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Tag: "kentucky"

“Much of the renown acquired for Kentucky by her surgeons was in the treatment of calculous diseases”: Visions of the Past, Thanks to Gutenberg (III)

[ 11 ] June 26, 2016 |

amputation

What’s the point of looking into old historical texts if not to explore texts about surgery? Thus, Gutenberg presents us with David Yandell’s 1890 treatise, Pioneer Surgery in Kentucky: A Sketch. * You know this is going to be illuminating. How drunk was everyone involved? Were Kentucky doctors still bleeding patients in 1890? Are they still in 2016?

The last question goes unanswered, sadly.

This is the start of the text:

1806. The earliest original surgical work of any magnitude done in Kentucky, by one of her own sons, was an amputation at the hip-joint. It proved to be the first operation of the kind in the United States. The undertaking was made necessary because of extensive fracture of the thigh with great laceration of the soft parts. The subject was a mulatto boy, seventeen years of age, a slave of the monks of St. Joseph’s College. The time was August, 1806; the place, Bardstown; the surgeon, Dr. Walter Brashear; the assistants, Dr. Burr Harrison and Dr. John Goodtell; the result, a complete success. The operator divided his work into two stages. The first consisted in amputating the thigh through its middle third in the usual way, and in tying all bleeding vessels. The second consisted of a long incision on the outside of the limb, exposing the remainder of the bone, which, being freed from its muscular attachments, was then disarticulated at its socket.

It goes from there. Unfortunately, some of Kentucky’s finest didn’t stay in the Bluegrass. They traveled abroad and came under the influence of the Celestials, and no doubt their opium:

While among the Celestials he amputated a woman’s breast, probably the first exploit of the kind by one from the antipodes. Unfortunately for science, he there learned the method used by the Chinese for clarifying ginseng, and thinking, on his return home, that he saw in this an easy way to wealth, he abandoned the profession in which he had exhibited such originality, judgment, and skill, and engaged in merchandising. Twelve years of commerce and its hazards left him a bankrupt in fortune, but brought him back to the calling in which he was so well fitted to shine. He moved, in 1813, from Bardstown to Lexington, where he at once secured a large practice, especially in diseases of the bones and joints. He was thought to excel in the treatment of fractures of the skull, for the better management of which a trephine was made in Philadelphia, under his direction, which, in his judgment, was superior to any then in use.

Of course, anyone can secure a functional career in Lexington, even under the influence of opium, as Farley can attest.

Most of the book is a combination of somewhat disturbing tales of pioneer surgery and odes to the glory of sweet, sweet Kentucky. Such as:

It would be neither fitting nor becoming on this occasion, and in this presence, to speak in detail of the technic observed by McDowell in his work. That has long since passed into history. I may, however, be permitted the remark that the procedure, in many of its features, is necessarily that of to-day. The incision was longer than that now usually made, and the ends of the pedicle ligature were left hanging from the lower angle of the wound. But the pedicle itself was dropped back into the abdomen. The patient was turned on her side to allow the blood and other fluids to drain away. The wound was closed with interrupted sutures. This marvel This marvel of work was done without the help of anesthetics or trained assistants, or the many improved instruments of to-day, which have done so much to simplify and make the operation easy. McDowell had never heard of antisepsis, nor dreamed of germicides or germs; but water, distilled from nature’s unpolluted cisterns by the sun, and dropped from heaven’s condensers in the clean blue sky, with air winnowed through the leaves of the primeval forest which deepened into a wilderness about him on every hand, gave him and his patients aseptic facility and environment which the most favored living laparotomist well might envy. These served him well, and six out of seven of his first cases recovered. He removed the first tumor in twenty-five minutes, a time not since much shortened by the average operator.

I don’t doubt it, but thankfully we have turned this pure Kentucky water away from something as useless as surgery and toward something of far greater value: bourbon.

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In all truth, this is kind of an interesting book if you are into reading about historical amputations. And who isn’t?

* I am proud to say that I am evidently one of four people who have downloaded this book.

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“But I also appreciate that we can make our own history”

[ 21 ] May 6, 2016 |

louisville-monument

The title is a quote from Louisville mayor Greg Fischer, justifying the dismantling of a large monument in his city honoring treason in defense of slavery.

A number of cities across the country have or are currently engaged in debates about the place of Confederate monuments on public ground. New Orleans recently voted to remove four monuments, but has yet to follow through. Only the University of Texas at Austin has removed Civil War related monuments from campus. Today, the city of Louisville and the University of Louisville announced that a major Confederate monument will be removed immediately from public land adjacent to the campus.

