|
|
|
|
A sampling of columns follows. A patient's obesity can get in doctors' way The premise A 600-pound man, George Hagel, is brought into the hospital in a coma. Dr. Gregory House and his team of diagnosticians are stumped as they consider Pickwickian syndrome (obesity hypoventilation syndrome), a stroke, a parasite, a sexually transmitted disease and diabetes. House tries to force Hagel to drink sugar water to rule out diabetes (a glucose tolerance test). Dr. Allison Cameron orders an MRI of the brain, even though Hagel is at least 150 pounds too heavy for the machine. (The million-dollar piece of equipment breaks when he wakes from his coma and begins to thrash around.) Cameron keeps Hagel from being discharged from the hospital by slipping him the antiseizure drug phenytoin, which causes him to stagger and crash through a glass wall. When cerebrospinal fluid is needed, Dr. Eric Foreman decides that the patient is too obese for a routine lumbar puncture, so he takes Hagel to the operating room and inserts a needle into the back of his brain. When he does this, Hagel goes blind. Finally, House notices that Hagel's fingers are deformed (known as "clubbing"), and orders X-rays, which confirm a paraneoplastic syndrome that House believes is associated with small cell cancer of the lung — which would explain the coma and blindness. The diagnosis is confirmed by bronchoscopy. Hagel will be treated with radiation but is only expected to live a few months. The medical questions Does extreme obesity interfere with obtaining essential medical tests such as an MRI and lumbar puncture? Can small cell carcinoma of the lung cause a coma and blindness and damage the fingertips? Is the prognosis as dismal as suggested? The reality A morbidly obese patient presents a series of unique diagnostic problems. Scanners have weight limits — 450 pounds in many cases — limiting imaging options. Because of Hagel's mass of fatty tissue, it would also be extremely difficult to place a spinal needle into his lumbar canal, the optimal place to draw fluid in a spinal tap. Ultimately, a neurosurgeon might be needed to place the needle in the back or the neck. But the needle would not generally be placed in the brain, and blindness as a direct result of this rare procedure is unlikely. A thorough physical examination is especially crucial when imaging tests are not an option. The clubbing of Hagel's fingertips, which is much more frequently associated with large cell cancer of the lung rather than the small cell type, should have been discovered when he was admitted. Although small cell cancer of the lung is extremely aggressive and the prognosis is poor (five-year survival is less than 6%), the response to treatment is not entirely predictable. Four percent of patients develop paraneoplastic neurological syndrome, in which cancer cells release antibodies against the brain's nerve cells. As in Hagel's case, these antibodies can attack the limbic system (the emotional center responsible for attention and memory), leading to confusion, memory loss and seizures, and the cerebellum, causing his unsteady gate. Rapid vision loss, which is indeed possible, can be caused by antibodies directed against retinal proteins. Lest patients think doctors can make decisions with impunity, they should know that the show's greatest foray into fiction is in the doctors' behavior. House's attempt to force the patient to drink sugar water and Cameron's drugging him are nothing short of assault and battery. In reality, both doctors should — and likely would — be charged with criminal offenses and lose their licenses to practice medicine. Pulling a fast one with killer lip gloss The premise The co-owners of a modeling agency are under investigation for allegedly plotting the murders of their models to collect on an insurance policy. As the suspicion against them grows, they turn on each other. One is shot in the chest, but not before she spikes the other's lip gloss with cyanide. A few minutes after applying the lip gloss, its wearer begins to cough, has difficulty breathing and dies. The medical questions Is it possible to spike lip gloss with a sufficient amount of undetectable cyanide to kill? Are coughing and rapid suffocation an accurate portrayal of cyanide poisoning? Although the investigators watch her die, could medical intervention keep a victim going until help arrives? Is there an antidote to the poison? The reality Although cyanide can be added to cosmetics, or food, in a potentially lethal amount, the concentration required (more than 500 milligrams per gram) would probably cause an almond taste and a burning sensation when licked. Further, victims would be unlikely to absorb or ingest enough to die as quickly as the show depicts. In general, victims of a large cyanide exposure — more than 200 milligrams of the crystal or 50 milligrams of hydrocyanic acid (the liquid form) — may feel anxious, nauseated, have