Dirty Hospitals
Two million patients are infected in hospitals each year and 90,000 of those Americans die.
By Katharine Greider
January 2007


Of every 20 people who go into a U.S. hospital, one of them picks up something extra: an infection. It's a lousy card to draw. Infection stalls recovery, sometimes requiring weeks of intravenous antibiotics or a grueling round of surgeries to remove infected tissue. And for 90,000 Americans a year, the infections are a death sentence.

A growing number of hospitals are working harder to stop infections, but as more bugs become resistant to antibiotics, it's an uphill struggle. Some 2 million patients get a hospital-acquired infection every year. In Pennsylvania alone, more than 19,000 infection cases occurred in 2005—up from 11,600 in 2004—out of 1.6 million admissions to 168 hospitals, according to a report issued in November by the state's Health Care Cost Containment Council. Pennsylvania, the first state to provide infection data collected directly from its hospitals, reported that nearly 13 percent of patients who got infections died, compared with slightly more than 2 percent of patients who didn't have infections.

Nationwide, hospital infections are the eighth-leading cause of death. One person who didn't recover was Dorothy Etheridge, a no-nonsense New Hampshire resident who raised five children and worked for 30 years as a mental health counselor. Etheridge had lung surgery in 2004 to remove an early-stage cancer, and doctors predicted a full recovery.

But within days, the normally robust Etheridge took a sharp turn for the worse. She had contracted a nasty antibiotic-resistant germ known as methicillin-resistant Staphylococcus aureus—MRSA—and she spiraled into respiratory failure. Through eight months of rehabilitation, bedsores and recurring infections, Etheridge fought back. "She was, to put it mildly, stoical and compliant and did everything and anything that she could to get herself home again," her daughter Lori Nerbonne says.

And get home she did. But after a week her temperature spiked. She was admitted to another hospital, where she died, at age 73, of a brain hemorrhage.

Left with painful memories of their mother's last months, Nerbonne and one of her sisters set to writing letters and testifying before the state legislature, joining a burgeoning nationwide movement that aims to stop infections in hospitals.

A leading light of that movement is Betsy McCaughey, a health policy expert and former lieutenant governor of New York. She founded the nonprofit Committee to Reduce Infection Deaths—RID—two years ago after hearing the story of Brad Moore of Washingtonville, N.Y.

In 2002 Moore was mugged. He survived brain trauma—but got an infection in the hospital and died at age 28. McCaughey recalls sitting with his mother, Pat, in her kitchen. "We looked through her family albums: Brad as a little boy. And then Brad's funeral. It was impossible not to be very, very saddened," she says. "I thought, enough is enough."

Now McCaughey pushes and cajoles hospitals to prevent the spread of infection. The necessary measures, she says, are simple and well documented in medical literature. Yet they're not consistently practiced or explained to patients. "A very good example," she says, is to tell patients to "shower with chlorhexidine soap if you're going in for surgery ... it's so easy. And you get it in the drugstore."

In fact, job number one for advocates like McCaughey is to debunk the notion that infection in the hospital is like bad weather—unfortunate but inevitable. Administrators, they insist, have set the bar way too low, content to keep their hospitals' infection rates to national averages—for example, a wound infection for one of every 24 surgical patients and a urinary tract infection for up to a quarter of those requiring a catheter for a week or longer.

"There's this culture that says that when people are old or immunocompromised, they're just going to get infections," says Lisa McGiffert, who heads the Stop Hospital Infections campaign at Consumers Union, the nonprofit publisher of Consumer Reports. "Well, they aren't 'just going to get infections.' If you're careful, they won't."

Generally speaking, there's little debate about what it takes to check the spread of infection in hospitals, from giving patients antibiotics before surgery to avoiding overuse of catheters and intravenous lines. But hospitals are busy places, and the foe is invisible. Research suggests that more than half the time, health care workers even fail to wash their hands as recommended—a critical bulwark against infection identified 160 years ago.

"These bacteria are largely spread through touch," says McCaughey of the RID committee. "In the old days," she says, "nurses and doctors were trained not to touch doorknobs, cabinets, curtains and blood pressure cuffs once they scrubbed and/or gloved. But all of that training really went by the wayside in the early '70s, when the liberal use of antibiotics replaced that attention to rigorous hygiene."

