Two thousand ten brought the realization of Obama’s labors into the lives of all Americans. Suddenly all of the rhetoric and campaigning and mudslinging from all sides provided an air of tangibility with respect to the newly signed healthcare reform law. Some of the most popular posts for 2010 on Doctor Pundit were related to the unveiling of issues surrounding the legislation — some immediate and some predictive. Concerning the latter, the cost of healthcare delivery under the new law was on the minds of many DP readers.

(#4) Report: Reform Bill to Cover More People, Cost More Than Projected

…HHS and Kathleen Sebelius are releasing a report that seems to contradict the CBO’s analysis on the long-term economic viability of the Obama reform bill. In adding over 30 million to the coverage rolls, the new Affordable Care Act may not control costs as keenly projected by the Democrats…

Avandia and its future also weighed heavily.

(#3) Report: Pharma Company Covered Up Known Cardiovascular Risks of Drug

GSK has always stuck to its guns in defending its assertions that statements like that are based upon faulty safety information gleaned from major trials casting the drug in a negative light — like the well-known RECORD trial, which found that the overall risk of cardiovascular death of Avandia was not statistically significant. That meta-analysis was commissioned by GSK at the request of the FDA.

Finally, the DP tribute to a medical pioneer garnered the second-most sets of eyes for 2010.

(#2) Robert Butler, MD, Medical Education Icon, Dead at 83

Butler was the first clinician who coined the term “ageism”, the result of such forward-thinking approaches to the geriatric patient that was characterized by the medical practice free of biased attitudes and treatment assumptions that, if employed today, would cause harm to many elderly patients receiving chronic medical care.

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Initially shunned by many in medical research at the time of its innovation, in vitro fertilization (IVF) was seen as transcending a previously unbreachable moral line: the process of creating a fertilized ovum in, essentially, a petri dish. Today, its pioneer, biologist Robert Edwards, wins the Nobel Prize for Medicine. I was only 10 years old when I first heard the term “test tube baby”. My, how far we’ve come.

Working for years with rabbits and then mice, often making trips to the lab in the middle of the night to collect eggs from the ovulating animals, he pioneered a process in which he could artificially cause the ovary to release several eggs at a time, and then conducted experiment after experiment with human eggs to correctly time the removal of the eggs with their fertilization with fresh sperm to generate an embryo.

Further innovation resulted in technologies today that make even Dr. Edwards’ original scientific discoveries seem a trifle mundane. For example, Edwards’s work lay the groundwork for pre-implantation genetic diagnosis. That is, researchers can test whether an embryo carries an inherited disease before they deposit it in the mother. | LINK

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Just how “80s” are the Eighties? Well, for me it just doesn’t get any more 80s archetype than the year 1985 –specifically that summer. With a sound that combined most, if not all, of the singular elements that gave the Decade of Excess even more excessive, larger than life meaning — 1985 represented the musical maturity that the decade yearned for. Disco had finally died by 1982. Post punk ethos gave way to moody early alternative Britpop. And cheesy late ’70s pop was not able to transcend early 80s schmaltz. It all added up to the incredible musical expression that was just aching to be heard and appreciated by 1985.

It was the summer before my senior year in high school, and its memory is essentially ingrained forever thanks to the indelible, enduring, and endearing nature of the music released that year. Billboard magazine has just released its Top Summer Songs lists of the past 25 years (1985-2010). The #1 summer song of 1985 is aptly named “Shout”, the second and final #1 song by Tears For Fears. It perfectly epitomizes the way I feel about that magical summer, year, and decade. “I’m talkin’ to you/Come on….” | LINK

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I’ve waited until today (after what seems like an interminable barrage of media coverage about him) to post about Michael Jackson’s death.  As a physician, who just happens to be a huge MJ fan, I have always wondered what this moment would be like — obviously not in a morbidly curious sense, but in an academically curious one.

Michael Jackson (1958-2009)

Thinking about the enormous toll living in the public eye, constantly, from the moment his father exploited his talents at such a young age, has had on his rather delicate frame; the numerous plastic surgeries which tell us more about his inner soul then he would orally; and the addiction to painkillers for more than, apparently, just pain — I wonder if death at this age was more serendipitous than precipitous.

What actually did cause his death?  If you believe media accounts, you probably should do so with a wary eye.  Not only were TV and print media awash throughout two 24-hour news cycles with continuous wall-to-wall coverage, but the effect of the news of his death on the sheer weight of Internet traffic is well documented.  Naturally, all of the information, particularly from the latter source, is probably not the most reliable. However, if one is to believe widely reported accounts of frank cardiac arrest, it does seen fairly plausible that any of the factors listed above could have contributed in some fashion.  We won’t know for weeks what the results of the toxicology post mortems will be; and with the Jackson family desperately searching for answers and coping the best way they can (for themselves and the trusting legions of fans faithful worldwide), a definitive cause of death may take some time to reach.

At least we’ll always have his music to console us, teach us, ponder, and enjoy for the rest of our lives.

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