On Thu, 1 Jul 1999, Ralph Walter wrote:

> Editor:
>
> How does it happen that the CDC M&MWR is required reading for the august
> Office for Metropolitan History?  Especially in July?
>
> Weekly Reader

I subscribed to the MMWR back around 1978 or 1979 when it was free.  All
you had to do was notify the CDC that you were interested, and they added
you to the mailing list.  The notion was that disseminating this
information was good for public health.

The MMWR is a little weekly newsletter with a very sober and consistent
style.  It contains a note in each issue that "The Editor welcomes
accounts of interesting outbreaks, hazards, ..." I forget the rest.
Along with pages of death and disease statistics, it has several articles
each issue with stories like the black pepper saga related by Christopher
Gray.

In June 1981, when I was in law school, the MMWR carried the first article
published anywhere about the syndrome that later came to be known as AIDS.
They put in on page 2 because they didn't want to make too big a deal of
it (see "And The Band Played On," by Randy Shilts, for the full story).
I still have that issue.

Not long after that, the Reagan administration decided that it didn't like
the idea of sending out hundreds of thousands of MMWRs for free.  A
very steep subscription charge was introduced, and so I stopped getting
it.

However, the Massachusetts Medical Society, publishers of the New England
Journal of Medicine, stepped in with a plan to republish the MMWR and sell
subscriptions for much less.  Eventually I and several friends got
subscriptions from them.

Of course, being an MMWR subscriber through the MMS means that they are
constantly pestering you with offers to also subscribe to the New England
Journal of Medicine.  One of my friends (a politician and non-practicing
attorney with no medical background) finally gave in to this pressure and
very soon his bathroom was stacked with dozens of copies of the NEJM,
which are thick and square-bound like National Geographics, but come out
much more frequently and hence accumulate rapidly.  Since my future wife
was one of the residents of that same house, I had plenty of occasion to
browse them.

My friend's favorite section of the NEJM, which he recommended to
everyone, was the column which was not actually called "stump the
experts".  An unusual case is described in detail, with a catalog of
symptoms and unsuccessful treatments, concluding with "A diagnostic
procedure was performed."  The guest expert or panel of guest experts,
high-prestige academic docs, are then expected to review the evidence and
guess the actual malady.  At the end, the answer is revealed, usually
something really screwball like tuberculosis of the heart.  Sometimes they
included excerpts from the autopsy report.

Another benefit of being an MMWR subscriber is that you get annual
surveillance reports about various communicable diseases, along with many
nifty maps and graphs showing geographic spread and change over time.

Histoplasmosis, an affliction of preservationists -- or anyone who spends
time breathing the air in old barns or attics in the Ohio River Valley --
has been featured in MMWR and NEJM.  When I visited the Butler County
Courthouse in "Hamilton!" Ohio, on a tour that was part of the AIA's
historic county courthouse conference in Cincinnati last year, the judge
took us up to the attic, and then belatedly cautioned us that we were all
now at risk for histoplasmosis.  From reading the MMWR, I already knew
this.

---
Lawrence Kestenbaum, [log in to unmask]
The Political Graveyard, http://politicalgraveyard.com