Not coincidentally, those same years brought a galloping increase in germs you can't knock out with standard antibiotics. In 1974 only 2 percent of staph germs in the United States were drug-resistant. By 2004, fully 63 percent—including the lethal one that attacked Dorothy Etheridge—proved impervious.

One outcome of the crisis is that more hospitals are working harder to stop deadly infections. In early 2005, for example, the nonprofit Institute for Healthcare Improvement in Cambridge, Mass., enlisted 3,000 hospitals to practice interventions proven to save lives. One approach targeted ventilator-associated pneumonia (VAP), a deadly infection that strikes about 15 percent of patients who have a breathing tube inserted. Hospital workers washed their hands frequently, closely monitored incision sites and raised patient beds to at least 30 degrees to prevent stomach fluids from backing up into the lungs—measures that enabled more than 30 hospitals to report no VAPs for at least a year.

Pittsburgh's Allegheny General Hospital is also waging war on infections. In the past few years, says Richard Shannon, M.D., who until recently was chairman of Allegheny's Department of Medicine, the staff has reduced the rate of bloodstream infections caused by large-vein catheters by 90 percent and ventilator pneumonias by 85 percent. Shannon demonstrated that devoting resources to controlling infection saved the hospital $1.2 million over two years. He and his team reported in a supplement to the November-December American Journal of Medical Quality that eliminating a single bloodstream infection case pays for nearly a year's worth of measures to stop the infections.

The savings to patients and insurers are more obvious. The November report on Pennsylvania's hospitals noted that the average charge for infection cases was $185,260, compared with $31,389 for noninfection cases. Reducing infections is a win-win situation, says Shannon. "You not only make human beings better, you actually eliminate a huge amount of waste" in money and time.

How did his hospital do it? By studying quality-control techniques of the industrial production line. One example: Signs everywhere remind workers to wash their hands. "You have to make it so it's second nature, you don't have to stop and think about it," Shannon says.

When an infection does happen, the treatment team meets to figure out what went wrong. In one case they identified a mistakenly reinserted, kinked IV line as a probable cause and explained their conclusions to the patient's family.

In most hospitals, patients won't get such a thorough review and disclosure about the source of an infection. Moreover, in most parts of the country, it's virtually impossible to find out how well hospitals are doing at infection control overall.

But that's changing, too, with Pennsylvania and California among the states leading the way. In the past three years, 14 states have passed laws requiring hospitals to report information about infections to the public.

Public reporting not only informs consumers, it motivates doctors and nurses to work for better results, says Joyce Dubow, associate director at the AARP Public Policy Institute. In 1989, when New York state started publishing hospitals' death rates after bypass surgery, the hospitals conducted internal reviews, hired new personnel and pushed out surgeons with the highest death figures. Statewide mortality dropped like a stone, by 41 percent in four years.

"Nobody wants their deficiencies published," says Dubow. "And places that do well take pride in their good work."

Katharine Greider is based in New York and writes about health policy and medical issues.

By Christine Kearney
Thu Jan 11, 6:32 PM ET

A major U.S. book publisher is hoping its new Web-based writing contest can tap into the popularity of interactive competitions like hit television show "American Idol."

As part of the "First Chapters" contest, aspiring first-time authors and members of www.gather.com can post manuscripts on that social-networking Web site, organizers from publisher Touchstone Fireside and gather.com said on Thursday.

Touchstone Fireside is an imprint of Simon & Schuster Inc., a division of Viacom.

If online readers like the manuscript's first chapter, the author is voted through to the next round. Two more chapters are posted and the public narrows the field in the same fashion.

After three rounds of judging, a winning manuscript will be picked from among five finalists in May. The winner will be chosen by representatives from Simon & Schuster, Borders bookstores and gather.com, Touchstone Fireside Vice President Mark Gompertz said.

The winner will receive $5,000, a book contract with Touchstone Fireside and distribution by Borders.

In an industry struggling to sell fiction books, this is the latest effort to find a top-selling author. It follows other competitions including The Sobol Award, a literary competition launched in September that folded this week.

"We keep laughing about it, but this is the 'American Idol' of book publishing," Gompertz said. "We hope that we will find a talented writer who might not in the traditional way get themselves noticed."

