On February 28, 1998, the revered British medical journal The Lancet published a brief paper by then-high profile but controversial gastroenterologist Andrew Wakefield that claimed to have linked the MMR (measles, mumps and rubella) vaccine with regressive autism and inflammation of the colon in a small case number of children. A subsequent paper published four years later claimed to have isolated the strain of attenuated measles virus used in the MMR vaccine in the colons of autistic children through a polymerase chain reaction (PCR amplification). The effect on vaccination rates in the UK was immediate, with MMR vaccinations reaching a record low in 2003/2004, and parts of London losing herd immunity with vaccination rates of 62%. 15 American states currently have immunization rates below the recommended 90% threshold. Wakefield was eventually exposed as a scientific fraud and an opportunist trying to cash in on people’s fears with ‘alternative clinics’ and pre-planned a ‘safe’ vaccine of his own before the Lancet paper was ever published. Even the 12 children in his study turned out to have been selectively referred by parents convinced of a link between the MMR vaccine and their children’s autism. The original Lancet paper was retracted and Wakefield was stripped of his medical license. By that point, irreparable damage had been done that may take decades to reverse.
How could a single fraudulent scientific paper, unable to be replicated or validated by the medical community, cause such widespread panic? How could it influence legions of otherwise rational parents to not vaccinate their children against devastating, preventable diseases, at a cost of millions of dollars in treatment and worse yet, unnecessary child fatalities? And why, despite all evidence to the contrary, have people remained adamant in their beliefs that vaccines are responsible for harming otherwise healthy children, whether through autism or other insidious side effects? In his brilliant, timely, meticulously-researched book The Panic Virus, author Seth Mnookin disseminates the aggregate effect of media coverage, echo chamber information exchange, cognitive biases and the desperate anguish of autism parents as fuel for the recent anti-vaccine movement. In doing so, he retraces the triumphs and missteps in the history of vaccines, examines the social impact of rejecting the scientific method in a more broad perspective, and ways that this current utterly preventable public health crisis can be avoided in future scenarios. A review of The Panic Virus, an enthusiastic ScriptPhD.com Editor’s Selection, follows below. Continue reading “The Panic Virus” and the Origins of the Anti-Vaccine Movement→
A Father’s Love and a Scientist’s Dedication in a Race against Time
Imagine this scenario: you are a young married professional, a rising star in a well-respected pharmaceutical company. You have three children, two of which suffer from a rare, inherited genetic disease for which there is no cure. They will die in about a year or two. What do you do? Inspired by the book The Cure: How a Father Raised $100 Million – and Bucked the Medical Establishment – In a Quest to Save His Children by Pulitzer Prize-winning journalist Geeta Anand, Extraordinary Measures is a drama about the real-life story of John Crowley (Brendan Fraser) and Dr. Robert Stonehill (Harrison Ford) as they work feverishly to find a cure for the disease afflicting Crowley’s children. The dramatic caveat is that said cure is based solely on a scientific theory. CBS Films’ motion picture debut touches on a myriad of salient modern-day issues, including personal morality, risk taking, scientific funding, pharmaceutical business practices, the dedication to science, professional relationships, and a man’s love for his family. For the full ScriptPhD.com review, please click “continue reading”.
Medical shows are a generational television stapleoften dramatic, rarely realistic, and only sometimes socially relevant. But tonight, on CBS, a different kind of medical show premiered. Three Rivers, based at a fictional world-famous transplant hospital in Pittsburgh, puts front and center an often misunderstood and ignored sector of modern medicineorgan transplantation. With wit, sensitivity, and a refreshing degree of accuracy, this important new show will shed light on the three branches of the organ donation and transplantation system: the donors, the recipients, and the transplant surgeons and staff who connect the two. Under the jump, ScriptPhD.com reviews the pilot and provides important information and resources for those who are considering signing up to be a donor.
