Khaled, Nathan and Medical Science

Dr. David Nathan is an 80 years old doctor. For the last forty years he is treating one patient suffering from thalessemmia. He is Khaled.

Dr. Nathan has penned the true story of those 40 years of Khaled’s treatment. It is not just a tale of a patient fighting an incurable disease. The entire story is of a doctor who is treating a patient and is involved in finding a new medicine too. The story is actually told as a doctor’s story – it talks of difficulties faced by a doctor, various considerations that go in treating a patient of a chronic disease, how in spite of the best possible treatment he gets HIV and Hepatitis C and how it compilicates the treatment, the developments in medical science, and the Ciba Geigy [Novartis] team that develops a medicine.

Khaled is now 41 and he is being treated by the same doctor for forty years is just the obvious part. Support from family, Research by pharma companies and intelligent treatment plan has made this possible.

Here is what Dr. Nathan says
“I worry about the future of the kind of medical care that we have provided Khaled. We have spent millions of dollars on his care alone. The scientific basis of that care would never have been developed were it not for a huge public investment in biomedical research (through the National Institutes of Health), the research budgets of other nations, private foundations, and the massive investments of the pharmaceutical industry. Had Khaled relied for his care on the fractured U.S. health system, he would have found himself penniless within a decade. Almost every private insurance company would have dropped him long ago. His staggering health costs were underwritten by a government because he is the son of a very highly regarded former diplomat and cabinet minister—scarcely a model that can be emulated.

When I try to visualize how we could find the resources to provide such treatment to an uninsured or underinsured U.S. citizen, I cringe. Yet I know that we have learned an enormous amount from Khaled, information that has been confirmed by others and then applied far more efficiently on behalf of other thalassemia patients in better-organized health systems around the world.

We are fortunate, here in the United States, that physicians like me, whose careers are devoted to clinical research in academic health centers, have the time and support to contribute to new treatments. But the application of those treatments to patients requires a cost-conscious and highly organized health system that is far from our ken in this country. I’m not sure that our citizens, our medical community, or our political leaders truly understand how broken the system really is. It must be reorganized if we are to provide this kind of research-based care to the many patients with serious chronic illnesses who need it, while we also offer high-level primary and preventive care to the vast population at large.

Meanwhile, I stay on the job, looking for patients like Khaled who can be helped by a creative union of physicians, nurses, basic scientists, and pharmaceutical companies. Those patients are the challenges who bring me to work every day. It’s an exciting honor and privilege to serve them.”

Kudos to you, Dr. Nathan.