Our hearts remain restless until they rest in thee, Oh Lord.

St. Augustine

By Dr. Jim Ferguson

Recently I told my wife, Becky, “I am no longer employable.” My regular readers know I am now retired from medical practice. In fact, I decided to let my medical license expire on my birthday this May because paying to renew the license, as well as Tennessee’s tax on professionals, was foolish. Actually, the decision was more psychological than monetary. I worked hard to become an MD and for the license that has been in effect for 48 years.

In Ecclesiastes, the Teacher said, “There is a time for everything and a season for every activity under the heavens.” There is a huge difference between being responsible for someone’s medical care, versus explaining medical issues or medical jargon to friends and family. It was an honor and a privilege to be someone’s doctor, but that demands you stay on top of your game.

I still routinely peruse three medical journals. However, the complexity of evolving medical science and my age convinced me it was time to step down before I was told to sit down.

I’ve advised many people that you should not retire without a plan. You can only play so much golf, garden, help with grandkids or travel. Humans need purpose which the French call raison d’être (reason for being). I believe our ultimate purpose is a relationship with God. The 17th-century scientist/theologian Blaise Pascal said we have a God-shaped vacuum in our hearts that only God can fill. So, I seek Him every day. And fortunately, I also have an avocation as a writer. It is a creative enterprise and less constrained than the complexities and demands of medicine.

Medical science is a blessing, but the potions and pharmaceuticals hawked on TV are a pain. People have asked me if I was ever persuaded to prescribe a drug because of a commercial. In my four and half decades of medical practice, I can’t remember a single instance of a patient asking me to prescribe drug X because of an advertisement. Maybe they sensed I would not be receptive. However, advertisements prompted this week’s column.

It’s been eight years since I wrote about “biologicals.” In fact, it was so long ago that I had forgotten I once wrote about this arcane aspect of medical science. So, if you have an eidetic memory and recall my discussions of monoclonal antibodies (moAb) you can skip this week’s column. However, the “back to the issues crowd” should be happy the Doctor is focused on medicine this week rather than his other interests.

Biologicals, biologics or biopharmaceuticals are “complex molecules produced through biotechnology in microorganisms, plant and animal cells.” These agents may be used in diagnostic testing, prevention of disease or treatment.

Medical terms can be confusing, especially the names of drugs. Often a medication’s generic name derives from its chemical class. Examples are penicillin, ampicillin, etc. which end in the suffix -lin.

Brand names of drugs are often influenced by marketing considerations. An example is Antivert, the brand name of meclizine, a drug used to combat vertigo (anti-vertigo). Sometimes a drug is remarketed with a different name. An example is dextropropoxyphene which was originally marketed as the anti-anxiety drug Novrad. Hadn’t heard of it? Well, it turns out Novrad was woefully inferior to Valium (diazepam), but had some analgesic properties. So, Eli Lilly reversed the drug’s name and re-marketed it as Darvon, an analgesic medication.

You may have noticed ads for medications whose names all end in the suffix, -mab, which indicates a monoclonal antibody class. There are currently dozens of monoclonal antibody drugs approved for treatment and more are on the way. Examples are adalimumab (Humira) for inflammatory conditions like rheumatoid arthritis, and trastuzumab (Herceptin) for breast cancer. Monoclonal antibody pharmaceuticals are “designer drugs,” some of which are designed to even treat high cholesterol, asthma and migraines.

Virtually everything in the body operates by proteins binding to receptors to produce or suppress a function. Think of electrical outlets and the plug on a lamp cord. If you insert the plug into the wall outlet, electricity flows to the lightbulb to produce light. When our kids were small, we covered unused outlets with plastic covers to prevent a youngling from sticking a fork, etc. into the outlet and getting electrocuted. By analogy, monoclonal antibodies are designed to bind to specific receptors, suppressing or stimulating cellular function.

The monoclonal antibody class name derives from its bioengineering. Injecting mice or other experimental animals with the protein of a microbe, cancer cell or a target cell’s receptor generates an immune response. This produces specialized white blood cells which generate antibodies, and a host of other white cells which aid in eliminating the foreign agent and remembering the invader in case the foreign protein is encountered again.

The spleen is a large lymph gland-like organ in the left side of the abdomen where memory cells reside. These can be harvested, and here’s the scientific magic: the memory cells can be fused with an immortal cell line to produce a “hybridoma.” These bioengineered cells are continuously grown in tissue culture and produce the specified antibody. These antibodies are then harvested and purified for therapeutic use or testing. It’s almost like Star Trek!

God’s creation is truly majestic, even if His highest creation, mankind, is sometimes less than noble. As I finish this essay, Alvin Bragg, the odious Democrat and Manhattan District Attorney, is moving to indict President Trump on a bogus case of salacious “he said/she said.” If this travesty goes forward, Bragg will effectively be interfering in a presidential election. Furthermore, Bragg plans to arrest President Trump which might expose him to the danger of a Jack Ruby-like attack.

I don’t know what will happen in Gotham. I am fearful for President Trump’s safety and for my country. Desperate people do desperate things. And Democrats are terrified by Trump. They have repeatedly lied, impugned and impeached him. Democrats are desperate, and wounded animals are especially dangerous.

Democrats can now add weaponization and destruction of the American justice system to their infamous resume. Pray for our country and for President Trump, because if, God forbid, something happens to him, we are done.