Claire Squires had been a healthy 30 year-old woman when she died less than a mile from the finish of the London Marathon two weeks ago. Her death has caused an outpouring of grief around the world and prompted more than £1m in donations to charity. This is laudable but what is unusual, is that even at this point after the tragedy, no cause of death has been announced. She is the 11th person to die in the London Marathon since 1990 - the others have all been male, ranging in age from 22 to 59. Most deaths in marathoners are due to cardiovascular causes, primarily in middle age men with preexisting heart diease. Claire was likely an outlier, having previously run a marathon in under four hours and successfully climbed Mount Kilimanjaro last year. Heart disease as the cause of her death, while possible, would be quite unusual.

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Who was the greatest American military commander of the 20th Century? Was it World War I General Blackjack Pershing or either of the two popular World War II biopic generals, George Patton or Douglas MacArthur? How about George Marshall, a superb leader of the war effort in World War II, but one whose role was more coordination and delegation than command? If the answer depends on military accomplishment alone, then it is unquestionably General Dwight Eisenhower, Supreme Allied Commander in Europe during World War II and coincidentally the 34th President of the United States.

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The National Football League faces an oncoming spate of lawsuits by former players over traumatic brain injuries. Class-action suits filed in several states have already been consolidated to a federal court in Philadelphia and more suits by former players suits are certain to follow. Meanwhile, the recent revelation that teams unofficially paid bounties to defensive players, offering large sums of money for “cartoff” and “knockout” injuries that removed opponents from games comes at a bad time, suggesting the NFL has condoned deliberate violence and downplayed the long-term consequences.

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# of brain tumors expected in 2012 from field personnel in 1980 = 7/100,000 x 1500 x 32 = 3.4

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Hull House, a hallowed Chicago institution for 123 years, recently closed due to lack of funds. For generations, it was the crown jewel of American settlement houses, important enough to be mentioned in history textbooks, and also an ongoing source of local civic pride. Today, every Chicagoan, from Mayor Emanuel and the city’s corporate fathers, to those in the Occupy Chicago movement should be ashamed at how the public has virtually ignored the death of Hull House.

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For forty years, his passion was teaching Moby Dick. Mr. G was my high school English teacher and for six weeks each year, he would parse “The Great American Novel” with a obsession like that of one-legged Captain Ahab pursuing the Great White Whale. Our eyes glazed over as he attempted, vainly, to captivate us with Melville’s tedious digressions about Nantucket whaling villages. Undeterred, Mr. G forged on. In retrospect, his single-minded devotion was touching. At the time however, his fixation was the epitome of high school torture.

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The current sordid child sex molestation scandal at Penn State has brought calls for the NCAA to close down the university’s football program. New York Times op-ed columnist Joe Nocera has called for Penn State to cancel their 2012 football season. Chicago sports attorney Eldon Ham, an adjunct professor at Chicago-Kent College of Law wrote, “To get the full attention of Penn State and every other out-of-control college football program in America, the NCAA should take away Penn State football - if only for a while”. The Nation’s Katha Pollitt goes even further, “Cancel the season. Fire everybody. Start again. Or maybe don’t start again. Maybe cancel college football too”.

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This weekend, The Baseball Hall of Fame Veterans Committee selects new inductees from the candidates who never earned enough votes during their original eligibility. If justice and logic prevail, two players closely associated with Chicago, who were never accorded their rightful due, should be shoo-ins – Ron Santo and Minnie Minoso.

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The young man from Dallas was a medical boy wonder. He graduated from the local medical school at the unheard of age of 22 and headed to Boston to study surgery at the prestigious Massachusetts General Hospital under some of the world’s greatest surgeons. This was right after World War II, when those surgeons revolutionized trauma care and resuscitation, refining what they had learned on the battlefields of Europe and the Pacific.

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What about a CEO’s major illness? This information will likely affect price of the company stock and leadership succession. Shareholders would certainly want information about their CEO’s condition. This conflicts with the notion of personal privacy and the CEO’s understandable reluctance toward disclosure. Steve Jobs’s case is particularly instructive. No CEO was more intimately identified, or more important to his company. Because of his well-known penchant for privacy, the medical facts in Jobs’s case are not completely clear.