The fourteen minute presentation is worth watching. You can even see that the equipment behind the monument is ready to go. What I find interesting is that not even the development of the nearby “Freedom Park” was sufficient to quell concerns about the presence of a Confederate monument. We often hear that additions to the commemorative landscape allow for monuments to be placed in conversation with one another, but that apparently was not considered as an alternative to removal.

Take ’em down.

Gilded Age Gender Norms, Horse Testicles, Civil War Memory

[ 166 ] May 4, 2014 |

800px-Morgan_Lexington_statue_behind

Why has Farley never written on this statue in Lexington of General John Morgan and his mare Bess? See, Bess has testicles because the sculptor felt it wasn’t manly enough for a general to be riding around a mare. This says a good bit about the late 19th century’s obsession with manliness and war, with the imperialists of the period going through a Greatest Generation-esque fetishization of the military experience of their fathers and comparing their own manhood unfavorably to them. Proper Civil War memory could provide young men examples of bravery, courage, and manhood they could then take with them to Cuba, the Philippines, or whatever Latin America country we decided to invade on a given early 20th century day. And thus, a man’s horse needed to be a male, at least so it seems to have needed to be for this gender-worried sculptor.

Dead Horses in American History (I)

[ 66 ] February 5, 2014 |

How have I blogged here for 2 1/2 years without exposing you all to my collection of dead horse images? Over the next week, it’s time to change that and fill a gap in your life you didn’t know existed.

Dead horse washed into tree by flood, near Louisville, Kentucky, 1937

Selenium

[ 31 ] November 16, 2013 |

This is not an acceptable decision from the EPA during a Democratic administration:

Today, the Environmental Protection Agency allowed the Kentucky Department of Environmental Protection to change how toxic selenium pollution from mountaintop removal mines is measured for the purposes of determining compliance with the Clean Water Act. Selenium, which causes significant biological damage to fish native to the waters of Appalachia, is a toxic pollutant discharged from valley fills into rivers and streams below mountaintop removal sites. The EPA-backed changes to how Kentucky measures selenium pollution allow the state to rely on an impractical and complicated test of tissue samples from fish rather than the current practice of directly sampling the water discharged below mountaintop removal mines and other selenium sources. EPA’s capitulation gives a free pass to industry and will allow unacceptably high levels of selenium pollution to continue flow into Kentucky’s waterways.

If anything, Obama’s EPA should be cracking down on coal mining and making it harder for the mountaintop removal industry to destroy the mountains and ecology of Appalachia. There is no good reason not to directly sample the water. None. Except that the coal industry doesn’t like it. Because ultimately this isn’t about the poisoning of fish. It’s about the poisoning of people. If the fish are poisoned, the people probably are at higher risk as well. Of course, one expects nothing else from the coal industry; it’s spent the last 125 years treating the people of Appalachia like feudal serfs. But for the Obama EPA to actually weaken testing rules, that I don’t get.

Here’s some background on why this all matters:

Current selenium limits in states like West Virginia have helped the Sierra Club and other nonprofits force coal companies to hand over millions of dollars in fines and cleanup costs, but those standards are based on older EPA water criteria and guidance that hasn’t been revised in nearly a decade. New data has suggested less stringent requirements would be adequate and the EPA has said it is updating the acute and chronic freshwater ambient water quality standards for selenium, though the agency has yet to act.

Kentucky is now trying to move ahead while the agency drags its feet, having developed its own criteria with help from the EPA and submitted it for federal approval. The proposal would require that high selenium levels be present in fish tissue before triggering a violation, and it would likely be emulated by neighboring states if it gets the green light from the EPA.

In taking the initiative, Kentucky is hoping to put more regulatory control in its own hands on an issue that has been litigated frequently in other states like West Virginia, according to Crowell & Moring LLP partner Kirsten L. Nathanson.

“The environmental groups have been driving enforcement through lawsuits,” Nathanson said. “Kentucky is trying to find an instructive solution to these issues and avoid some of these ad-hoc enforcement actions by taking affirmative control of its regulatory program for selenium.”

Industry has always preferred state-led regulatory programs because the states are far easier for industry to control than the feds. Politicians come cheaper and they tend to be much friendlier to local industry.

A very disappointing decision.

Not Allowing Prayer in Classrooms Is Totally the Same Thing as Genocide

[ 198 ] July 31, 2013 |

Conservatives in Kentucky are very angry. After all, the state might adopt scientific standards that teach actual science instead of Christian mythology. The responses are quite rational:

Matt Singleton, a Baptist minister, is one of the opponents who spoke to the board about why the standards should not be adopted, according to The Courier-Journal. “Outsiders are telling public school families that we must follow the rich man’s elitist religion of evolution, that we no longer have what the Kentucky Constitution says is the right to worship almighty God,” Singleton said. “Instead, this fascist method teaches that our children are the property of the state.”