a headache, feel short of breath and cough, then gasp for air, have convulsions and heart arrhythmias, lose consciousness and die — all within an hour after ingestion. They also may appear flushed and have a bitter almond smell on their breath. Victims suffocate from respiratory depression or sustain lethal heart arrhythmias as the cyanide interferes with hemoglobin metabolism (depriving the body's tissues of oxygen). The initial treatment is to administer pure oxygen. Common cyanide antidotes are nitrites and sodium thiosulfate, which work together to restore the hemoglobin. These aren't often completely effective, however, in part because the cyanide may have already done a lot of damage by the time the antidotes are administered. Notably, the CSI investigators don't initiate cardio-pulmonary resuscitation or call 911. The former may be partly understandable — the would-be rescuer can be poisoned by the lips of the victim. But calling 911 wouldn't have necessarily been a wasted effort. Though it is true that CPR, gastrointestinal decontamination (induced vomiting, gastric lavage to wash out the stomach and activated charcoal to absorb the poison) and even oxygen are not completely effective, all of these measures could have bought some time for paramedics or medical professionals to administer a cyanide antidote. The risks of removing tumors and tree limbs The premise Benjamin O'Leary (Peter Paige) is a patient with a tumor pressing on the frontal and temporal lobes of his brain. As a result, he is uninhibited, saying whatever comes into his mind, calling his sister "fat" and commenting on the sexual tensions between the doctors. As Benjamin is being readied for brain surgery, 14-year-old Harly Hernandez is brought to the emergency room impaled on a large tree branch. Harly has sustained major damage to his kidney and intestines, and his father is told that his son has only a 60% chance of survival. After Harly's organs are repaired, the large tree branch is removed in sections, and he lives. Benjamin, however, dies when his brain hemorrhages and swells during surgery. The medical questions Can pressure on the frontal and temporal lobes of the brain cause a patient to say outrageous things? Is it reversible with tumor removal? Is removing such a tumor likely to result in death? With impalement injuries, is removing the object best accomplished in pieces after the organs have been repaired and the bleeding has stopped? The reality The rapidly changing emotions and impulsiveness that Benjamin displayed is known as orbitofrontal syndrome, a common manifestation of brain tumors pressing on the frontal and temporal lobes. In the episode, the surgeon is asked, "If the tumor is removed, is he going to get his old personality back?" The surgeon (Patrick Dempsey) replies, "If we get the tumor out and Benjamin lives, everything else will be icing on the cake." It's not entirely wishful thinking, but by the time such tumors are removed, they have often permanently damaged that region of the brain. In the case of a benign tumor, the direct pressure on the brain or an interruption of its blood supply can cause some nerves to die. Successful surgery with tumor removal would most likely cause the behavior to diminish, but not disappear. As for the survival rate, all brain surgery is risky, and swelling and bleeding are common complications. State-of-the-art stereotactic techniques using MRI mapping can reduce the risks. With that procedure, the surgeon wears a helmet that superimposes MRI images on the surgical field. Although hospital mortality from meningioma re-section has dropped — as low as 1.8% in 2000, according to a nationwide sample — the rate of complications increases with a difficult tumor location. In this episode, the location close to the cavernous sinus (behind the nose) makes a complication much more likely. Impalement injuries, especially with sharp objects, carry a high risk of major-organ damage, as the abdominal cavity is tightly packed with organs. Although beginning a surgical procedure with the object protruding from the body may seem counterintuitive, it can make sense — if the object is in a stable position. This allows doctors to immediately stop the bleeding and begin to suture the damaged organs before removing the object. Removing the object prematurely or all at once can risk further bleeding and organ damage. A delicate procedure for family The premise PLASTIC surgeon Sean McNamara, played by Dylan Walsh, has learned that his unborn son (to be named Connor) has ectrodactyly (malformed hands or feet with absence of fingers or toes) and a cleft palate. McNamara plans to operate on Connor soon after his birth to try to correct these congenital malformations. The medical questions HOW common are these malformations? How successful would corrective surgery be if performed early? Is it possible to operate in utero (while the fetus is still in the womb)? What