The list of people who have succumbed to tuberculosis reads like a who’s who of politicians, writers, artists, musicians, royalty and so on. Eleanor Roosevelt, Robert Louis Stevenson, Frederick Chopin, the entire Bronte clan, King Edward VI of England, D.H. Lawrence, Amadeo Modigliani, and Vivian Leigh (aka Scarlett O’Hara) all succumbed to the disease.

TB remains a huge problem today, complicated by the advent of multidrug resistant strains which are extremely difficult to treat and cure. And it’s still a problem in the U.S., even though we don’t hear too much about it. There were more than 16,000 cases were reported in 2000 in the U.S.

So what is this leading up to? Well, on this date in 1882, Robert Koch announced that he had discovered the bacteria responsible for causing tuberculosis. While antibiotics were still decades away, his discovery made it at least possible to accurately diagnose the disease. Koch was awarded the Nobel Prize for Physiology or Medicine in 1905.

I’m a day or two late on this, but here’s another great tidbit to enter in the annals of healthcare history. And this one is for the nurses.

Everyone probably knows the story of Florence Nightingale, and how she and her pack of mighty nurses traveled to the Crimea to tend to wounded British soldiers. As the mythology goes, it was Nightingale who was responsible for miraculously downsizing a 45% morality rate to 2%. In the revised version and accurate version of the story, it was British engineers and sanitation experts who cleaned out the clogged sewers at the hospital, thus eliminating the spread of several dread diseases such as cholera and typhoid fever. While Nightingale and her nurses certainly were an asset in providing comfort to the wounded soldiers, as well as scrubbing that filthy hole from top to bottom, they had relatively no effect on the death rate.

Okay, I’m getting off track. Back to Nightingale. In 1860, she hit upon a new fangled idea. Why not train nurses in a new and scientific way? Give them some real classroom learning about anatomy (rather shocking for proper Victorian ladies to be aware of certain body parts), science, and medical knowledge of the day, as well as practical work on the wards. Nursing training, up until this point, was rather haphazard if it existed at all, and hospitals were generally dreadful places that killed more people than they saved.

In 1860, with the blessing of her pal Queen Victoria, the first Nightingale-style school opened at St. Thomas’s Hospital in London. After doctors got over their initial fear of trained nurses ( they saw them as competition, not quite understanding that nursing was a totally different discipline), the idea spread. And it wasn’t too long that it spread across the Atlantic to Britain’s former colony.

In the halls of nursing history, it is usually assumed that Bellevue Hospital in New York hosted the first, real training program for nurses in the US. While it became the most famous one, turning out a squadron of women who went on to become leaders in nursing, it was not the first. The Woman’s Hospital of Philadelphia established a school of nursing in 1863 and was the first such school to award a diploma, on March 22, 1865. So 140 years ago, the first trained nurse in the United States received a diploma.

Harriet N. Phillips is listed as the first nurse to receive a diploma at this school, so I guess we can say that she was the first graduate nurse of this new-fangled educational system. Blockley Hospital and Pennsylvania Hospital were also used as training facilities during the early years of nursing education, and the school remained open for 101 years. University and community college based training programs began to replace hospital based ones, especially in the second half of the 20th century. The School of Nursing graduated its last class in 1964 and then closed its doors. The following year, Woman’s Hospital became part of the Hospital of the University of Pennsylvania.

So what else is new? Bush doing something stupid? Is that news? Medicare and Social Security appear to be two of the biggest thorns in the Bush agenda, and I’m sure that if he could work his will, both would vanish completely. Who cares if old people can get medical care, or buy food–certainly not the hard-core Bush team.

Bush Ignores Medicare Reforms In Favor of Social Security Deform; Wall Street and Drug Company Campaign Contributors To Benefit

Santa Monica, CA — The Bush Administration ignored a report released yesterday by the trustees of the Social Security and Medicare programs which found that Medicare’s financial outlook is much worse than that of Social Security because those conclusions are contrary to the political goals of President Bush’s biggest contributors, according to the Foundation for Taxpayer and Consumer Rights (FTCR).

The Foundation for Taxpayer and Consumer Rights (FTCR) is a nonpartisan consumer advocacy organization. For more information, visit us on the web at http://www.ConsumerWatchdog.org

Here and there, I’ve noticed and heard comments from people that the circus which has erupted from the Terri Schiavo case would never have happened in Europe. And they are correct, although not for the reasons that they thought.

Europe, or at least certain nations, do have a very different view of life and death, particularly when it comes to end-of-life-issues. But for those who think that the Terri Schiavo case would be a no-brainer in Europe, that the woman’s feeding tube would be “compassionately” removed and she would be allowed to die, think again. If Terri lived in a country such as Belgium or Germany, rest assured, she would be settled quietly in bed, her feeding tube snugly in place, and nourishment and fluids flowing through it.

The Netherlands, Switzerland and Belgium allow physician-assisted death in various incarnations. About 2,000 people die through assistance from their doctor each year in the Netherlands alone. But Terri Schiavo would most definitely not be among them.

You see, these nations do not take death lightly, regardless of the way it is often perceived over here. There has to be a firm directive from the patient, made while they were mentally competent, that they choose to die. The same is true for withholding care, such as a feeding tube. The type of half-baked statement which emanated from the mouth of Terri’s estranged husband (yes, a man living with another woman and fathering two kids with her is estranged) several years after her collapse–that he didn’t think that “Terri would want to live like this,” simply wouldn’t make the grade. A patient in Europe would not be starved to death based on such a feeble argument. And especially, when there is such vehement opposition from parents and siblings.

From Deutche Welle: Dutch laws, like those in Switzerland and Belgium, require that the patient clearly and insistently request death. Schiavo, had she ever requested death should she fall into a vegetative state, did not insist on it. For this reason, even relatively socially liberal groups, like the Union of Protestant Churches in Germany, or the German Medical Association, have not recommended removing Schiavo’s feeding tube.

“The patient’s doctors are required to continue to treat her and to feed her, because it’s not clear what will happen next with her illness,” said Jörg-Dietrich Hoppe, the head of the German Medical Association.

Hoppe said there have been cases “of people who lived for 20 years in a ‘waking coma’ and then later came back to consciousness. The patient is certainly not dead.”

So in many ways, even though some think that the euthanasia laws in Europe are “immoral” and that they have no respect for life, it seems that they have a great deal more respect for life than we do. That a patient such as Terri would never be put in this position, that no one will ever be denied care unless there is absolute certainty that this is what they wanted.

I think we have a great deal to learn from “Old Europe.”