Thursday, November 14, 2013

Repaying, with gratitude, Henry Dawson's selfless act of Agape

Thanks to her genes, my mother and her children never met a strep disease we didn't like and if it weren't for Henry Dawson's selfless act of Agape, it is possible that I won't even be here today.

Grateful ?! Of course, I'm bloody grateful !

Grateful enough to be glad to spend tedious years tracking down the missing history of the man who improved our lives and the lives of ten billion others since 1940.

My mother was born in October 1928, the same time Alex Fleming started messing about with penicillin and the same year Gerhard Domagk started on the path that led to the sulfa drugs.

She was about seven or eight, around 1936, when she got GN (glomerular nephritis) after a case of strep throat.

In children her age, this relatively common auto immune reaction of certain people to certain strains of  GAS strep, only damages their kidneys for a few months and recovery appears to be full.

Prompt treatment with sulfa, then very new on the market, would only have helped if given at the time of the strep throat - an event then very unlikely to happen with any child.

But sometimes with GN the damage left behind is permanent and in certain circumstances leads to a chronic form of this kidney disease.

In 1947-1948, my mother was in newly communist Hungary, studying under extremely impoverished circumstances.

She got sick with GN nephritis again (a condition much more serious in adults) and was given sulfa - and got a severe sulfa allergy reaction and so was taken off it.

The Cold War meant Hungary didn't have much penicillin.

As a result, her kidneys and high blood pressure never seemed to have fully recovered and in fact got worse and worse.

Usually as a result of the extra strain put on her kidneys and blood pressure with each new pregnancy (she had seven).

It didn't help she literally had each pregnancy (except for the last two) several thousands of miles away from the last one, each time with different doctors and no back medical records to check.

In the Spring of 1962, she was dying of acute kidney infection and after throwing everything at her, the doctors tried a single course of streptomycin and saved her life .

She was permanently deaf in one ear as a result (a common side effect) but she never ever complained.

Many, many times she told me , "Why complain - that antibiotic saved my life - if I had died your father would have been left with four very young kids and a brand new baby - and him still a grad student."

I didn't then connect her adult disease with her childhood disease because she never told me - only telling of her childhood disease in girl talk with my partner Rebecca and I believe, my sister Margo or Tracy.

My only known childhood encounter with strep was tonsillitis acute enough that my swollen tonsils so affected my voice that I sounded like I was a midget on helium.

But after they were removed, that seemed to have ended me having childhood strep throat instead of ordinary colds, though it is hard to tell for sure.

But my sister Kathi got the once deadly strep disease SF (scarlet fever), a childhood disease that is very highly contagious.

So the authorities came and put a big black Q on a bright yellow back upon our door to indicate we were under legal quarantine and so no one could visit us and we kids had to stay in our yard for weeks.

Kathi got antibiotics at the time but continued to have severe chronic tonsillitis until her teen years.

She has had serious medical problems all her adult life -- they don't seem to be directly related to her love affair with strep bugs -- but there is still a lot we don't know about GAS bacteria.

Next to meet the streps was my brother Bruce. He too had tonsils big and bad enough to make the doctors want to take them out.

But more seriously, one day he suddenly dropped to the carpet in our Victoria BC living room complaining he didn't feel good.

Rushed to a doctor, it was quickly revealed that he had RF (rheumatic fever) because of his persistent heart murmur. Persistent as in he still has it 55 years later.

RF is still deadly today, still potentially fatal, but fortunately rare - at least in in the industrialized world. But until 1960, it was still the leading cause in the industrial world
of school age children having long hospital stays ,dying or facing a lifetime of potentially fatal heart worries.

Yes, RF not Polio!

 Severe Polio was relatively uncommon and inclined to be a middle class suburban disease, while RF traditional hit the urban and rural poor, minorities and immigrants (the so called "Polio of the Poor").

Just guess which disease got by far the bigger press when I was growing up in the 1950s ?

By the time my mother was born and growing up, dying of RF was less common for kids in urban settings, even if poor.

How it did kill them was the fact that the same permanently damaged heart valves that left their mark with their irregular murmur, also became the attractive home for the kind of strep bacteria that form that unattractive green film on unbrushed teeth.