are the ethics or advisability of a father operating on his child? The reality ECTRODACTYLY, often known as lobster claw syndrome or split hand/foot malformation, is fairly common, with six cases per 10,000 human births. All forms are associated with at least one genetic mutation, one of the most frequent (Type 1) caused by a mutation on chromosome 7. Ectrodactyly often occurs in common with other congenital anomalies — such as a cleft lip and palate, and ectodermal dysplasia (hair, skin and nail deformities). In "Nip/Tuck," McNamara views a photograph of a hand with ectrodactyly and contemplates Connor's surgery. This surgery should be performed between the ages of 1 and 2, before hand dominance is defined and psychological trauma accelerates, according to Dr. James P. Bradley, chief of pediatric plastic surgery at UCLA. The surgery involves separating out a thumb, leaving the patient with a three-fingered hand, which "allows the patient to eat and care for himself. He will not be able to perform fine motor functions like writing, but the deformity will not be as easily observed." More fingers can't be created because of the preexisting bones and joints. In terms of the cleft lip and palate, Bradley believes that it should also be corrected between 1 and 2 years "to avoid long-lasting speech problems." Although surgery for these malformations can be done in utero, providing "scarless healing," and overall better results, this is generally not done because the benefit is not worth the risk of premature labor. But if a more life-threatening abnormality is being corrected in utero, then the hand and facial surgery can be done at the same time, Bradley says. As to whether McNamara should operate on his own child, Bradley bucks conventional wisdom. Most doctors say that the lack of emotional distance interferes with medical judgment and surgical precision. But Bradley disagrees, asserting that such a decision isn't unwise as long as the doctor is qualified. "A good surgeon can learn to suspend the emotional component," Bradley says. "If you're the best-trained surgeon for the procedure, then you're the one to do it." As in 'Ant Bully,' even small behavior lessons can
be mighty The premise LUCAS NICKLE (voice by Zack Tyler Eisen) is a short, spectacled 10-year-old boy whom his mother calls "Peanut" and treats him like a much younger child. He is bullied by Steve (Myles Jeffrey), who says, "What are you going to do about it? Nothing, because I'm big and you're small." Lucas turns his pent-up anger and humiliation toward an ant colony in the garden, besieging it with a water hose until the ant wizard Zoc (Nicolas Cage) devises a magic potion to shrink "Lucas the Destroyer" down to ant size. The ants then capture the shrunken boy, and the queen ant (Meryl Streep) decides to teach him the ways of the ants: mutual respect, teamwork, rules of cooperative behavior. Ultimately, these lessons enable a newly confident, full-sized Lucas to stand up to his mother and to defeat the old bully. The medical questions DO bullies attract a coterie of innocent bystanders as the movie portrays? Are victims of bullies prone to identify with the aggressor and transfer this aggression to weaker targets? Can parents contribute to the problem by undermining a child's self-esteem? Can learning to respect others and working as part of a team build confidence in real children? The reality "MANY bullies were once bullied themselves and they have learned to identify with the aggressor," says Dr. Heather Krell, associate professor of psychiatry and pediatrics at UCLA. "It is totally believable that Lucas would transfer his aggression to the ant colony." Like Lucas, many children who are bullied are not treated properly even by their own parents until they learn to "respect themselves and find their own voice," she says. This parental treatment can contribute to a low self-esteem and sensitivity that bullies then prey upon, continuing a vicious cycle. But, Krell adds, bullies — and those they bully — can be taught more social, respectful behavior. Over the last three years, UCLA researchers have conducted several groundbreaking studies on bullying. They've found that bullies are often popular and considered cool, while their victims suffer from social isolation and are often depressed and anxious. Almost half of the sixth-graders surveyed reported having been bullied, they found. As in the movie, a collection of misfit bystanders can become part of a bully's ring rather than take the chance of being bullied themselves. "Some kids can try to ignore the bully but it feels like a loss of power — it goes inside and feels toxic," says Ava de la Sota, a health educator at UCLA's Corinne A. Seeds University Elementary School. She's developed a program that teaches one-liners to kids like Lucas who are sensitive about being short or wearing eyeglasses. They learn not only how to defend themselves verbally, but