Another opponent, Dena Stewart-Gore, suggested that the standards will make religious students feel ostracized. “The way socialism works is it takes anybody that doesn’t fit the mold and discards them,” she said, per the The Courier-Journal. “We are even talking genocide and murder here, folks.”

What killed the Jews in the Holocaust was the Nazis teaching them that the Earth was not 6000 years old. They all dropped dead of heart attacks or something.

Friends of Coal Miners

[ 30 ] March 25, 2013 |

Who are the real friends of coal miners? Like in the timber wars of the 1980s, an exploitative industry and its lackey politicians have claimed that the industry looks out for the miners against those evil environmentalists, while at the same time engaging in land management and labor policies that make workers’ lives worse. Given a declining industry due to overexploitation of the resource and because of a lack of economic alternatives for scared workers, this political move has been very effective both in logging towns of the Northwest and Appalachian coal country.

But in both places, activists have pushed back against the false choices of industry versus environment. Here is an outstanding letter from retired UMWA organizer Carl Shoupe about the lies of the coal industry to the people of Kentucky.

Since I’ve been around coal all my life, I guess I should be pleased when our “leaders” say they are Friends of Coal. But lately, I’ve been wondering, which part of coal they’re friends with.

Peabody Energy and its new company, Patriot Coal, are trying to weasel out of paying health and pension benefits promised to thousands of retired UMWA miners. Have you heard any objection from these Friends of Coal in our marble palaces in Frankfort? Those miners earned their benefits with their sweat and their blood, but now Peabody wants to dump them like they’re just more overburden.

These politicians may be friends of coal, but they’re not friends of coal miners and their families. These miners and their families are being robbed of their retirement and benefits.

My friend Truman recently spent a week hooked up to a hospital ventilator. Like thousands of others, he suffers with black lung, caused by working in underground mines filled with coal dust. Today, the number of severe black lung cases is on the rise again, affecting workers on strip mines and below ground. And yet Congressman Hal Rogers has led efforts in Congress to block rules designed to protect miners from that awful disease.

Another friend of mine had to move with his daughter away from the homeplace where his family has lived for over 200 years. Toxic runoff from mountaintop removal was poisoning him and his family.

But his state representative, House Speaker Greg Stumbo, stood up at an Environmental Protection Agency hearing about water pollution and insisted that anyone who wants to save the mountains should just “go buy one.”

The speaker may be a friend of the coal companies, but he’s no friend of coalfield families threatened by mountaintop mining and poisoned water.

Coal companies and politicians of both parties who are beholden to coal money are not the friends of workers. At the very least, political progressives should be aware that environmentalists are not the enemies of coal miners. The enemy is the employer who has zero concern for the aftermath of coal mining and the long-term effects of coal dependency on Appalachia.

Crisis Simulation

[ 8 ] February 27, 2013 |

This past weekend we held the annual Patterson School Crisis Simulation. This year’s topic was cyber-warfare; I have a long writeup at Information Dissemination, and a shorter writeup at the Diplomat:

Coincidentally, my institution (the Patterson School of Diplomacy and International Commerce) ran a simulation last week on a cyber attack against U.S. defense contractors.  Although the simulation abstracted a great deal from reality, it nevertheless provided some policy lessons.  The attackers in our simulation (representing a Russian criminal organization rather than the PLA) shied away from directly assaulting U.S. government institutions, instead focusing their efforts on a law firm associated with several contractors.  The attackers hoped to gain access to intellectual property, including patent applications and trade secret information, as well as patterns of communication between the firm, the government, and the contractors.

In our simulation, the attackers substantially succeeded in most of their goals, although they did run into some difficulty selling the information. The most important lesson we learned is that poor communication between government and private organizations can doom cyber-defense efforts.  In our case, the law firm only reluctantly relayed its concerns about a breach to the government and to its clients, leaving the attackers with ample time to conduct their theft. This reluctance was hardly irrational; the perception that secrets could be at risk would prove devastating to the firm’s business prospects. Although our simulation did not subdivide the U.S. government (by creating different teams for different departments), similar dynamics surely complicate interagency responses to cyber-attacks.

 

 

Ashley!

[ 77 ] February 26, 2013 |

Thanks to the Daily Caller, I’m now a strong supporter of Ashley Judd’s potential 2014 Senate bid:

– On her comparing mountaintop removal to the Rwandan genocide: “President Clinton has repeatedly said doing nothing during the genocide in Rwanda in 1994 is the single greatest regret of the Presidency. Yet here at home, there is full blown environmental genocide and collapse happening, and we are doing nothing. Naturally, I accept that I set myself up for ridicule for using such strong terms, or perhaps outrage from human victims of slaughter.”

