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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 08-August-2003, Vol 116 No 1179

Symbols and snakes

Symbols are the signatures of human endeavour. They are soundings of the past, statements of the present and signposts to the future. Medicine has its share of symbols. These once included the stethoscope, the white coat and the black bag; but the white coat has been shed, the black bag abandoned and technology stalks the stethoscope.
One symbol persisted – the snake-entwined staff of Asklepios, hero physician and mortal son of the Greek god Apollo, from whom he inherited his mythical healing powers. Not so long ago, this familiar emblem graced the cars of doctors. But with persistent raiding of their cars for drugs and other booty, the badge of Asklepios has also been abandoned.
Disappointed as these symbolic losses are, of further concern is the usurper in the New World – the ‘medical caduceus’, the double-serpent staff with its surmounting wings. The ‘medical caduceus’ is based on the ancient staff of Hermes, messenger of Zeus. Among other things, Hermes was the god of thieves, merchants and commerce. Mercury, Hermes’ Roman counterpart, ‘was even more closely identified with commercial pursuits and was commonly depicted carrying a purse bulging with coins’. In truth, Apollo judged Hermes to be ‘a schemer, subtle beyond belief’.
Some may argue that Hermes’ staff is an inappropriate symbol for modern medicine. But, given medicine’s current climate of corporatisation, commercialism and advertising, it may well be entirely apposite.
MJA 2003;178:529

The media and medicine

Alan Cassels and colleagues recently analysed Canadian daily-newspaper stories from the year 2000 about five new drugs – atorvastatin, celecoxib, donepezil, oseltamivir, and raloxifene – all selected for their high profile in the media. Their most startling findings are that only 32% of the articles mentioned potentially harmful effects, while benefits were discussed almost five times more often than harms. Only 32% of stories mentioned drug costs, and only 26% of stories citing a scientific study included information on the funding source for the study. After excluding industry and government spokespeople, in only 3% of cases did stories mention the potential conflicts of interest of those quoted.
For celecoxib, only 16% of Canadian newspaper articles mentioned potential harmful effects – yet the drug may be associated with an ‘increased incidence of serious adverse events’ compared with older cheaper alternatives. Similarly, when paying for celecoxib was about to cause major financial burdens for public and private health-insurers worldwide, only 13% of stories covered the drug’s cost. Cassels and colleagues conclude that their results ‘raise concerns about the completeness and quality of media reporting about new medications’.
Lancet 2003;361:2097–8

A hot potato?

A genetically modified potato developed in India to contain extra protein is under attack, with opponents claiming that it will result in the neglect of traditional sources of protein and thus exacerbate protein deficiency.
A senior Indian biotechnology official said last week that the potato, which has undergone nearly three years of field trials, could be approved for commercial cultivation before the end of this year.
The potato expresses 40% more protein than wild or cultivated potatoes. The potato has been engineered with a gene, AmA1, from the amaranth plant, a grain that has been consumed for centuries in central America and Asia.
But opponents say the potato will have little impact on human health because the absolute increase in protein is not significant. The protein content of wild potatoes is less than 2% of their weight. An increase of even 40% would raise it to a maximum of 2.8%. Pulses are the most important source of protein in the Indian diet.
BMJ 2003;326:1351
     
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