As recently as four or five years ago,and for many years before that, I often had a runny nose. I went through boxes and boxes of Kleenex. I carried a handkerchief everywhere and often used it. Not because I had a cold–I almost never got colds. It was different than that. You might say I was mildly allergic to something in the air. (more…)
Anne Weiss recently repointed me to an interview with the epidemiologist Tom Jefferson about swine flu. Jefferson, let me stress, is a good epidemiologist. In the interview he makes a point I make on this blog, that research is heavily shaped by two questions: 1. what will make money? 2. what will be good for my career? (How curious that economists — with the exception of Veblen and Robin Hanson — spend so much more time on #1 than #2.) For example: (more…)
I have proposed that three things — a tendency to touch each other (e.g., shake hands), a tendency to touch near our mouths, and our tonsils — together form an early warning system for our immune system. The early warning system helps the immune system get tiny exposure to microbes circulating in the community. It performs self-vaccination. Like ordinary vaccination, exposure to tiny amounts of Microbe X protects against exposure to a large amount of Microbe X.
In Daniel Everett’s anthropological study of the Pirahã people (Don’t Sleep, There are Snakes: Life and Language in the Amazonian Jungle, 2009) he says the Pirahã “all touch one another frequently” (p. 85). “They loved to touch me too.” He has never seen kissing but “there is a word for it, so they must do it.” This supports the idea that a tendency to touch others is widespread.
If this theory is true, reducing microbe exposure to zero (e.g., sterile food) is a seriously bad thing. It’s been proposed that the polio epidemics of the first half of the 1900s were caused by cities becoming too clean.
Thanks to Anne Weiss.
Thanks to Tucker Max.
Thanks to Adam Clemens, Melissa McEwen, and Navanit Arakeri.
In a recent post I made an obvious point. If our immune systems were stronger, we would need antibiotics less often and antibiotic resistance would become less of a problem. I hadn’t heard this point made (for example, this WHO report fails to say it). This was one example, I said, of how mainstream health care ignores the immune system. Perfectly obvious things, such as this idea about antibiotic resistance, fail to be noticed. I gave five more examples. Since then I have come across even more examples:
1. Hospitals do little to help patients sleep and often interrupt sleep, Nancy Lebovitz pointed out (better sleep –> better immune function). This article describes the problem. One way to improve hospital sleep — beyond don’t wake patients up — would be to provide exposure to strong sunlight-like light in the morning and prevent exposure to sunlight-like light after dark. I found that an hour of sunlight or similar light from fluorescent lamps in the morning improved my sleep. Most fluorescent light resembles sunlight (both have strong bluish components), incandescent light (reddish) does not. Until they install dual lighting systems (bluish light during the day, reddish light at night), hospitals can provide blue-blocker glasses to wear after dark.
2. The book Immortal Bird (sent me by the publisher) tells how Damon Weber, born with a defective heart, had a heart transplant when he was a teenager. After the transplant, problems arose. The doctors involved (at NewYork-Presbyterian Hospital/Columbia University Medical Center) took the problems to be signs of transplant rejection. In fact they were due to infection. Drugs given to deal with the mistakenly-assumed rejection suppressed Damon’s immune system. They reduced his ability to fight off the infection and he died. The author of the book, Damon’s father, sued the doctors and hospital for malpractice. The doctors did not exactly “ignore” the immune system, but they apparently failed to fully grasp the danger of immune suppression, even though the infection that killed Damon is common in transplant cases. (Although Columbia Presbyterian charged half a million dollars for the transplant, “three years into the lawsuit the [hospital's] medical director claimed Damon’s post-op records couldn’t be located.”)
3. I asked a UCSF medical student what she’d been taught about the immune system. “We cover it!” she said. In a section called “Infectious Disease, Immunology, and Inflammation”. What makes the immune system work better or worse? I asked. “If you’re stressed out, it doesn’t work well,” she said. If you’re malnourished, like in Bangladesh. You need “nutrients and vitamins”. (A booklet I got telling me to take less antibiotics told me to “eat healthy”.) She also said the students get entire lectures on how to treat diseases so rare they might never be encountered. There is a whole section on genetics. Sure, they cover it. So superficially that they don’t remember the most basic idea: Better sleep –> better immune function. I said our health care system is built around first, let them get sick. That’s right, she said. Ignoring the immune system is an excellent way to allow people to get sick.
4. Melissa McEwen pointed out that proton pump inhibitors, such as Nexium, reduce the body’s ability to fight infection. They are prescribed for acid reflux and reduce how much acid the stomach makes. Because stomach acid kills bacteria, there should have been far more concern about their safety. “Proton pump inhibitors (PPIs) are among the most widely prescribed medications worldwide [billions of prescriptions]. . . . The collective body of information overwhelmingly suggests an increased risk of infectious complications,” says this article. Because the drugs are so common, the damage is great and, because of more infection, not restricted to those who take them. It could have been avoided by research into treatments that do not harm the immune system.
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