May 30, 2007

Why Fly When You Have Tuberculosis?

Have you heard about the nut who, after being diagnosed with a rare tuberculosis, takes two transatlantic flights?  Putting everyone at risk?  Especially after doctors managed to track him down in Europe to tell him his tuberculosis strain was "extensively drug [isoniazid and rifampin] resistant" and very dangerous, and ordered him into isolation?  Why would this nut do it?

The man told a newspaper he took the first flight from Atlanta to Europe for his wedding, then the second flight home because he feared he might die without treatment in the U.S.

He wasn't in the Sudan, or Kazakhstan-- he was in Italy. And he went to Prague to catch a plane to Canada SO THAT HE COULD DRIVE TO THE U.S.

I suggest everyone think long and hard about this, before we take any further steps down the road towards universal healthcare.   You can't give away what you didn't pay for.


5/31/07 Addendum:  AK (see comments) discovered that the guy is actually a personal injury lawyer.  That's irony.  And his new father-in-law is a CDC doc specializing in... go on, guess... 


This story is pretty awesom... (Below threshold)

May 30, 2007 7:06 PM | Posted by Andy: | Reply

This story is pretty awesome. I hadn't realised just how far he travelled.

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Well, there's "democracy" i... (Below threshold)

May 30, 2007 10:12 PM | Posted by Nah, blame solar flares.: | Reply

Well, there's "democracy" in Iran, and there's "democracy" in the US. I do not accept that universal healthcare is just one animal.

Are we so unimaginative and helpless that we can't figure out a better way? Are we so stupid that we'd reproduce the same errors? How pessimistic.

And are things so bad in Italy? The hospital I went to there was older, but I received the same care there as I did here for a similar issue. Of course, I REALLY would've preferred care here because, ohhhhh, I don't know--only one of the hospital staff spoke English (but was cranky as hell), and because everyone I knew was overseas. Being sick, unable to communicate, and away from people I knew was extremely difficult and scary, even for a relatively minor issue.

Anyway, this is just a rehash of one of the most central public health issues: personal freedom versus public safety. Typhoid Mary was locked up for years, then went back to preparing food that killed people. People do stupid, reckless stuff. I'm sure the guy could've received treatment in the US, seems he was mostly pissed about the armed guards. Furthermore, looking at a few different stories, it's not clear whether he would've been treated in Italy in the first place. "The man said the CDC contacted him in Rome during his honeymoon, telling him that he had to return home and that he had to turn himself in to Italian authorities."

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Dear Admin:This pe... (Below threshold)

May 31, 2007 11:45 AM | Posted by AK: | Reply

Dear Admin:

This person is not an ordinary 'nut'. He is reportedly a personal injury attorney.

What fascinates me is that it is possible to master the complex information and procedures needed to become a professional, and yet function in other respects as a two year old in an adult body, a two year old's heedlessness and lack of awareness of others, alongside the ability to function competantly, even with distinction in a demanding profession that requires adult levels of cognition and social finesse.

And--it is not insanity in the usual sense of the word, either.

Here is the text:

"ATLANTA - The tuberculosis patient under the first federal quarantine since 1963 is a 31-year-old personal injury attorney [italics mine] who practices law with his father in Atlanta, a federal law enforcement official said Thursday....

The man knew he had TB when he flew from Atlanta to Europe in mid-May for his wedding and honeymoon, but he didn't find out until he was already there that it was an extensively drug-resistant strain considered especially dangerous.

Despite warnings from federal health officials not to board another long flight, the man flew home for treatment...

The man flew to Paris on May 12 aboard Air France Flight 385... he and his bride also took four shorter flights while in Europe — Paris to Athens on May 14; Athens to Thira Island May 16; Mykonos Island to Athens May 21; and Athens to Rome May 21 — but

It was while the man was in Rome that he learned further U.S. tests had determined his TB was the rare, extensively drug-resistant form, far more dangerous than he knew. They told him turn himself over to Italian health officials and not to fly on any commercial airlines.

Instead, on May 24, the man flew from Rome to Prague, then flew to Montreal aboard Czech Air Flight 0104 and drove into the U.S., according to CDC officials...

"With drug-resistant tuberculosis, it's quite a challenge to treat this," [Dr.] Daley told CNN Thursday. "The cure rate that's been reported in other places is very low. It's about 30 percent for XDR-TB.";_ylt=AthGnbEoDtWCQte2PXjlvZqs0NUE

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Kudos to AK for followin... (Below threshold)

May 31, 2007 12:17 PM | Posted by Admin: | Reply

Kudos to AK for following up on this story.

I was just being flippant by calling him a nut-- and now he turns out to be a personal injury lawyer? Oh, the irony.

And I agree with AK-- even though he feared he would die without proper treatment, he was totally oblivious-- or uncaring-- about the risk to others. And you have unkowingly/knowingly hit upon the exact pathology when you said, "a two year old's lack of awareness of others..." There's a word for that obliviousness to others... I wonder what it could be...

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(Wildly waving a pair of me... (Below threshold)

May 31, 2007 2:56 PM | Posted by AK: | Reply

(Wildly waving a pair of metaphorical pompoms)

"Giiiiveee us an N....!!!"

This just in, boys and girls: The lawyer's father in law is, reportedly, a CDC doctor and an expert on TB.

