EDITORIAL — What You Can’t See Can Kill You

January 12, 2009
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garfieldCharles Guiteau, the assassin of President James Garfield, futilely argued in court that it wasn’t his bullet that had killed the 20th president, but rather incompetent medical care that took his life. Although Guiteau’s defense was preposterous (he was subsequently hanged), most historians now agree that the agonizing blood poisoning and  bronchial pneumonia Garfield suffered before his fatal heart attack had indeed been caused by the unsterilized fingers of his doctors probing in vain for his assassin’s bullet.

Given that the life-saving benefits of sterilization weren’t widely understood in 1882, Garfield’s medical team can hardly be blamed for his death. Today, however, we understand the importance of cleanliness and sterilization, yet some 100,000 patients a year still die from hospital infections, according to the U.S. Centers for Disease Control and Prevention.

An especially nasty and invidious culprit in all this sickness and dying is called Clostridium difficile (C.diff). While found in our soil, vegetables and meat, the bacteria thrive in health care settings, in particular hospitals and nursing homes. While many conscientious hospitals have taken aim at the usual suspects — cleaning and sterilizing floors, walls, medical instruments, bedrails, tables, toilets, sinks, stethoscopes, thermometers, telephones and remote controls — they’ve overlooked the most obvious source of contamination: their own staff!

If you happen to be a patient staring at a swarm of scrubs-wearing medical personnel – nurses, doctors and medical technicians — take cover. Turns out, those scrubs aren’t so squeaky, scrubby clean; in fact they can be walking petrie dishes saturated with superbugs. Lab coats are the biggest offenders. At the University of Maryland, 65% of medical personnel confess they change their lab coat less than once a week. Fifteen percent admit they change it less than once a month. These figures were quoted by Betsy McCaughey in her Wall Street Journal article, “Hospital Scrubs Are a Germy, Deadly Mess.” If the numbers aren’t chilling enough, consider how many times you’ve seen medical professionals wearing their scrubs out to a lunch or dinner break. Heaven forbid you take their spot at the lunch counter or booth after they’ve gone back to work. Although not on the menu, the germs they leave behind can cause extreme diarrhea, dehydration, inflammation of the colon, and death.

In a move to save money as much as lives, the British National Health Service provides nurses with hospital-laundered “smart scrubs” that come with short sleeves, said to be more sanitary than longer-sleeve scrubs. Many British hospital workers also don disposable aprons before approaching any patient’s bed. Each apron costs a nickel.

In the interest of saving lives and reducing health care costs in our country, we should also insist that all U.S. hospitals come clean by providing fresh, clean uniforms for their workers. Happily, some U.S. hospitals are now doing this. In exchange for picking up the cleaning bill, hospitals must insist their workers never wear them in public.   
Garfield died from an apparent lack of good medical knowledge. We can’t let 100,000 people a year die from our lack of will.


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