LymeNet Newsletter Volume 2 Issue 16

Volume: 2
Issue: 16
Date: 28-Sep-94

Table of Contents:

I. LYMENET: National LymeNet Hits the Internet II. J CLIN INVEST: Early and specific antibody response to OspA in Lyme Disease III. LYMENET: LD Surveillance Goes High Tech IV. OP-ED: What a Doctor Should Be, By Karen Angotti V. How to Subscribe, Contribute, and Get Back Issues

Newsletter:

*********************************************************************** * The National Lyme Disease Network * * LymeNet Newsletter * ***********************************************************************

IDX# Volume 2 - Number 16 - 9/28/94 IDX# INDEX IDX# IDX# I. LYMENET: National LymeNet Hits the Internet IDX# II. J CLIN INVEST: Early and specific antibody response to IDX# OspA in Lyme Disease IDX# III. LYMENET: LD Surveillance Goes High Tech IDX# IV. OP-ED: What a Doctor Should Be, By Karen Angotti IDX# V. How to Subscribe, Contribute, and Get Back Issues IDX#

QUOTE OF THE WEEK:

"A doctor should be someone who loves what he is doing so much that he would do it if he were not paid or otherwise compensated. For in this ongoing battle between life and death, God's most precious creation, Man, must inevitably confront his soul."

-- Author Karen Angotti (see Section IV)

I. LYMENET: National LymeNet Hits the Internet ------------------------------------------------- Source: LymeNet News Byline: By Marc Gabriel <[email protected]> Date: September 24, 1994

After a full year of fundraising, planning, construction and debugging, the National LymeNet is finally directly connected to the Internet. In volume 1, issue 16 of the Newsletter, The Lyme Disease Network of New Jersey, Inc., announced their intentions to build a computer network designed to facilitate information dissemination and communication between individuals interested in LD. One full volume of the Newsletter later, the system is a reality.

The Network has been in operation since last April, but accessible only via modem. The opening of the LymeNet to the Internet gives LymeNet users access to the wide resources of the Net, while providing Internet users with valuable information on LD.

In upcoming issues of the Newsletter, we will announce new LymeNet services available to Internet users, as well as services available only to subscribers of the National LymeNet. As of today, Internet users can access the LymeNet gopher server by pointing their gopher clients to:

gopher.lymenet.org

For information about subscriptions to the National LymeNet, contact Bill Stolow, President of the Lyme Disease Network of New Jersey at: [email protected] . The National LymeNet has been made possible by the generous donations of both individuals and organizations. Corporate contributors include Sun Microsystems, Novell, Hewlett Packard and Digital Express Group.

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II. J CLIN INVEST: Early and specific antibody response to OspA in Lyme Disease ------------------------------------------------------------------- AUTHORS: Schutzer SE, Coyle PK, Dunn JJ, Luft BJ, Brunner M ORGANIZATION: Department of Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School REFERENCE: J Clin Invest 1994 Jul;94(1):454-7 ABSTRACT:

Borrelia burgdorferi (Bb), the cause of Lyme disease, has appeared not to evoke a detectable specific antibody response in humans until long after infection. This delayed response has been a biologic puzzle and has hampered early diagnosis. Antibody to the abundant organism- specific outer surface proteins, such as the 31-kD OspA, has rarely been detected less than 6 mo after infection. Antibody to a less organism-specific 41-kD flagellin protein, sharing common determinants with other bacteria and thus limiting its diagnostic potential, may appear after 4 to 6 wks. To investigate our hypothesis that specific antibody to OspA may actually be formed early but remain at low levels or bound in immune complexes, we analyzed serum samples from patients with concurrent erythema migrans (EM). This is the earliest sign of Lyme disease and occurs in 60-70% of patients, generally 4-14 d after infection. We used less conventional but more sensitive methods: biotin-avidin Western blots and immune complex dissociation
techniques. Antibody specificity was confirmed with recombinant OspA. Specific complexed antibody to whole Bb and recombinant OspA was detected in 10 of 11 of the EM patients compared to 0 of 20 endemic area controls. IgM was the predominant isotype to OspA in these EM patients. Free IgM to OspA was found in half the EM cases. IgM to OspA was also detected in 10 of 10 European patients with EM who also had reactive T cells to recombinant OspA. In conclusion a specific antibody response to OspA occurs early in Lyme disease. This is likely to have diagnostic implications.

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III. LYMENET: LD Surveillance Goes High Tech --------------------------------------------- Sender: David Katsuki <[email protected]> Source: Aviation Week and Space Technology, Sept 12,1994: Headline: Tracking Infectious Disease from Above.

Scientists are predicting high risk areas for the transmission of debilitating Lyme disease using Landsat imagery combined with computerized overlays of related canine infection data. Results of a joint NASA-New York Medical College survey of suburban areas in Westchester County, N.Y., will help improve future infectious disease surveillance and prevention techniques. Lyme disease is transmitted to humans via infected deer ticks and is one of the most rapidly emerging insect-borne diseases in the U.S. Using satellite sensors saved the cost of sending survey teams throughout the 450 sq.-mi. area.

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IV. OP-ED: What a Doctor Should Be, By Karen Angotti ------------------------------------------------------ Sender: Karen Angotti

A doctor should be a hero in shining armor, the sheriff in the white hat. A brave, courageous defender against wanton diseases and virulent pestilences that kill, maim, and destroy. He should be someone who doggedly pursues the enemy without a thought of retreat. Relentless and determined, he fights until the last breath is gasped and the last, faint heart beat is pumped through the struggling body of someone he may not even know. For this is his mission, to fight death and pain, to endeavor to soothe, heal and relieve. It is a thankless task for death and suffering are as much a certainty as anything in this world. For as soon as one hideous disease demon is squashed with his seemingly pitiful weaponry, another more dreadful and fierce replaces it; and the battle begins anew.