ATLANTA - The honeymooner quarantined with a dangerous strain of tuberculosis was identified Thursday as a 31-year-old Atlanta personal injury lawyer whose new father-in-law is a
CDC microbiologist specializing in the spread of TB and other bacteria.

Bob Cooksey would not comment on whether he reported his son-in-law, 31-year-old Andrew Speaker, to federal health authorities. He said only that he gave Speaker "fatherly advice" when he learned the young man had contracted the disease.

In a statement issued through the CDC, Cooksey also said that neither he nor his CDC laboratory was the source of his son-in-law's TB.

The CDC had no immediate comment on how the case came to the attention of federal health authorities.

"I'm hoping and praying that he's getting the proper treatment, that my daughter is holding up mentally and physically," Cooksey told The Associated Press in a telephone interview. "Had I known that my daughter was in any risk, I would not allow her to travel."

No novelist could make this up.

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New reader. Nice blog.... (Below threshold)

June 1, 2007 11:28 AM | Posted by abeedle: | Reply

New reader. Nice blog.

I sympathize with this guy's concern that he would be lost in a strange sort of limbo had he 'turned himself in' in Rome. Likewise, I think he's probably being quite truthful in his assertion that he wasn't told he shouldn't fly until he got to Europe.

It's clear that he was made aware that he is at risk and poses a risk in more concrete form while on the trip. He's also acutely aware that once he has been sucked into the cycle of public health policy, he no longer matters -- his identity will change to that of 'detainee'. Only a fool would choose that willingly given the social and political tenor of the last few years. And turn yourself over the Italian health authorities? You're kidding, right?

Now he's operating under a significant amount of pressure and panic. What happens next? Well, given that I remain amazed at how parents in our little town act at high school girls' soccer games... I guess nothing would surprise me.

So, no I wouldn't have wanted to be sitting next to him on the plane. And I can feel pretty strongly about him putting people at risk. I can even believe that I might have done things differently. But I'm not sure about the last point simply because the chain of events seems so plausibly bizarre that it could only have stemmed from the intersection of self-involved-lawyer and large-bureaucracy.

If someone had clearly said to me, "Hey, you have this really terrible and contagious form of disease X for sure and, well... your only hope of cure/survival is this hospital in Denver." then, I think that I might have skipped the whole wedding thing and driven like all heck to Denver. Or wondered WTF anybody was thinking in telling me this outside the context of admitting me to an isolation ward post-haste.

Which I guess leads me to ask, "What kinds of risks is it acceptable to foist on other people?" Drunk drivers -- are we pissed at them for driving drunk? Or pissed at them for changing up the risk game when it comes to driving? As a culture and a species our inability to accurately assess and act on risk is so deep and so wide that it pretty much beggars description.

I'm not saying he was right. Just that it's complicated.

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When I was 14, I looked for... (Below threshold)

June 1, 2007 11:18 PM | Posted by AK: | Reply

When I was 14, I looked forward to attending my favorite cousin's wedding.

But--I did not get to go.

A day or two before the ceremony, I came down with a nasty cold. My mother told me in no uncertain terms that I was to stay home.

The reason for Mom's decision was that my uncle had diabetes and heart disease. Mom did not consider it an acceptable risk that Uncle Leo be exposed to my URI--too much potential for him to get bronchitis or pneumonia.

My mother acted as she did because understood a thing or two about public health and care for others--and it came from vivid personal experience.

Mom's father died from TB in the years before drug treatment was available.

Grandpa was an angry alcoholic and in sheer spite, had refused to take sanitary precautions. He spat on the floor, instead of into covered containers, exposing the rest of the family to his germs.

As a result, everyone who lived with Grandpa--Grandma and all seven children--were exposed to TB and had the germs in their lungs. One of my uncles told me that after Grandpa died, he had lived in terror that his mother would also die from TB and that he and his brothers and sisters would be scattered and sent to orphanages.

The only way my uncle could console himself was to trust that his oldest sister would not let this happen. My aunt Virginia was only 16 when her little brother put his faith in her.

My uncle was not being a paranoid child. His fear was reality based.

Grandma had been turned down for all forms of assitance after being left a poor widow. These the depression years. There was an orphanage in the neighborhood, and Aunt Virginia told me told me she and the kids walked by each Sunday while on their way to attend church. They the orphanage kids looking out at them through the fence.

'It was heartbreaking to see them' Virginia told me. 'Times were hard and you just knew most of these kids wouldnt find homes.'

After my aunt told me this, I spent several nights weeping on my pillow. I couldnt imagine the raw terror my aunts and uncles faced as children, worrying that could happen to them.

They were left with that fear because of TB and because their father had refused to take sanitary precautions out of concern for his wife and children.

It was sheer good fortune that Grandma and the kids all stayed healthy. Otherwise, if Grandma had died from TB contracted from Grandpa, her kids might have ended up behind that orphanage fence.

Our actions affect others, for good or for worse.

These days you cant know if someone else next to you has a compromised immune system due to diabetes, heart disease, HIV or from being on cancer chemo.

Our lives are interconnected. We are not lone atoms. Our actions affect others, for good or for ill.

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I cannot believe that the d... (Below threshold)

June 4, 2007 6:53 PM | Posted by Boggart: | Reply

I cannot believe that the daughter of a TB expert would actually go on a honeymoon with a sufferer.

I can recommend as 'a good read' This NYT blog which has asked "What are the chances"?.

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