Monday, October 21, 2013

"Code Slow", the wartime SBE patients and Hearst's "Code Yellow"

What really happens whenever a family directs a hospital that its relative receives the full and rapid CPR response ("Code Blue") in the event of their quickly fatal cardiac or breathing arrest ?

Most the time, the medical and nursing staff will do their damnest to bring that patient back from the imminent grave.

But at times, the medical and nursing staff will form a silent consensus that they will just pretend to "code blue" a patient, but will actually merely go through the motions.

This is known as "Code Slow" and it is a serious breach in medical ethics.

The staff do so because (a) they believe that particular patient isn't worth saving ----(b) or less controversially , they honestly believe that particular patient at this point in their illness can't really be saved by fullout CPR and will merely experience additional pain en route to their death.

Reasons (a) and (b) are often mixed confusingly in actual practise ---- patients judged (subconsciously) as less valuable are more often also judged less able to benefit from full out CPR on strictly medical grounds.


During WWII, the millions of young people worldwide who had e potential to suffer the invariably fatal disease known as "Subacute Bacterial Endocarditis" (SBE) as a result of endemic Rheumatic Fever, were viewed by both Allied and Axis medical elites alike as 'useless mouths' during a total war.

They consumed a lot of scarce medical care and even if 1% of the time their illness was checked , it always returned a few months later and no one was ever known to survive a second or third hospital stay while suffering SBE.

True, by early 1943, Martin Henry Dawson had cured a few SBE patients , at least the first time, with moderately high amounts of what little public domain penicillin was available between 1940 and 1943 , but the Allied medical elite decided his success had to be discounted at all costs.

For if his success with SBE was accepted and publicised , it would lead overnight to a sudden sharp public demand for enormous amounts of penicillin.

(The thinking being that ordinary doctors would believe that if penicillin can cure SBE, the Mount Everest of infectious disease, then surely to God it could easily cure their patient's less invariably fatal infection.)

This would guy the game for those who hoped to use penicillin as a secret weapon of war - keeping it secret from the Allied public and hence the Axis-friendly diplomatic corps, so it was only available  to the Allied side during the big D-Day push.

It would also guy the game for those who hoped to hold off the public demand for this miracle drug until it had been safely synthesized and patented, when Big Pharma would finally freely sell it to everybody dying of bacterial infections ---- provided the dying or their families also had big wallets.

The hope was to keep Dawson's success out of the public eye until penicillin had been both patented and had been a surprise success on D-Day - mostly by denying him anymore public domain penicillin to repeat his feats.

He was known as not the type to 'spill all' to the press if he was denied more penicillin.

The SBEs wouldn't be denied all medical care and simply left to die, tempting as that was, because that could backfire and clash fearsomely with the Allied talk of the Four Freedoms.

Instead, they would be "code slow"-ed to death : given enormous amounts of useless (and abundant) sulfa drugs so their families would think something useful was being done for them, when it actually was not.

Unfortunately for these schemers, a fiery Italian American doctor,Dante Colitti, armed with his own private grudge against a medical elite for being prejudiced against allowing Italian Catholic cripples to get medical licenses, was far more willing to go to the media.

He got the master of the Yellow Press, Citizen Hearst and his paper chain, to go full out on behalf of this miraculous Yellow Magic stuff.

The rest, as they say, is history.

For in the end, "Code Slow" proved no match against "Code Yellow" .

A "Good News Story" from the "Bad News War".....

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