A doctor should be someone who cares more for people that for money or prestige. A doctor who does not care is like an airborne blind pilot who cannot see the runway or read his instruments. All the knowledge in the world will not land that plane without the eyes to see. And likewise all the knowledge in the world will not cure a patient that a doctor blinded by indifference and apathy cannot see is truly ill. For a real doctor will listen to his patients with a heart of concern. He will listen to all his patients not just those who are comley or form, polished, refined, and educated. And adding that working knowledge of the patient to his book knowledge and experience, he will attempt to piece together a treatment that will work. No computer can compete with this ability. For though computers can spit out a diagnosis based on symptoms and then prescribe a standard treatment, no computer has a heart that can see and hear the patient with his own peculiarities and idiosyncrasies like a real doctor can.
Compassion is at the heart of that indefinable "art of medicine." Without it, a doctor might as well be replaced by a timesaving, efficient state-of-the-art computer whose memory has less capacity for error that a frail, fallible human mind.

A doctor should be humble realizing that his craft is far from perfected. Medicine is a science that is constantly changing and growing; and the modern "discoveries" of today may soon become the obsolete "discarded failures" of tomorrow. Only a doctor who is humble enough to recognize the gaps in knowledge that exist can begin to have the kind of open mind that considers intriguing, new ideas and possibilities which may become the discoveries of tomorrow. He no longer looks for answers and the three little words, "I don't know" cannot pass though the swelling lump of pride in this throat. Pride can construct an impassible roadblock on the path to the future.

A doctor should be someone who enters not a profession but a ministry -- someone who is there to serve not to be served. People (even doctors) are not at their best when they are sick and scared. Who would not be irritated by listening to endless complaints all day long year after year? Only someone who realizes that the reason for choosing this calling was to alleviate as many of those complaints as possible.

And given the impossibility of curing all of these ailments, the reward must not come totally from lessening of complaints or the adulation of patients but from the knowledge of a service well rendered. The greatest satisfaction must come from knowing that you have done your best, sometimes against seemingly impossible odds. Unraveling an intricate, diagnostic puzzle, using an innovative technique, or maybe simply holding someone's hand and saying "I am sorry." These are the things that making being a doctor worthwhile. These are the intangible things that make the endless complaints, petty annoyances, and invasions of time bearable.

A doctor should be someone who is honest and trustworthy. Qualities that we often ascribe as more necessary for bankers and accountants. But which has more intrinsic value -- mere money or an irreplaceable life? Trust is necessary between doctor and patient or a crucial element that may mean the difference between life and death is missing. If a doctor is saying one thing to a patient and writing another in the chart or gossiping about him with other doctors and nurses, then a sacred, unspoken trust has been broken; and the breach may impinge the entire relationship.

A doctor should be someone who is courageous and undaunted by the challenges which he most surely will face. There will always be some in every profession who are dishonest and even evil, those who will use their power for gain no matter how many or who it harms. "All it takes for evil to prevail is for good men to do nothing." In medicine, perhaps more than any other field, it is imperative that the good men restrain the unsavory. For if they do not, who else will have the necessary knowledge or expertise to do so?

A doctor should be someone who is kind and discreet for ill-spoken words can scar and main as surely as a knife. And because these hidden scars are undetectable by any test or examination, they almost always cause a permanent affliction -- most notably a communication rift between doctor and patient that cannot be bridged.

A doctor should be someone who loves what he is doing so much that he would do it if he were not paid or otherwise compensated. For in this ongoing battle between life and death, God's most precious creation, Man, must inevitably confront his soul.

--To my doctor, Edwin J. Masters, M.D., who showed me that a doctor could be what he should be.

Karen Angotti is the author of "Lyme Disease: A Mother's Perspective" (Anerak Books, 1993)

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V. HOW TO SUBSCRIBE, CONTRIBUTE AND GET BACK ISSUES ------------------------------------------------------

SUBSCRIPTIONS: Anyone with an Internet address may subscribe. Send a memo to: [email protected] in the body, type: subscribe LymeNet-L YourFirstName YourLastName

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CONTRIBUTIONS: Send all contributions to [email protected] or FAX them to 908-789-0028. All are encouraged to submit questions, news items, announcements, and commentaries.

BACK ISSUES: Available via 3 methods: 1. E-Mail: Send a memo to: [email protected] on the first line of the memo, type: get LymeNet-L/Newsletters x-yy (where x=vol # and yy=issue #) example: get LymeNet-L/Newsletters 1-01 (will get vol#1, issue#01) 2. Anonymous FTP: ftp.Lehigh.EDU:/pub/listserv/lymenet-l/Newsletters 3. Gopher: Site #1: extsparc.agsci.usu.edu Menu Selections: Selected Documents, Fact Sheets, Disease ----------------------------------------------------------------------- LymeNet - The Internet Lyme Disease Information Source ----------------------------------------------------------------------- Editor-in-Chief: Marc C. Gabriel <[email protected]> FAX: 908-789-0028 Contributing Editors: Carl Brenner <[email protected]> John Setel O'Donnell <[email protected]> Frank Demarest <[email protected]> Advisors: Carol-Jane Stolow, Director <[email protected]> William S. Stolow, President <[email protected]>
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