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Reading the obits on Gent, even from the “great newspapers” is a joke. All he becomes is a caricature guy who blew the whistle on pro football in his best-known, but not his best work, North Dallas Forty. He was a superb writer. The obits all talked about how he wrote North Dallas Forty and “exposed the seamy side of football”, typical obits not really capturing his brilliance, In reality, he was a much more nunaced character.

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Why did Andres Brevik go on a mass murder spree in Oslo? The motivation may forever remain unknown. However, in the wake of the carnage that left over 70 dead, the summer of 2011 will forever be indelibly burned in the memory of every Norwegian as the Summer of Hate. America had a summer like that in 1966 when the nation was similarly stunned by mass murder, shootings, and violence - the Summer of Hate in America.

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A new collective bargaining agreement means the millionaires and billionaires of the National Football League will provide America with football for another decade. However, another storm cloud on the horizon threatens the game’s prosperity - the growing problem of head injuries in high school, college, and professional ranks.

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Since the end of World War II, American medicine has been acclaimed throughout the world for mass vaccination programs in the quest to eradicate deadly infectious diseases. In the 1950s, Dr. Jonas Salk became an international hero with his discovery of the polio vaccine, when polio was a global scourge. Dr. Baruch Blumberg, who died recently, won the 1976 Nobel Prize for discovering the hepatitis B virus and developing the vaccine that prevented hepatitis and liver cancer caused by the virus. He is a revered figure in China, Taiwan and other parts of Asia where hepatitis B is endemic because the vaccine he developed saved millions of lives. Salk, Blumberg and other vaccine pioneers are true 20th century heroes of American medicine.

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The enforced neighborhood bonhomie was because no one had electricity. The friendly chats at the fence ended once the 21st Century returned and electricity was finally restored 77 hours after violent storms supposedly knocked out power. Of course, that is the “official story”. But the neighbors aren’t buying that stuff about downed power lines, damaged transformers, and lightning. That’s what “someone” want you to believe. That thunderstorm ruse is just a devious cover story. We know what really happened

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Google recently announced it was discontinuing its electronic medical and health records service, Google Health. Launched in 2008, Google Health was created so people could gather and store their personal health information electronically but was shut down with little notice. The company cited lack of consumer interest as the primary reason the site closed. A brief explanation by Google managers on a blog explained, “With a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would…in the end, while we weren’t able to create the impact we wanted with Google Health, we hope it has raised the visibility of the role of the empowered consumer in their own care.”

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Do you own your own genes?

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The concerned neighbour suspected something amiss. She came to check on the old lady and saw the mailbox covered with cobwebs. The only letters in it were yellowing, untouched bills. Forcing open the barricaded front gate and peering through a broken window, she saw lights illuminating a formerly beautiful interior now in total disrepair, filthy clothes, junk mail and boxes strewn everywhere.

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Bushwa.

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While Congress debates the pros and cons of Obamacare, a silent revolution proceeds apace in American medicine. Actually, it is not totally silent; it is heralded by the low hum of the CT scanner. Studies indicate patients are receiving more CT scans than ever before in emergency rooms, hospitals, and outpatient settings. This burgeoning application of CT scanning, has important implications for individual patients, diagnostically and in terms of radiation exposure, as well as consequences for the country’s overall medical budget.

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The crossing guard was a squat, balding man in his 70s. He was charged with guiding schoolchildren, kindergarten through fourth grade, safely through a busy intersection every morning and afternoon. At a little more than 5 feet tall, he was shorter than some of the fourth-graders he directed across the street. If not for the huge stop sign he wielded to halt traffic, one might be forgiven for getting the impression that it was they leading him safely to the sidewalk.

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With the Chicago Bears’ defeat in the NFC Championship Game comes all sorts of criticism of their quarterback Jay Cutler for sitting out essentially the entire second half with a medial collateral ligament sprain. Reaction has been mixed from vigorous defense by his teammates to harsh criticism form the Chicago fans and other football players.

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In King Lear, one of the supreme works of the English language, William Shakespeare details the tragic plight of the impaired elderly as they exit the public stage. Lear, the formerly powerful fictional king, has divided his kingdom unwisely in “the infirmity of his age”. This incomprehensible act, which no one was willing to challenge, ultimately leads to a brutal internecine war in his kingdom and results in his death as well as that of his children.

