Word: treatment
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...young black woman named Henrietta Lacks was admitted to Johns Hopkins Hospital and given a diagnosis of cervical cancer. During treatment, doctors removed a sample of her tumor and sent it to a research lab without her permission. Lacks died a few months later, but the sample lived on--and on and on. The strain, dubbed HeLa, was the first human tissue to be successfully kept alive as a culture. Since her death, Lacks' cells have been shot into space, infected with tuberculosis and zapped with radiation to test the effects of a nuclear bomb. HeLa helped develop the polio...
...would operate if the fracture was really bad. It generally worked out satisfactorily, but tellingly, many had learned not to operate when the fracture was really, really bad. The surgical results when the wrist was truly blown to bits often seemed to be worse than the results with closed treatment. The body can get it right - or at least more right than a surgeon can - once in a while...
...gone from hardly every operating on these common wrist fractures to almost always operating on them. Somewhat better outcomes have been reported in large studies of many broken wrists treated surgically, but there are so many different surgical techniques and the level of skill (and effort) put into closed treatment is so variable that the "statistical evidence" comparing surgical to closed treatment is easy to challenge. I explained this to Peter - and also let him know that he actually lives down the block from a professor who made his career studying, and mostly operating on, these wrist fractures...
...begin, the very worst outcomes I personally have seen with these fractures have been with the operated ones. I reminded Peter that my father, an orthopedist himself whom Peter knows well, had this fracture, and he treated it closed. I reminded him that closed treatment was not perfect - but neither were the results with surgery. I would expect Carol's wrist to be somewhat stiff and occasionally achy either way. A scientist could appreciate that there is ultimately very little pure data here. Surgery would be my choice if and only if the doctor couldn't get (and hold) good...
...take out the metal and loosen up scar tissue. A year of therapy. Lots of pain meds. Now it's two years out and she's all right, but not perfect. I honestly think her condition is about the same as it would have been with closed treatment, minus some scars, some scary days in the hospital and a good bit of pain. Yet had she opted for closed treatment, any pain or stiffness at all would invariably bring up that doubt: "wouldn't I have done better with the surgery? Everybody's doing it." The bottom line is that...