid millions of dollars is disgusting,” a critical-care physician says bitterly.

For the full review, see:

Sandeep Jauhar. “Plagued.” The New York Times Book Review (Sunday, July 3, 2022): 12.

(Note: ellipses added.)

(Note: the online version of the review has the date June 19, 2022, and has the title “Facing Death During the Pandemic.”)

The book under review is:

Brenner, Marie. The Desperate Hours: One Hospital’s Fight to Save a City on the Pandemic’s Front Lines. New York: Flatiron Books, 2022.

Spreading Smallpox Inoculation to Impress Voltaire

(p. A15) Dimsdale had been summoned by Catherine the Great to inoculate not only the empress herself but also her 13-year-old heir, the Grand Duke Paul.

. . .

As Lucy Ward dramatically relates in “The Empress and the English Doctor: How Catherine the Great Defied a Deadly Virus,” Catherine’s invitation was a high-stakes affair, a testament to Dimsdale’s writings on the methodology of smallpox inoculation and his reputation for solicitous care. His Quaker upbringing had encouraged a brand of outcome- rather than ego-led practice.

. . .

As devastating as smallpox was, for the empress herself and the grand duke who would succeed her to personally undergo inoculation was a risk to both patient and doctor. On the success side stood immunity from the disease, an almost holy example for Catherine’s people, and as-yet-untold riches for her nervous doctor. On the other side, not only the fact that all Russia would refuse the treatment if their “Little Mother” died, but also a disaster for Dimsdale and the son who had accompanied him. Geopolitics came into play too—if things went wrong, some would interpret it as a foreign assassination.

. . .

With a happy result for her and her less-robust son, Catherine sets about publicizing the success. Dimsdale receives the equivalent of more than $20 million and a barony. Bronze medals are cast of Catherine’s profile, reading “She herself set an example.” It helps that Catherine was competitive beyond reason: “we have inoculated more people in a month than were inoculated in Vienna in eight,” she wrote to Voltaire, determined to beat Empress Maria Theresa’s efforts.

For the full review, see:

Catherine Ostler. “BOOKSHELF; Inoculate Conception.” The Wall Street Journal (Thursday, June 23, 2022): A15.

(Note: ellipses added.)

(Note: the online version of the review was updated June 22, 2022, and has the title “BOOKSHELF; ‘The Empress and the English Doctor’ Review: Inoculate Conception.”)

The book under review is:

Ward, Lucy. The Empress and the English Doctor: How Catherine the Great Defied a Deadly Virus. London, UK: Oneworld Publications, 2022.