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Every boy growing up throwing a baseball dreams of being the pitcher whose blazing fastball can strike out any hitter. Cub fans are familiar with young phenoms with great fastballs, just as they are accustomed to the disappointment those phenoms bring. 20 year-old rookie Kerry Wood threw a one-hitter, tying the single game strikeout record with 20. Gone now from Chicago following Tommy John elbow surgery, Wood was last spotted in the Yankees’ bullpen in New York. Mark Prior, his erstwhile teammate and fellow phenom, dominated the National League when young. In the notorious year of Bartman, he brought the Cubs tantalizingly close to the World Series. Following injuries, Prior is now a distant memory, out of baseball.

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“There are no second acts in American life.” Written by F. Scott Fitzgerald in notes for his unfinished novel, The Last Tycoon, that line has become almost a cliché. The conventional interpretation, especially given Fitzgerald’s alcoholism and death at a young age, is that in America once people make a mistake they are not allowed a second chance. This, of course, is demonstrably untrue since people from Martha Stewart to Michael Vick to Eliot Spitzer have reinvented their careers after serious mistakes.

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A recent cholera epidemic has devastated Haiti, killing nearly 1500 people and hospitalizing 25,000. Cholera, caused by a waterborne bacterium, thrives in areas of unsanitary conditions, overcrowding, and shortages of clean water. It results in diarrhea and rapidly fatal dehydration unless treated promptly with fluids and antibiotics.
The Haitian epidemic resulted from conditions after recent tropical storms and the devastating January earthquake. It is a reminder cholera, a pandemic disease in the 19th Century, can still ravage the 21st Century Third World.
Because improved sanitation and modern medicine have drastically reduced the threat of cholera in the industrialized world, few remember its impact on the United States two centuries ago. Cities, including Chicago, were plagued by successive cholera epidemics, causing tens of thousands of deaths. Because Chicago developed along Lake Michigan, its early history was profoundly influenced by those outbreaks and vestiges of that influence remain today.
Until 1816, cholera was a disease limited to the South Asia. The first cholera epidemic remained contained in eastern Asia until 1823. However in 1826 a second Asian pandemic began and cholera was carried by Russian troops into Poland in 1831. Within a year, the disease was endemic in Europe and the British Isles, devastating London and Paris. It spread as a byproduct of the early Industrial Revolution. Steam powered rapid transportation, urban population migration, crowded slums, inadequate water supplies, ineffective elimination of sewage, and unprepared city governments all played a part.
With trepidation, Americans read in their newspapers of the European epidemic. Inevitably, immigrants on crowded ships from Britain brought cholera to Montreal in 1831. Cholera crossed the St. Lawrence River and Great Lakes, cutting a swath through Buffalo, Detroit and the Eastern Seaboard cities.
Cholera reached Chicago as a consequence of the 1832 Black Hawk War. Driven from Illinois, Chief Black Hawk, tribal leader of the Sauk and Fox, led a party from Iowa back across the Mississippi. The Illinois Governor dispatched the Illinois militia and requested several thousand federal troops who arrived on ships from Buffalo, commanded by General Winfield Scott (future war hero of the Mexican–American Conflict). This move was probably an overreaction since Black Hawk’s “hostile war party” consisted of only 1000 including 600 women and children, bearing seeds for planting crops.
The Illinois militia quickly dispatched Black Hawk, ending forever the Native American threat to Cook County. However General Scott’s troops, who proved unnecessary, brought cholera from Buffalo to Fort Dearborn and hundreds died just before Chicago was incorporated in 1833.
The continuing threat of cholera was impetus for the creation of the Chicago Board of Health in 1835. Despite this, subsequent cholera epidemics broke out in 1845 (traveling up the Mississippi and brought by workers on the Illinois & Michigan Canal), and at least four other times before 1873, killing thousands of Chicagoans.
Those cholera epidemics were also responsible for Chicago’s first hospitals, several small temporary structures built in the 1840’s and 1850’s designed to isolate cholera and smallpox victims. Inadequate for Chicago’s burgeoning population, they were replaced by Mercy Hospital, the oldest continuously running hospital in Chicago.
Today, orphanages, homes for parentless children, are a little remembered historical footnote. But they were once prominent institutions housing thousands in 19th Century Chicago. The first Chicago orphanage, the Chicago Orphan Asylum and the Catholic Orphan Asylum, began as a result of an 1849 cholera epidemic, which left many children without parents. Social concerns caused orphanages to disappear eventually but the eradication of cholera was one reason they were no longer necessary.
An 1851 cholera epidemic prompted creation of Chicago’s first public water board. The board commissioned an engineer with previous experience working on the Erie Canal to design a city water supply system. The city’s first water pipes were laid with a goal of preventing cholera and other diseases as well as fighting fires in wooden structures of the central business district.
The early burial grounds in Chicago were near Lake Michigan at Fort Dearborn, along the river. In the 1840’s a large city cemetery complex extended in what is now Lincoln Park, including land the city purchased from the estate of a wealthy cholera victim. After another cholera epidemic, the proximity of the city cemetery to the water supply became a public health concern. In the 1860’s large numbers of bodies were transported to cemeteries farther from the lake that remain today, including Graceland, Rosehill, and Oak Woods.
Improvements in sewage and sanitation finally ended the scourge of cholera in Chicago in the early 1880’s. Over the years there were reports of a terrible 1885 epidemic of cholera and typhoid fever that killed 90,000. It is almost certainly an urban myth since no contemporaneous accounts exist, which would be incredible considering the improbably high number of deaths (equivalent to 250 Chicago Fires) . By then, cholera had basically been eradicated in Chicago.
Today, cholera’s impact on early Chicago has been largely forgotten. Barring a cataclysmic natural disaster or major societal upheaval, Chicagoans will never again experience a cholera epidemic. But the story of cholera is as integral to the fabric of Chicago as the colorful accounts of crooked politicians, World’s Fairs, and gangsters that regale us in our history books.