ScriptPhD.com recently reviewed and recommended a new medical mystery thriller, Beat the Reaper, written by real-life medical doctor Josh Bazell. A longtime aspiring writer, Josh majored in English Literature with Honors at Brown University, after which he entered the English Lit PhD program at Duke. He ultimately chose to pursue a post-graduate degree in medicine at Columbia University, and completed his residency in the Department of Psychiatry at the University of California at San Francisco. He is currently working on his second book and is a practicing psychiatrist.
House meets The Sopranos—there’s your Hollywood pitch line for the debut novel of talented newcomer Josh Bazell. But it’s so much more than that: part medical mystery, part action-adventure thriller, part character study, Beat the Reaper deftly explores the scope of revenge, loyalty and one’s capacity for redemption. We are introduced to the novel’s protagonist, a New York City doctor, as he’s getting mugged on his way to work. But rather than acquiescing, he expertly dislocates the mugger’s arm, smashes his nose in and takes his gun. Peter Brown is clearly no ordinary doctor. Left to fend for himself at the age of 14 after the vicious murder of his grandparents, Pietro Brnwa takes up karate and a fateful friendship with David Locano, aka Skinflick, whose father was a lawyer by day, a mobster by night. Initially attracted to the mafia for personal retribution, Brnwa descends deeper into the Locano family and their ties, and finds that he is disturbingly good at his job. A perfectly orchestrated series of events leads Pietro into murder, a test of his friendship with Skinflick and the threat of jail. Instead, he ends up at dingy, dilapidated Manhattan Catholic Hospital as Dr. Peter Brown, a member of WITSEC, the U.S. Marshal’s Service Witness Security Program. Peter’s anonymity comes to a crashing halt when he treats a blast from the past, in the form of terminally ill patient Eddy Squillante, who recognizes him as the erstwhile “Bearclaw” Brnwa. As long as he can keep Squillante alive, he staves off some angry mobsters looking to get reacquainted. To do so, he must navigate through a sea of other patients, a shady surgeon assigned to Squillante’s case, and external forces looking to ensure that he fails. Oh and by the way, he has eight hours. (Why is Peter known to the mobsters as Bearclaw? You’ll have to read the book and find out… it’s downright incriminating!)
Pietro Brnwa is a unique, memorable character in the best tradition of detective fiction heroes. Not one you’d call warm and fuzzy, he ascribes himself as “God’s original asshole” and his sycophantic medical students as “two cups of human misery in short white coats”. He has a short temper, a snarky aside for most everything and everyone that crosses his path, and generally looks at the glass as half empty. But Pietro also has a defined moral code of ethics. His very reason for joining the Mafia—to avenge his grandparents’ senseless death—is practical, not glamorous. He won’t kill women or children, as evidenced by his refusal to kill the sister of the man that sold his grandparents to Auschwitz. And he manages to show a tender side with the only woman he’s ever loved, and who plays a tragic role in the final showdown between his past and present. More importantly, Brnwa, as Peter Brown, is an excellent doctor. Sure he has plenty of insults for fellow physicians, no patience for patients, and crunches on Moxfane tables to stay awake enough for rounds. But he also cares enough to make time for a frightened cancer patient awaiting surgery, to retrieve a lost well-meaning elderly patient with dementia and to perform an impossible surgery on the dying Mob messenger that’s been sent to warn him. Okay, that last one was a necessity.
