it was an interesting day in my hometown. I love the sense of belonging, my place on earth. Out at the cemetery are 6 generations of Miller's whom I visit with some regularity. Children do the same things I did as a child. Many around me are far too poor to have joined the video game age. They play baseball in the evenings on "invented" baseball fields in the middle of nowhere. When I was little, one of the games we played involved batting yellowjackets with broom handles. It was a wonderful game. We'd troop through the fields at the edge of the woods looking for yellowjacket nests. Here's how you do it... walk along, a group of six or eight dirty sweaty little urchins, looking for a yellowjacket. When you spot one, yell out and everyone gathers and follow the nasty little creature to his home. The chase was gloriously fun all in itself. Once we had home located the game began. We'd all have our bats... old broom handles or some other straight stick 3 or 4 feet long. One elected soul would go up and jam a stick in the hornet nest. Then the fun began. We'd circle the hornet nest in a 30 or 40 foot circle and wave our sticks. As you saw one of the little demons coming at you, the idea was to whap him with your bat. One point for each hit. If you got stung, you'd go back to zero. Believe me, it was a fair fight and boy oh boy did it improve you ability to keep your eye on the "ball". Warren Buffet and "fat pitch" investing had no place in our game. With that experience under my belt, I don't think I ever saw a curve ball I couldn't hit. But... this is a medicine story... I think. Well, I'll be damned if some little boys around these parts still play a variation of the game. Some little crew were playing the same old game yesterday with hornets (not quite the challenge of a nest of angry yellowjackets... but still a fine test of hand-eye coordination and nerves). One of the little boys got stung and shortly after developed an anaphylactic reaction. Thankfully it was near home and he was rushed to our ER where I, as one of the ICU guys, consulted. With some benadryl, some epinephrine, and lots of steroids he did just fine. And so my thoughts drifted to steroids and cortisone and the Mayo Clinic and Dr Phil Hench. When I was at the Mayo back in the mid-70's it hadn't even been twenty years since cortisone had been discovered. You simply won't believe how that discovery came about. Dr Hench was a rheumatologist and he was desperate to find a treatment for rheumatoid arthritis, one of the illnesses out biotech friends are trying to make billions from. Dr Hench had noticed how women who get pregnant often seemed to go into remission. So he was on a constant search for the "thing" in pregnancy that produced this remission. Down in one of the basement bowels of the MC was a biochemist isolating compounds from various organs of the body. One of the isolates came from the adrenal gland and had some association with pregnancy (I don't remember what). It was labeled "compound F". Now you'll not believe what I'm going to tell you next. Dr Hench had been periodically injecting these various isolated compounds into people. This story came directly from the mouth of one of Dr Hench's assistants. To my knowledge there were no animal models and no animal studies had been performed. Hard to believe? Can you just imagine strolling by a biochem lab and getting unknown "compounds" and then injecting them into living breathing sick human beings? It was indeed a different day.Lo and behold, when Dr Hench injected compound F into a rheumatoid patient something magical occurred. A day or two later... the patient was "cured". Nobody sees an untreated patient with severe rheumatoid disease anymore. They lay motionless in bed, in agony and pain.... joints swollen, staring at the ceiling, and you just want to help them so bad. It was Dr Hench's dream... and by all accounts he felt the pain of his patients acutely. One of the patients at that time was a ballerina who'd been rendered immobile by her disease. They used to show this old 8mm movie of her. One day she lay in motionless agony and a few days later she was filmed dancing and whirling and turning while a magnificent smiling face of redemption and cure. Remarkable stuff. They started treating scores of patients with compound F and the Mayo clinic quickly held a press conference where this triumph was announced. It was trumpeted around the world and less than one year later Dr Hench, the biochemist, and some guy from Switzerland were awarded the Nobel prize... that was in 1958. I used to have a copy of the original Mayo Clinic Proceedings article. When I was at Mayo, these were still "fresh"events. It hadn't even been twenty years (this whole post is just from memory). It was the only Nobel ever awarded to Mayo scientists.Dr Hench was a world renounced medical hero. Then the earth began to shake and the sky fell. It turned out they were treating patients with doses of steroid equivalent to 200, 300, even 500 mgm of prednisone... they had no idea what they were doing. Then the patients started returning. The complications were horrific and terrible. Moon faced, buffalo humped, psychotic, bruised, breaking bones, desperate wrecks of humanity. In the guise of cure, Dr Hench had visited hell upon the patients he loved.I was told that Dr Hench had problems with intermittent depression over the years as he tried to help his patients. As they began returning, Dr Hench descended into a hellish depression from which eh never recovered. Several years later this Nobel prize winner committed suicide.I cannot imagine the number of lives saved over the years by cortisone and its derivatives. As I watched my little 11 yo hornet batting knucklehead return to the world of the living I thought about drug discovery and how far its come in my short life. I thought about all the money hungry biotechs, the hopeful investors who've unknowingly donated billions upon billions to research and that the end result will hopefully be some advance in our collective condition. I thought about the recent discussion on the treatment of MS, that devastating disease.And I thought about good men like Dr Hench. And I thought about the importance of letting research have its way and not getting in too much of a rush to "do good". Do you know what Dr Hench's old assistant loved to say. He was one of the grand men of the rheumatology department when I was there... I can see his face right now... but I can't recall his name.When the residents would get all in a great rush to save lives and do good... he would calmly say... don't just do something, stand thereOh lord, that's a hard lesson to learn. But when you hurt someone in the process of trying to do good... it's a lesson not soon forgotten.ahhhhh boy, my own bones ache alittle these days and my wife is aggravated with me because the PIP joint on my ring finger has a touch of arthritis and I can't get my wedding ring on,... I'm going to have to have it bumped up a size or two... and so my last thought is that above all else..I wish I was an 11 yo dirty little urchin swatting furious yellowjackets again ... but with some cortisone around... just in case.. you know lololwith all thy getting, get wisdom. Proverbs 4:7
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