This much different strep from deadly GAS strep was usually harmless.

But it grew as successfully on heart valves (normally impossible for bacteria) as it did on teeth and its little home on the valves would eventually kill all patients, in a great variety of ways, before Henry Dawson got involved.

It was called subacute bacterial endocarditis but not even doctors ever called it that : it was SBE and spoken of in a whisper or a sigh : as in 'invariably fatal SBE'.

SBE usually started killing former RF patients in their late teens and twenties but it could hit babies and the elderly.

RF and SBE packed quite a punch in both the death and terror department.

This is because unusually, both could come back again and again, each time leaving more damage which only made the next attack far more likely.

Because the deadliest strains of RF and SBE came and went intermittently while strep throats were an inevitable fact of life for child and adult, literally no one was potentially free of falling to this combo until they were safely in their forties.

If my mother had gotten severe RF instead of GN, she was statistically likely to get her first, and usually fatal, bout of SBE in her teen years, during WWII.

The Allied medical authorities around the world ignored the fact that Dawson was curing this hitherto invariably fatal disease with penicillin and proclaim that no one, (potentially including my mother) with SBE was to get penicillin and was to be pretend- treated with useless Sulfa doses and left to die (the notorious so called 'Code Slow').

If my mother had had SBE in Canada during WWII and left to die, I won't have even been born.

But she , thank God, didn't get RF or SBE and I was born, only to get her disease GN, was I was 18.

GN for adults is more serious than for children and my abnormal chemical readings, recorded by a brand new hospital machine on paper with a wet ink pen, were impressive indeed.

The technician told my family doctor that some of values recorded were so literally 'off the paper' that the tech had to shut off the machine for fear it would break.

But the kidney disease seemed to have cleared itself by the time I got to hospital six months later --- just as well , as in adults it can lead to renal failure deaths or permanent dialysis.

Only partly my fault for the unusual delay - but of course as a young teenage male I hadn't gone to my doctor until a month after I first got my sore throat, by which time the bacteria was gone but I had so much edema and high blood pressure that I walked like a very old and sick man.)

Characteristically, I was too cheap to consider a taxi and slowly, slowly,slowly walked the mile downhill to my doctor's office --- and back up the hill again afterwards !

Now, unfortunately, in some cases, GN is accompanied by acute haemorrhagic cystitis in a sort of syndrome - and that will be me !

Severe or mild, this bladder condition, if it is permanent, is a life-altering condition.

I will spare you all the embarrassing personal effects, but if you look it up online, I can assure you I have had them all as described here - though fortunately in relatively minor forms.

Now generally me and my family have survived this family tendency to form auto immune responses to GAS strep fairly well - this is mostly down to the fact that the most virulent strains of this bug were knocked back by the fact that unusually cheap penicillin g allowed people normally too poor to receive treatment to get the antibiotic.

So, finally, the reserve pools of virulent GAS found among poor and isolated populations that kept these diseases endemic or epidemic for millenniums ,were wiped out or severely cut down to a minimum.

So when we did get these diseases , we got a less frequent and less virulent strain and we got prompt antibiotics to wipe the diseases out in ourselves.

But this would never have happened without Henry Dawson's moral cry that wartime penicillin must be made available to ALL humanity.

When the general public bought into his radical un-Republican, un-Conservative notion, a vast potential market opened up and as profit-seeking firms flooded in, ways were found to cut the cost of penicillin G from the equivalent of today's Avastin ($100,000 a year) to a price cheaper than water, literally too cheap to meter.

When dealing with a medicine that cures a contagious disease, a cheap drug is also an effective drug - by curing even the poorest and thus wiping out the traditional reserve pools of virulency, this produces a quasi-herd immunity for all the rest of us ---- free !

Henry Dawson gave his life to save only ten from a heartless government, but ten billion have benefited since.

I think there is still a lesson here for all , 75 years on, for all of us involved in Obamacare-like disputes over why provide health care for those who can't pay.

I hope to offer my book for free, or if that is not possible, at least ensure I don't profit from any book sales.

Selfless ? Hardly - I merely intend to give up any book profits - by contrast Henry Dawson "GAVE ALL" ....

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