On top of the intricate action, mind-bending medicine and humor, the book’s style is immensely enjoyable—sexy, sleek, fast-paced, and a little too cool for old school. Bazell unfolds the plot cleverly with side-by-side storylines. Peter Brown’s impending peril is told compactly over the course of the eight hours that interweaves his reunion with old friends with an interesting medical mystery and a rather unfortunate incident with an Assman and a needle. All in a day’s work. Concomitantly, Pietro Brnwa’s story transpires over a more protracted period of time, and the reader absorbs the tragedies that befell Pietro from his early days in the mob through to the deal that lands him in witness protection, learning what makes him tick along the way. The past merges seamlessly with the present to culminate in an ending so shocking and imaginative, you will want to have an anatomy textbook, not to mention a strong stomach, to piece it all together. Interspersed throughout are little factoids and medical footnotes that add a rich third dimension to the novel’s flow and to our protagonist’s hilariously sarcastic wit. Did you know that scrub suits are reversible, that some of the most prosperous pharmaceutical companies had a shameful history of slave labor at Auschwitz, that you can’t run DNA tests from urine, that surgeons will use some pretty superfluous silly vocabulary to avoid saying “head up” or “head down” in surgery, or the real reason that Tony Soprano’s cover as a garbage consultant is ironic? Neither did I. Rarely does a thriller afford you the opportunity to pick up some knowledge while you’re being entertained, and for that, Beat the Reaper gets the ScriptPhD.com seal of approval!
As if all of this isn’t enough to get you excited, the book is currently being adapted for film by the same team of screenwriters that brought you Ocean’s Thirteen. There are even rumblings of Leonardo DiCaprio playing Peter Brown/Pietro Brnwa/Bearclaw. So go out and please support a local bookstore in picking up a copy today!
Suddenly, in the world of TV medicine, RN are the letters you want after your name. Two summer cable shows garnering considerable buzz, SHOWTIMEs Nurse Jackie and TNTs HawthoRNe, shine the spotlight on nurses, the hospital heroes often relegated into the shadows of doctors on prime time. ScriptPhD.com got a sneak peak of the HawthoRNe pilot and the first half of the Nurse Jackie season.
Nurse Jackie (SHOWTIME) ScriptPhD Grade: A
I didnt want to love Nurse Jackie, I just want to say that for the record. First of all, shes been taunting me on the billboards of Los Angeles all spring and summer long with that intimidating needle. Secondly, I didnt know if I had it in me to get attached to yet another medical show. Third, after hooking me with brilliant shows like Dexter, Weeds and newcomer The United States of Tara, could SHOWTIME extend their magic touch to this newest addition to their franchise? They could, they did, and the result is some of the freshest television this side of basic cable. Starring three-time Emmy®-winner Edie Falco, Nurse Jackie is based on the provocative tell-all journal of a real-life Manhattan nurse. Shot on location in New York City, the show spares nothing in projecting the goings-on of a big-city ER through the eyes of one very unorthodox nurse.
And Jackie Peyton is certainly not an easy character to love. Shes decidedly cantankerous and has little time for people or their stupidities. I dont do chatty, she barks. I like quiet. Quiet and mean. Those are my people. Shes got an unhealthy attachment to painkillers. No matter the delivery system (mouth, nose, coffee) or the type (Adderall, Vicodin, OxyContin, Percocet), Jackies not very picky. She views rules as bendable at best, nonexistent at worst. Oh yeah, and then theres the part where shes cheating on her husband. But theres two sides to every coin, and Jackie is no exception. At home, hes a devoted wife and mother. Her picture-perfect husband Kevin (Dominic Fumusa) struggles between tending to their daughters Grace, sporting an escalating emotional anxiety disorder, and Fiona (Ruby Jerins and Daisy Tahan) and running his bar. At the ironically named All-Saints Hospital, shes an extraordinary, deeply empathetic nurse. Whether shes helping a 10-year-old take care of her mom with some contraband pharmacy supplies, assisting a terminally ill fellow nurse, helping a mute stroke victim shut up his obnoxious family or stealing money from a criminal to help a dead patients poor fiance, Jackie weaves through the murky moral grey area to ultimately do whats right for her patients. Part saint, part sinner, Nurse Jackie is never less than totally compelling.