how to deflate conflicts and understand others' points of view. The program, de la Sota, says, can prevent them from being bullied — and from becoming bullies. In this environment, bullies are no longer able to thrive. "Bullies know how to go for the weakness. This can be overcome with a carefully developed school-wide, ant-like support system that promotes resilience and offers mediation and follow-through." For de la Sota, ants stand as a metaphor for an adult community that teaches children the mature adaptive skills needed to combat bullies. Not your garden-variety dysfunction The premise NANCY BOTWIN (Mary-Louise Parker) is struggling to bring up her two sons and maintain the same lifestyle in the wake of her husband's sudden death. She secretly becomes a local pot dealer. Meanwhile, her family's life deteriorates. While Nancy is on a romantic tryst, her older son, 16-year-old Silas (Hunter Parrish), has his girlfriend stay over, and 10-year-old brother Shane (Alexander Gould) observes them having sex. Nancy's pot supplier Heylia (Tonye Patano), mother to a large brood of her own, suggests that family dinners are the "superglue" that holds families together, and that studies have shown children do better in the long term, with higher test scores and less depression, when families eat together regularly. The medical questions WHAT is the effect of parental secrecy and absence on children? How traumatic, for a 10-year-old, is viewing a sibling having sex? Is it true that family meals are a positive factor in terms of psychological outcome? The reality "IT'S terrible to wake up in the middle of the night and not know where your mom is," says Irene Goldenberg, family therapist and professor emeritus of psychiatry at UCLA. In her opinion, a bigger problem than the fact that Nancy isn't home much is that she is lying to her kids about her actions and whereabouts. Goldenberg also believes that it is traumatic for a preteen to observe an older sibling having sex — worse than if he'd walked in on his parents, because on some level he expects his parents to be doing that, whereas the actions of his brother are against the rules. In addition, Shane is learning that "there may not be a responsibility that goes with sex. He is more likely to take risks and experiment as a result." There is truth to the statement that family dinners matter, says Dr. Harold S. Koplewicz, director of the New York University Child Study Center. For example, Harvard University researchers have reported that family dinners are a crucial factor in fostering healthy child development, and a study from the University of Illinois found that children ages 7 to 11 who did well on achievement tests had spent a large amount of time at family meals. Focus groups conducted by a network of nutrition professionals in Washington state have reported improved communications and better relationships among families who dine together. Koplewicz believes that parents and kids are far too busy with their own separate lives these days. "We as a society have forgotten that there's tremendous importance of regular, relaxed meals to make sure we can connect with our kids. Kids need a protected time where they have access to a caring adult." And, indeed, surveys show that teens want to spend more time with their parents, who are still the most influential factors in their lives. Unfortunately, the kind of role model you can be is much diminished if you are living a lie and are almost never available, as is Nancy Botwin of "Weeds." Older rookie could make the team, but wouldn't be
'Invincible' The premise VINCE PAPALE (Mark Wahlberg) is a 30-year-old teacher and part-time bartender with only one year of high school football experience, when Dick Vermeil (Greg Kinnear), the new coach of the NFL's Philadelphia Eagles, decides to hold open tryouts. Papale, possessed of more persistence and enthusiasm than pure physical ability, tries out — and manages to make the team, avoid major injury despite using light shoulder pads and even star in an NFL game by scoring the winning touchdown. The questions IS an unseasoned athlete less prone to injury because he hasn't had to endure the constant pounding of professional football, or is he more prone because of his inexperience and lack of caution? And is it really possible that an amateur with little experience could suddenly succeed at the highest level of professional sports — buoyed by desire and persistence? The reality TO start with, though "Invincible" is based on a true story, "it is not a documentary," says Ray Didinger, writer-member of the Pro Football Hall of Fame, senior producer for NFL Films and a former reporter who followed the real Vince Papale for the now-defunct Philadelphia Bulletin. The real Papale "was a nationally ranked decathlon champion and had an extensive football pedigree including two years as a star in the now-defunct World Football League," Didinger says.