Would-be authors without an agent have traditionally submitted manuscripts to a publishing house hoping to be picked out of a "slush pile," Gompertz said.

"This is an experiment on a sort of needle-in-the-haystack approach," said Gompertz, noting the voting public could outdo publishers who have picked "a lot of great stuff and a lot of dreck."
Judged by web addicts? Hmmm why not? lol TCBS BC

Hope is a good breakfast, but it is a bad supper.
Francis Bacon

I do not believe that any man fears to be dead, but only the stroke of death.


I had rather believe all the Fables in the Legend, and the Talmud, and the Alcoran, than that this universal frame is without a Mind.

I will never be an old man. To me, old age is always 15 years older than I am.


If a man be gracious and courteous to strangers, it shows he is a citizen of the world.


If a man will begin with certainties, he shall end in doubts, but if he will content to begin with doubts, he shall end in certainties.

If a man's wit be wandering, let him study the mathematics.

If we do not maintain justice, justice will not maintain us.

Imagination was given to man to compensate him for what he is not; a sense of humor to console him for what he is.


In order for the light to shine so brightly, the darkness must be present.

In taking revenge, a man is but even with his enemy; but in passing it over, he is superior.


It is as natural to die as to be born; and to a little infant, perhaps, the one is as painful as the other.

It is impossible to love and to be wise.


It is in life as it is in ways, the shortest way is commonly the foulest, and surely the fairer way is not much about.


It is natural to die as to be born.


Judges must beware of hard constructions and strained inferences, for there is no worse torture than that of laws.

Judges ought to be more leaned than witty, more reverent than plausible, and more advised than confident. Above all things, integrity is their portion and proper virtue.


Knowledge and human power are synonymous.

Knowledge is power.


Lies are sufficient to breed opinion, and opinion brings on substance.


Life, an age to the miserable, and a moment to the happy.

Little do men perceive what solitude is, and how far it extendeth. For a crowd is not company, and faces are but a gallery of pictures, and talk but a tinkling cymbal, where there is no love.

Many a man's strength is in opposition, and when he faileth, he grows out of use.


Men fear death as children fear to go in the dark; and as that natural fear in children is increased by tales, so is the other.

Money is like manure, of very little use except it be spread.

Money is like muck, not good except it be spread.

Nakedness is uncomely, as well in mind as body, and it addeth no small reverence to men's manners and actions if they be not altogether open. Therefore set it down: That a habit of secrecy is both politic and moral.

Natural abilities are like natural plants, that need pruning by study; and studies themselves do give forth directions too much at large, except they be bounded in by experience.

Nature is often hidden, sometimes overcome, seldom extinguished.


Nature, to be commanded, must be obeyed.

Next to religion, let your care be to promote justice.

Nothing doth more hurt in a state than that cunning men pass for wise.

Nothing is pleasant that is not spiced with variety.

Of all virtues and dignities of the mind, goodness is the greatest, being the character of the Deity; and without it, man is a busy, mischievous, wretched thing.

Oh! death will find me long before I tire of watching you.


Opportunity makes a thief.

People have discovered that they can fool the devil; but they can't fool the neighbors.


People usually think according to their inclinations, speak according to their learning and ingrained opinions, but generally act according to custom.

Pictures and shapes are but secondary objects and please or displease only in the memory.

Prosperity is not without many fears and distastes; adversity not without many comforts and hopes.


Prosperity is the blessing of the Old Testament; adversity is the blessing of the New.

Read not to contradict and confute, nor to believe and take for granted... but to weigh and consider.


Rebellions of the belly are the worst.


Revenge is a kind of wild justice, which the more a man's nature runs to, the more ought law to weed it out.

Riches are a good hand maiden, but a poor mistress.

Science is but an image of the truth.


Seek ye first the good things of the mind, and the rest will either be supplied or its loss will not be felt.


Silence is the sleep that nourishes wisdom.


Silence is the virtue of fools.

Small amounts of philosophy lead to atheism, but larger amounts bring us back to God.

Some books are to be tasted, others to be swallowed, and some few to be chewed and digested.


Studies perfect nature and are perfected still by experience.


Studies serve for delight, for ornaments, and for ability.


The best part of beauty is that which no picture can express.