– On fathers giving daughters away at weddings: “To this day, a common vestige of male dominion over a woman’s reproductive status is her father ‘giving’ away her away to her husband at their wedding, and the ongoing practice of women giving up their last names in order to assume the name of their husband’s families, into which they have effectively been traded.”

– On the coal industry, which employees thousands of Kentuckians: “The era of coal plant is over, unacceptable,” she tweeted in October.

– On how Christianity “legitimizes” male power over women: “Patriarchal religions, of which Christianity is one, gives us a God that is like a man, a God presented and discussed exclusively in male imagery, which legitimizes and seals male power. It is the intention to dominate, even if the intention to dominate is nowhere visible.”

– On men: “Throughout history, men have tried to control the means of reproduction, which means trying to control woman. This president is a modern day Attila the Hun.”

Of course, we’ll see how all this plays out in an election, and how strong a candidate Judd proves to be (if she does indeed run). Kentucky is a funny place; we all remember how devastating the Aqua Buddha scandal was to Rand Paul’s political career.

This Won’t Happen on Ashley Judd’s Watch…

[ 80 ] February 19, 2013 |

Oh dear:

On November 14, 2012, Mitch McConnell (R-Ky.) wrote to Elizabeth King, the Pentagon’s congressional liaison, with an unusually credulous query. “I am writing on behalf of a constituent who has contacted me regarding Guantanamo Bay prisoners receiving Post 9/11 GI Bill benefits,” McConnell wrote in a letter acquired by Danger Room. “I would appreciate your review and response to my constituent’s concerns.”

Um, Guantanamo detainees getting GI Bill benefits? Yes, that’s from the Duffel Blog, as McConnell’s constituent clearly states, complete with the reference URL. Said constituent even notes that he or she can’t find any information about the alleged government payouts to suspected insurgents and terrorists.

 

 

A Sound of Wailing Ran from Piraeus Through the Long Walls to the City, One Man Passing on the News to Another…

[ 12 ] February 16, 2013 |

This is ugly. Take a look at the Jerry Tipton and John Clay twitter feeds to get a sense of the emotional dead space at the core of Big Blue Nation.

… post-game press conference even more ugly, if possible:

“We’ve got a couple of guys that are basically not real coachable,” said John Calipari after his worst loss in four years as UK’s coach. “You tell them over and over what we want to do, what we have to do, and they do their own thing. That’s where we are.”

Horror and Pornography

[ 71 ] January 10, 2013 |

I hesitate to link to this; take care, because it’s a genuinely horrible story of the death of a small child.  Newspapers acquire, justified or not, reputations for certain kinds of stories. The Lexington Herald Leader, it seems, almost invariably has some terrible tale of something awful befalling a toddler, whether shooting or car accident or fall from great height or some other mishap.

For reasons I haven’t been able to fully articulate, this story affects me more than most.  I’ve thought about it since the incident first hit the news, for reasons that should be obvious.  The story of the last moments is incomparably horrible, both for mother and child. At the same time, the participants oddly defy blame.  The father will likely go to prison, but this is clearly not a case of intentional homicide; it is perhaps too easy for parents to imagine something like this happening, if they ever found themselves with the misfortune of being forced to live in a trailer-turned-meth-lab.

While we can make social-science-laden-public-policy observations about events like this, in a country as large and varied as the United States, the overall impact of any public policy shift is simply to marginally increase or decrease the number of toddlers who die horrible deaths.  Policy shifts can have an impact that is hardly trivial; any of more investment in schools, an easing of drug prohibition, anti-poverty programs, greater access to and information about birth control, and better funded social service programs might have made a difference in this case.  Nevertheless, people are going to die in ways that shock and horrify; state policy only changes the “who” and “how many.”

I should also say that I’ve been reluctant to post on this because of a nagging feeling that, for the family, there ought to be something deeply private about this event. Reading the story, especially in the excruciatingly clinical style of the first link, feels like watching pornography; there’s something wrong about the notion that I have the right to know about it.  The story activates my horror/outrage/despair centers in an almost voyeuristic manner. That the story happens to be true only enhances the emotional rush. Surely the state needs to intervene, even if the principles have already been horribly punished.  Clearly, the media should stand as watchdog to the state, and evaluation of the events should inform our politics and policy. Still, I can’t help but feel that the combination of righteous outrage and horror that I feel when I read about the case is inappropriate; this belongs to someone else, and I have no right to this sense of despair.

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