Without this wear and tear to slow him, Papale was more spry and could more easily elude the kind of direct, bruising hits that might have caused injury. Dr. Michael L. Gross, chief of Sports Medicine at the Hackensack University Medical Center in New Jersey, says that by staying in shape, an older rookie such as Papale "could conceivably avoid severe injury." Many published studies, he says, have shown that increasing strength, agility and coordination help protect against such injuries. A well-supervised and constructed weight training program, he adds, decreases injury rates not only in the middle-aged "weekend warrior" population, but in athletes of all ages. Although it may seem paradoxical, Gross believes that the thin, less-protective shoulder pads also might have helped Papale because they increased his maneuverability and agility and helped him to avoid injury. (In the 1970s, when Papale was playing, all shoulder pads were light compared with today's.) Neither Gross nor Didinger believe a player without major talent and skill could succeed in professional football. But that's not all it takes. Desire, says Gross, matters just as much as skill in high level sports. And Didinger believes that those who can make it in professional football have other characteristics that the rest of us lack — such as their ability to deal with pain. "They have to be very tough mentally to play through all the pain and injuries," he says. He's made of steel, but his heart's another issue. The premise AFTER returning to Earth from an extended sojourn, Superman (Brandon Routh) saves a space shuttle and its carrier jumbo jet from disaster, is assaulted by and prevails over criminals (in an incredibly vivid scene, his invulnerability to bullets is depicted as one is actually flattened by his eyeball), and is attacked by the evil Lex Luthor (Kevin Spacey). Luthor has discovered tiny remnants of Superman's home planet of Krypton that glow an unearthly green and make Superman ultra-vulnerable, and uses them with crystals from Krypton to build an expanding island that threatens to supplant North America. In trying to rid Earth of this island, Superman comes close to death and is brought to Metropolis General Hospital for treatment. The medical questions IS the vivid portrayal of the effects on the passengers of the airplane's plummet accurate medically? Once wounded with kryptonite and suffering like any human, is Superman's treatment in the hospital appropriate? The reality IN the wake of lost cabin pressure, passengers subject to the cold and the sudden lack of oxygen at high altitude over several minutes as the plane falls would not be breathing comfortably as the film depicts. In reality, most if not all passengers would have difficulty breathing, would have lost consciousness and would have turned blue from frostbite. Many would likely not survive, even with Superman there to land the plane in Yankee Stadium. As far as Superman's own near-death experience, it is excellent medicine that the doctors who treat him search for wounds and discover and remove the last shred of kryptonite. It is less believable that doctors would administer a shock to the heart after it had already stopped beating entirely, because the purpose of the shock is to correct an aberrant rhythm, not to jolt a dead heart back to life. Only rarely is a "still" heart shocked, as a desperation move, and it's not generally expected to succeed. As Superman recovers, the monitor shows his heart rate as 40 beats per minute. This may seem slow, but it's actually the rate of some athletes who exercise vigorously. President Bush, who engages in brisk daily exercise, has a heart rate that has been clocked in the mid-40s (an average person's heart rate is 70 beats per minute for men, 75 beats per minute for women). After all, a well-developed exercising heart can deliver a greater volume of blood at a slower rate — and no one exercises more vigorously than Superman. You can tune out, but not like this The premise MICHAEL NEWMAN (played by Adam Sandler) is an architect bored with his life. When his TV remote breaks, he goes to a Bed Bath & Beyond store and meets Morty (played by Christopher Walken), a man with mysterious powers. Morty provides Michael with a new remote that enables him to move through time, fast-forwarding through the boring, irritating and routine parts of his life without consciously experiencing them. The medical questions WE'VE all had the experience of operating on autopilot. What happens in the human brain when we "space out" like that? How does the human brain work to affect varying levels of consciousness? Can we make decisions and respond to questions without being fully aware of it as the movie suggests? The reality HUMANS, while awake, can sometimes exhibit automatic behavior that they don't fully remember later on. Consciousness depends upon a nerve network in the brain — called the reticular activating system — that responds to sight, sound, smell and thought by maintaining attention and alertness. But, as the movie suggests, a person can still be awake without this system being fully engaged, and so not be as aware of his or her surroundings. This is what happens when you are driving along the highway and pass your exit without realizing it. It is sometimes useful to be able to briefly "zone out" while continuing to perform functions you know very well — such as riding a bicycle or folding laundry. But long periods of mental absence are problematic and often pathologic. In the movie, during his periods of prolonged mental absence, the automaton Newman develops halting movements and inappropriate social behavior. In real life, symptoms like these can occur when there is damage to the brain's frontal lobe, which is responsible for planning, abstract reasoning, sustained attention and insight, and is needed for full alertness. When clicker Newman clicks past a period of his life, he leaves the