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In March 1900, Dr. Joseph James Kinyoun, a surgeon with the Marine Hospital Service and the founder of the Hygienic Laboratory, which became the National Institutes of Health, discovered bubonic plague in San Francisco. His finding led to an immediate outcry from the governor, local and state politicians, and the city's commercial interests. In the hyper-sensationalized journalism of San Francisco's newspapers, Kinyoun was ridiculed, leading to death threats and a $50,000 bounty on his head. Eventually, California's quarantine caused an enormous uproar. By the time a special federal commission produced a report (initially withheld from the public, leading to charges of a coverup) that vindicated Kinyoun, a deal had been brokered wherein the pioneering doctor was removed from his post. This book tells a timely story about yellow journalism, coverup, corruption, the struggle between science and politics, and the consequences of blind denial of the truth.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.