Thorac Cardiovasc Surg 2019; 67(08): 615
DOI: 10.1055/s-0039-3400490
Editorial
Georg Thieme Verlag KG Stuttgart · New York

The End Is Nigh

Markus K. Heinemann
1   Department of Cardiac, Thoracic and Vascular Surgery, Universitaetsmedizin Mainz, Mainz, Germany
› Institutsangaben
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Publikationsdatum:
20. Dezember 2019 (online)

I am writing this while slowly recovering from a severe bout of some viral infection: a common cold, men's flu, whatever you like to call it. In fact, this disease is so eponymously common that everybody reading these lines will have had a similar experience more than once. It all starts with a dry cough or some sneezing, nothing special, but during the night several supernovae explode throughout the body, each releasing a new viral load, cell detritus, inflammatory agents, and whatnot. The patient is shivering from a biting cold which in reality is a high body temperature, is completely exhausted but cannot sleep, becomes shy of light and noise like a rabid dog, and feels utterly helpless.

No wonder that in these restless hours the feverish mind embarks on bizarre journeys. First you start to marvel about the technicolor variety of mucopolysaccharides you did not know you could produce, but which clog every opening urgently needed for breathing. Then you challenge the similarly colorful medications with their optimistic promises of fast and efficient relief. If this is the best palliation one can get, you are pretty much lost. A mug of hot squeezed lemon with honey plus or minus a dash of Bourbon definitely tastes better, is much cheaper, but of equally little avail. Oh, that damned helplessness – something the medical profession is not very good coping with.

The next shower of vasodilating agents causes feverish half-dreams about post-viral myocarditis, congestive heart failure, organ support and replacement technologies, the only aspect of the flu in the treatment of which a cardiac surgeon's expertise may be required – a knowledge he currently wishes he did not have.

Another half-hour of half-sleep, followed by the next half-crazed thought: If that disease is so common, how come we cannot cure and barely palliate it? Weren't “Lower respiratory infections” already the number 4 cause of death worldwide? We keep reporting continued success in fighting heart disease. Our colleagues from oncology also do their best to battle cancer. Must there be a shift in causes to die from, then? Looking at the world around us the likelihood to become a victim or a collateral damage of warfare (including the urban variety) must certainly be taken into more consideration. But in the end, it will be the bugs who will get us. “Communicable conditions” in tech speech, infectious diseases for most of us. With the bacteria outsmarting the development of antibiotic medications at increasing speed and with the viral army always that tiny but crucial bit out of reach by simply and quickly invading the host's cells, it can only be a matter of time before the next Great Plague will start to successfully and persistently decimate mankind.

It is a bit unfair, however, that its test run seems to have started in my bedroom.