The correlative to loving our neighbors as ourselves is hating ourselves as we hate our neighbors.


The desire of excessive power caused the angels to fall; the desire of knowledge caused men to fall.

The fortune which nobody sees makes a person happy and unenvied.


The genius, wit, and the spirit of a nation are discovered by their proverbs.

The great end of life is not knowledge but action.


The job of the artist is always to deepen the mystery.


The joys of parents are secret, and so are their grieves and fears.


The momentous thing in human life is the art of winning the soul to good or evil.

The mould of a man's fortune is in his own hands.

The pencil of the Holy Ghost hath labored more in describing the afflictions of Job than the felicities of Solomon.

The place of justice is a hallowed place.


The remedy is worse than the disease.


The root of all superstition is that men observe when a thing hits, but not when it misses.

The subtlety of nature is greater many times over than the subtlety of the senses and understanding.


The way of fortune is like the milkyway in the sky; which is a number of small stars, not seen asunder, but giving light together: so it is a number of little and scarce discerned virtues, or rather faculties and customs, that make men fortunate.

The wise man will make more opportunities than he finds.

The worst men often give the best advice.

The worst solitude is to have no real friendships.


There is a difference between happiness and wisdom: he that thinks himself the happiest man is really so; but he that thinks himself the wisest is generally the greatest fool.

There is a wisdom in this beyond the rules of physic: a man's own observation what he finds good of and what he finds hurt of is the best physic to preserve health.

There is as much difference between the counsel that a friend giveth, and that a man giveth himself, as there is between the counsel of a friend and of a flatterer. For there is no such flatterer as is a man's self.

There is no comparison between that which is lost by not succeeding and that which is lost by not trying.

There is no excellent beauty that hath not some strangeness in the proportion.
Francis Bacon
Like the Ol fellows' take...BC

Mon Jan 8, 2007 7:58 AM ET

PHILADELPHIA (Reuters Life!) - A U.S. college student imprisoned for three weeks for trying to take flour-filled condoms onto an airplane has settled her lawsuit against Philadelphia for $180,000, a city spokesman said on Friday.

Janet Lee, 21, a student at Bryn Mawr College in Pennsylvania, was arrested at Philadelphia International Airport in 2003 after police and security officials thought the flour was an illegal drug.

She was held in Philadelphia on drug-trafficking charges and released only when tests proved the substance in the three condoms was flour.

The condoms, which are sometimes used to smuggle drugs, were a joke among the students, and Lee was taking them home to Los Angeles.

Her civil rights case against Philadelphia, which had been set to go to trial on Thursday, was settled for $180,000, said Ted Qualli, spokesman for Philadelphia Mayor John Street.

Such well trained agents!They had to wait 3 weeks and a lawsuit to find out it was a joke...Hell,I will do that time for 60K a week...
what a country!!! BC

I called my local pharmacy late/early on Wednesday...2:30 AM to use the auto refill option.(a great boon to mankind since it eliminates the attitude of the overpaid burnouts that actually"work" there)Much to my surprise, shock and stammering dismay, a LIVE PERSON answered the phone!Fuckall I thought..what now?The man tolerated my cannabis drenched amazement and explained that the auto cue had gone down, as well as the whole PC reliant brain of the Walgreens Nation.E fucking Gads I thought...as he took my script number and said that he would try to get it ASAP.
Well,what only I know is that I get that particular form of manatee tranquilizer in a dose that is twice what I need.That way I ALWAYS have enough for an extra month orso, no matter.Tricky, huh?
It only works if you fib to the Doc after you experiment with dosage.But since I am an evil genius, its no prob to me.hehehe...
OK back to the pharmacy...went there today at about 9:30 AM and wouldn't you know there was some old asshole cranking away at the poor fops behind the counter still trying to get caught up with the backlog from the puter crash.Being the shy man I am I looked at him and said"Whata Dick!"...and he looked, grumbled at the counter person and left.Now you would think that there would be less fuss from a glitch in a system, but you must know that Florida is retirement "heaven"and the fossils be takin some meds I tell ya.
I have ALWAYS had respect for my elders, but at 51, how much should I utilize when these old cranks are wasting my time as they gripe.You are right,I just tell em WTF I think and tough shit to them...hell, nobody else ever speaks their minds.end rant...TCBS BC