Trailing Jackies every move (much to her dismay) is overly earnest, perky nursing student Zoey Barkow (Merritt Weaver). Luckily, Jackie can take reprieve from her besotted young acolyte and her problems with the rest of her hospital family. Providing cover is her partner in crime, fellow nurse Mohammed Mo-Mo de la Cruz (Haaz Sleiman), with whom she bends the rules, shares coffee breaks and romantic advice. Providing narcotics and lunchtime quickies is pharmacist Eddie Walzer (Paul Schulze). Her best friend and confidante is the wry Brit Dr. Eleanor OHara (a razor-sharp Eve Best). She has a penchant for expensive clothes, snappy comebacks and mid-town lunchcapades with Jacks, but seems to be holding back a painful past. Peter Facinelli (Damages) is the handsome, young Dr. Fitch Coop Cooper, who could easily be dismissed as a one-dimensional, book smart but inept playboy. But with lesbian moms (the devine Blythe Danner and Swoozie Kurtz), a proclivity for Tourettes-like inappropriate touching, and better doctor skills than he gives himself credit for, Coop is more than meets the eye. Rounding out the ensemle is rote ER administrator Gloria Akalitus (The West Wings Anna Deveare Smith), who rules with an iron fist, thinking shes hip to every trick in the book. (By the way, who knew Deveare Smith had such a gift for physical comedy? Two gags with a Taser and some wayward painkillers had me rolling on the floor.)
Employing top-notch writing and directing, led by creative team Evan Dunsky, Liz Brixius and Linda Wallem, Nurse Jackie shies away from tired old medical show tropes to peel back the layers of a functional addict leading compartmentalized lives, to realistically show the challenges nurses face in saving lives under the limitations of our broken medical system, and to ask, What does it really mean to be good? Nurse Jackie may be addicted to bad behavior and every painkiller on the planet, but in the end, Im addicted to her. I wouldnt have it any other way.
Nurse Jackie airs on SHOWTIME Mondays at 10:30 EST/PT, following Weeds.
HawthoRNe (TNT) ScriptPhD Grade: B
A number of high-profile film actors have recently settled comfortably in starring TV roles, most successfully Emmy® winners Glenn Close (Damages) and Alec Baldwin (30 Rock). TNT, with their long and storied tradition of strong female drama leads, from Kyra Sedgwicks The Closer to Holly Hunters Saving Grace, extends the same small-screen opportunity to Jada Pinkett Smith, who stars in new medical drama HawthoRNe. Lest there be any doubt about the girl power behind this series, it is being co-produced by Pinkett Smiths 100% Womon [sic] Productions. In the first five minutes alone, Christina Hawthorne races to Richmond Trinity Hospital in the middle of the night, out(wo)mans an armed security guard, tends to a wandering psych ward patient, pays care to a homeless woman shes befriended and talks down a suicidal cancer patient. But it turns out, there are some cracks in Christinas impenetrable armor. For one, the pilot takes place on the one-year anniversary of the death of her husband, whose ashes she still talks to. To celebrate, her rebellious, headstrong daughter Camille (Hannah Hodson) chains herself to the schools vending machine, much to her mother’s consternation. And a deliciously saccharine Joanna Cassidy is the still-meddling mother-in-law who also serves on Trinitys board.
As the hospitals Chief Nursing Officer, Christina is organized, uncompromising, decisive, empathetic, and always puts the needs of patients first. Her charges include nurse Bobbie Jackson (Suleka Matthew), one of her best friends and nurse Ray Stein (David Julian Hirsh), a man caught in a womans world. Aliass Michael Vartan (welcome back to television Mr. Vaughn!) is Dr. Tom Wakefield, the Chief of Surgery with whom Christina often butts heads administratively, but who also treated her late husband for cancer.