automaton Newman behind, stuck in lesser consciousness, where he continues to ritually move and speak without being fully aware, and later experiences amnesia. All these symptoms are characteristic of what are known as "fugue states," an abnormal condition where the complex network of consciousness is short circuited and a person experiences a loss of identity, awareness and memory. Such a person may still make purposeful movements and even speak, but he is not completely aware. A fugue state can be caused by an atypical seizure, injury to the brain or as part of a psychiatric breakdown. But in real life, a normal person is not capable of Newman's prolonged mental absences. Mental dissociation this protracted would certainly lead to irreversible brain damage. His mindless success in business and his unfeeling pile-driver sex are more believable. Out of whack on `Sopranos': valerian tea and ER
protocol. The premise CHRISTOPHER Moltisanti's (Michael Imperioli) new girlfriend is Julianna (Julianna Margulies), formerly involved with Tony Soprano. Christopher and Julianna meet at an Alcoholics Anonymous meeting, which they attend because of drug addiction. During one of their trysts, Julianna is suffering from a bad cold, and Christopher suggests Robitussin with dextromethorphan. Julianna declines, seeming to know that dextromethorphan is a semi-synthetic narcotic that, if taken in high doses, could make her high and perhaps again provoke her drug addiction. Instead, she suggests eight to 10 tea bags for a container of valerian tea, which she says is in the same chemical family as Valium. She hopes it will help her sleep and treat her cough. When we next see Julianna, her cough is clearly improved, but she is again snorting drugs with Christopher, who carries a container of what appears to be valerian tea. Meanwhile, Patty Leotardo takes her husband, Phil (Tony Soprano's enemy), to the hospital with a tightness in his chest "up by my esophagus." The emergency room doctor reports that his cardiac enzymes are normal and sends Phil home, but he soon returns with a massive heart attack. The medical questions WHAT is valerian tea? Is it in the same family as Valium? Does it treat a cough? Is it addictive and would it cause a patient to return to using narcotics? Does it help a person sleep? Is it believable that the doctor would tell Phil that his heart is fine? Could his chest pains be coming from his esophagus rather than his heart? Could this type of heart attack be avoided through proper emergency care? The reality VALERIAN is an herb with sedative properties used to ease insomnia and anxiety. It isn't chemically related to Valium, and it won't relieve a cough. Long-term use of the herb has been shown to have addictive properties, but there is no evidence that its use — whether in tea or capsule form — would cause someone to return to drug addiction. Regarding Phil's heart attack, a doctor is unlikely to send him home with classic angina symptoms — whether his cardiac enzymes initially showed damage or not. It is standard hospital protocol to admit a patient with these warning symptoms overnight for further monitoring and cardiac tests (beginning with serial cardiac enzymes). Timely intervention with a cardiac catheterization and coronary stent may prevent a big heart attack from occurring. Fallacies take flight in bird flu scenario The premise IN "Fatal Contact: Bird Flu in America," which aired Tuesday night
on ABC, a businessman returns to the U.S. from Hong Kong, where he has
unwittingly picked up a newly mutated strain of the H5N1 bird flu from being
coughed on by a factory worker. France has the only vaccine, and is reluctant to distribute it here. The few doses that arrive are contested for by street gangs who attack the truck laden with vaccine. Just as the pandemic seems to be ebbing, news comes that an entire town in Africa has succumbed overnight to what appears to be a newer and more lethal subtype of H5N1. The medical questions DO flu viruses mutate so rapidly that a bird flu can be transformed to a human killer flu overnight with a second, even more sinister, change occurring a few months later? And is the H5N1 bird flu virus close to mutating to a form that can go from human to human and cause the next pandemic? Are we so defenseless to flu that we will require mass graves when the next pandemic hits us? The reality ALTHOUGH flu viruses mutate rapidly, the changes necessary to cause even a mild pandemic would take at least several weeks and several steps as a newly evolving strain attempted to adapt to a human host. The idea that H5N1 could transform instantly from a bird virus to a human virus, jump to a businessman who becomes "patient zero" and spreads it throughout the U.S., is dramatic hype, not science. And, according to recent studies, the current H5N1 bird flu virus appears to be multiple mutations away from becoming the next pandemic strain. Though our highly mobile society does not have the hospital surge capacity or the food, energy or medicine independence to handle the kind of monstrous pandemic that the film depicts — and though our country's current vaccine-making capacity is terribly out-of-date — this sort of scenario is made much less likely by the technology we do have (antibiotics, vaccines, antivirals, treatments for secondary illnesses that could kill flu sufferers). The film is also riddled with smaller medical inaccuracies. Paper masks are not actually effective barriers to the virus; the risk of spread by touching is limited; noses are unlikely to gush blood; and corpses most assuredly won't be dumped in mass graves. And although the film flatly states that the antiviral drug Tamiflu doesn't work, in real life it would likely have some effect. In a coincidence, however, the medical journal Lancet just published a French study announcing a somewhat successful vaccine against H5N1 in humans. |
|
Copyright © 1990-2007 Marc K. Siegel, M.D. |