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Todd Ricketts, a member of the new ownership of the Chicago Cubs, recently donned a disguise to work menial jobs at Wrigley Field during a summer homestand for the CBS reality series, Undercover Boss. His assignments included posting numbers manually in the centerfield scoreboard, working on the field with the groundcrew, and cleaning stadium toilets.

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It was the pearls. They seemed so out of place. She always wore pearls, whether she was doing housework, eating breakfast or just reading the newspaper. Barbara Billingsley, aka June Cleaver, the archetypical 1950’s American mother, died yesterday.

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Kathleen Sebelius, Secretary of Health and Human Services, recently outlined the Obama Administration’s plan to implement electronic medical records in every American hospital and clinic. She wrote, “Over the last 30 years, we’ve watched information technology revolutionize industry after industry, dramatically improving the customer experience and driving down costs. Today, in almost every other sector besides health, electronic information exchange is the way we do business. A cashier scans a bar code to add up our grocery bill. We check our bank balance and take out cash with a debit card that works in any ATM machine.”

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Sooner or later, your favorite local radio music format will be gone. One day, perhaps without warning, it will be replaced by talk, news, or some “contemporary” format. Popular songs you once enjoyed, or maybe loved to hate, first become oldies and suddenly one day a program director somewhere decides the demographic skews too old and those songs just vanish from the radio.

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The National Football League is doing a comprehensive review of head trauma and their conclusions may change how football is played. Spectators and television viewers may appreciate the violence of football but not the true elemental level of danger. As a physician and fan, I learned this firsthand from Darryl Stingley and Jack Tatum. Tatum died this week but his legacy remains current.

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On Saturday, Ghana (2009 estimated population, 24 million) eliminated the United States (2009 estimated population, 307 million) from the World Cup. Since patriotic rooting interest no longer factors in, it’s time to address the eternal American sports question - soccer or baseball?

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A perfect game. The pitcher retires 27 batters in order; no one reaches base. There have been only 20 in Major League Baseball since 1876, making it one of sports’ rarest accomplishments (although in a statistical oddity, two have been pitched this season).

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“Wha’chu talkin’ bout, Willis?” That question is in the pantheon of iconic TV sitcom phrases along with, among others, “To the Moon, Alice” (Jackie Gleason), “Lucy, I’m home” (Desi Arnaz), “Dyno-mite!” (Jimmy Walker) and “I’m coming to join you, Elizabeth” (Redd Foxx).

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One of the knocks on show business is that it is kinder to men than it is to women as they both grow older. Men like Cary Grant and Sean Connery who age gracefully often get choice acting parts while the phone stops ringing for women who were once big stars in their twenties and thirties. True enough. But last week’s news has the stories of four women, all of whom proved talent and determination can overcome. They survived and prevailed.

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