Still working out its kinks, HawthoRNe feels a bit uneven at times, mostly due to relying on some trite, atavistic medical formulas that come off stale. A genuinely compelling storyline about a homeless woman besieged with mental problems giving birth outside the hospital is negated by an unnecessary (and gross!) side plot involving a grateful nurse (Christina Moore) um thanking a wounded soldier for his service. Her name is Candy. Seriously. And a chance to explore doctor-nurse synergy and conflict in providing effective patient care turns downright silly when the characters in question ride two extremes: the stupendously arrogant, omniscient doctor whose decisions Cannot. Be. Questioned. and the equally timorous nurse who dare not think independently. And dont forget to save some snickers, because hes a male nurse, which is funny, or was in 1975.
TNT may know drama, but HawthoRNe needs to tone it down a bit. To be fair, having only viewed the pilot, the show has definite potential to grow. With the departure of ER, no current medical show centerpieces medicine in a cash-strapped, blue-collar city hospital. Set in Richmond, VA, HawthoRNe has a unique opportunity to tell stories pertaining to the challenges of its setting and patient population. It also is clearly a character-driven drama, establishing some fascinating early relationships. The tension between Christina and her bitchy mother-in-law, tempered by working through the shared grief with her still-angry daughter, makes for a rather interesting family triangle. And sparks fly between Pinkett Smith and Vartan, who is obviously being set up as a potential love interest. But the biggest asset is Pinket Smith herself. She brings an intensity, compassion and resolve to a complex character. Her movie star power translates well to the small screen, and could easily make HawthoRNe a fine vehicle for her considerable acting chops. Assuming they steer clear of Clicheland.
HawthoRNe premieres this Tuesday, June 16th on TNT at 9 EST/PT.
This sudden focus on the nursing profession doesnt come a minute too soon. According to the American Association of Colleges of Nursing, the United States is in the midst of an imminent nursing shortage, compounded by the rapidly aging baby boomer population and low enrollment in nursing programs that is not expected to meet this demand. As of July, 2007, total RN vacancies across the US totaled 135,000, or 8.1%, according to a report released by the American Hospital Association. Projections from the U.S. Bureau of Labor Statistics published in the November 2007 Monthly Labor Review foresee that more than one million new and replacement nurses will be needed by 2016. Contributing factors vary, from a shortage of nursing school faculty and projected enrollments, to a slowing rate of growth for the overall nursing population, resulting in a climbing average age of the nursing population. The result for nurses? Insufficient staffing is raising their stress levels, impacting job satisfaction, and driving many nurses to leave the profession. The result for patients? Inadequate access to quality health care. An eye-opening report released in August 2002 by the Joint Commission on Accreditation of Healthcare Organizations, revealed that a shortage of nurses in America’s hospitals is putting patient lives in danger. JCAHO examined 1609 hospital reports of patient deaths and injuries since 1996 and found that low nursing staff levels were a contributing factor in 24% of the cases.
Less than a month ago, members of major nursing unions that included the California Nurses Association/National Nurses Organizing Committee, the United American Nurses (UAN), and the Massachusetts Nurses Association, congregated on Capitol Hill as part of a National RN Day of Action in Washington, D.C., that included a conference focused on promoting legislation that would guarantee certain ratios of nurses to patients nationally, a march and rally, and visits to their congressional representatives to advocate on various legislative issues. The legislation, House Resolution 2273, also seeks to protect the rights of nurses to advocate on behalf of their patients, and to invest in training new nurses to address the current nationwide nursing shortage.
To discuss some of these issues, and to get a dose of real-life perspective on the profession, ScriptPhD.com sat down with Dr. Suzette Cardin, Assistant Dean of Student Affairs at UCLAs venerable School of Nursing, ranked in the top ten of national nursing programs. Dr. Cardin has over 35 years of experience in nursing, and prior to her faculty appointment, she spent 14 years as Unit Director of the Critical Care Unit and the Cardiac Observation Unit at the UCLA Medical Center. She has been honored as a Fellow of the American Academy of Nursing and the American Heart Association. To read our interview, please click “continue reading”. Continue reading TV REVIEW: Nurses Ratchet Up the Medical Show Ladder→