Baylor University Medical Center Proceedings July 2017 - 387

once they begin to fall. The CDC had reported earlier that older
people falling was the top cause of injuries and estimated that
27,000 Americans die from falls each year. These falls obviously
can be major game changers. Handrails and tacked-down rugs
are important preventive measures.
RUSSIAN LEECHES
Believe it or not, leeches are still widely prescribed in Russia,
about 10 million of them every year, as a low-cost substitute for
pharmaceutical blood thinners like warfarin (28). The leeches are about 2 inches long and slithery. Their job is to suck
blood. A medicinal leech costs <$1, and a typical application
requires 3 to 7 of the little creatures. Leech treatments, available throughout the country, take 30 to 40 minutes, though
the resulting wounds ooze blood for an additional 6 hours or
so until the natural anticoagulant in leech venom wears oﬀ.
Russia, it appears, is not the only country still using leeches.
They are creeping back into Western medicine. As many as
6000 are used annually in the US, but not in the same way
as in Russia. The US Food and Drug Administration (FDA)
cleared the sale of leeches as medical devices in 2004, along
with maggots, while European pharmaceutical companies have
focused on isolating therapeutic blood-thinning chemicals in
the venom and delivering them in a less creepy manner. The
FDA has approved leeches for draining blood, for example,
using them to remove excessive blood from body parts that
have been reattached. The Russian health care system, which
has been socialized since 1993, is simply short of money, and
some drugs like anticoagulants are in short supply in many
areas, particularly rural ones.
THOMAS EARL STARZL, MD (1926-2017)
Thomas Starzl became the ﬁrst surgeon to transplant a
human liver successfully in 1967 and went on to do hundreds
more (29). He was instrumental in starting the liver transplant
program at Baylor University Medical Center in the 1980s.
Despite his successes, he was haunted by the patients who died
during or shortly after liver transplantation, was dogged by
medical turf battles and cautious regulators, and was thrust
into ethical issues on how to allocate organs and whether it was
worth doing such costly operations.
Dr. Starzl was born in March 1926 and grew up in Le Mars,
Iowa. His father wrote science ﬁction as a young man and later
ran a small-town newspaper. His mother early on was a surgical
nurse and wanted her son to become a surgeon. In his 1992
memoir, The Puzzle People, Starzl indicated that Latin was his
favorite subject in junior high school. He served in the Navy
near the end of World War II. He then earned a biology degree
at Westminster College in Fulton, Missouri, and then a medical
degree at Northwestern University. He trained initially in surgery at The Johns Hopkins Hospital in Baltimore and ﬁnished
his training at the University of Miami. There he learned the
art of replacing blood vessels and in dogs devised a technique
for removing and replacing livers. He made his ﬁrst attempt
to do a liver transplant in 1963 at the University of Colorado
on a 3-year-old child. The operation was unsuccessful. Several
July 2017

more liver transplants were also unsuccessful. Feeling a lack of
support for his projects at the University of Colorado, he moved
to the University of Pittsburgh in 1980 and soon made the city
a global center for transplantation. He talked companies into
lending their corporate jets to rush livers to recipients. In 1990
he had coronary bypass surgery. He retired as a surgeon shortly
thereafter but continued his research.
CLIMATE CHANGE AND IMMIGRATION
As Thomas Snyder, professor of history at Yale University,
wrote, "To deny the consequences of global warming in 2017 is
not only disastrous to the interest of the United States, it is archaic" (30). Snyder opines that President Donald Trump might
be remembered as the most pro-immigration and pro-terrorist
president in US history because global warming will force tens of
millions of people northward from Latin America and Mexico.
It will also further destabilize the Middle East, bringing the
chaos and war that give rise to terrorism. The Pentagon and
Intelligence Services, he indicates, have long regarded global
warming as a major national security issue, a threat making
existing problems more eminent and threatening.
Snyder further opines that so much of what frightens us
today has its roots in climate change. ISIS and "Syrian refugees"
are, he indicates, a result of climate disaster in the Middle East.
In 2010, a hot summer and fatal harvest brought a spike in food
prices, leading to a wave of bread riots, civil war, and eventually revolution across the Middle East. Meanwhile, a persistent
drought in Syria brought an end to what we used to call its
"fertile crescent," pushing about 2 million people into the cities
and beginning the civil conﬂict that led to war and the spread
of ISIS. The only way to prevent new disasters, according to
Snyder, is to slow climate change. Worldwide, the region most
aﬀected by climate change is the crescent from North Africa to
Indonesia-where the Muslims live.
Further climate change will make the US-Mexican border
meaningless, he opines. Future food spikes are likely to destabilize Mexico's government and immigration control. About
one-third of Mexicans derive their income from agriculture,
making them vulnerable both to longer droughts and to the
reduction of water supplies from the north. The Colorado
River has been shrinking at a rate of more than 1% per year
since 2000. Unless climate change is halted, the American
Southwest and northern Mexico will essentially be without
water. The situation is perhaps more dire in Mexican cities.
About 10% of Mexicans live in or near Mexico City, a massive (27 million people) urban megatropolis that will literally
sink if people are forced by climate change to keep drilling
for water.
As temperatures increase, chemical reactions accelerate, making smog in the cities more unbearable. Millions of
Mexicans could migrate north for environmental reasons. If
we choose to accelerate global warming, that would simply be
the beginning of an overwhelming trend in which hundreds
of millions of people seek shelter from forces that are beyond
their control, but not beyond ours. We must all do our share
to prevent this potential coming disaster.

Facts and ideas from anywhere

387

Table of Contents for the Digital Edition of Baylor University Medical Center Proceedings July 2017