Acts of Gratitude: Remembering A Doctor’s Heroic Care

This morning I got word that Dr. Robert S. Modlinger, the endocrinologist who saved my life, has died at 72. Here is the obituary giving the considerable accomplishments of his career. But Bob Modlinger meant so much more than that to me and to so many other patients, despite his own disabling medical issues.

This is the column I wrote a few years ago to thank him.

BY RICHARD CONNIFF/The New York Times

JULY 5, 2007 6:53 PM

I’m too big a skeptic to put much faith in the circularity of life, with deeds done long ago coming round years later to haunt us or make us whole. But I began to think about the possibility recently, during a visit to Columbia University’s College of Physicians and Surgeons. One of the lectures that day was about the art of listening to patients’ stories with an almost literary ear, as a way of treating them with greater insight and sensitivity.

The speaker was looking at things only from the doctor’s perspective. But it struck me that there are at least two sides to every medical story. And it got me thinking back 30 years, to when I was a young man dying of no apparent cause.

My symptoms then included listlessness, faint-headedness, an inability to climb stairs without resting and unquenchable thirst. Twice, I took home a jug for a 24-hour urine test, and both times I came back with an extra bottle on the side. It didn’t seem to signify much to my doctor. The heart was his specialty, and he kept doing electrocardiograms suggesting something wrong there, but no particular diagnosis. I wasn’t much interested, in any case. I was only 26 years old, but the idea of dying seemed perfectly fine.

Then one afternoon

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A Probiotic Vaccine Aims to Stop Cholera Epidemics Fast

by Richard Conniff/Scientific American

The most terrifying things about cholera is its lethal speed. A victim can consume contaminated food or water, come down with diarrhea a day later and, if untreated, be dead a day after that—having inadvertently spread the microorganism to friends, neighbors and family members in the meantime. Hence cholera’s reputation for tearing explosively through populations, mostly recently in Haiti beginning in 2010 and Yemen in 2016.

Two major challenges—one diagnostic, the other preventive—make it difficult to stop cholera epidemics: A simple field test can distinguish cholera from other forms of diarrhea, but only after symptoms have already appeared. And although existing vaccines can prevent the disease, they require two or three weeks to elicit protective immunity. Neither diagnosis nor vaccination is fast enough for public health workers racing to stop the first few cases of cholera from breaking out into an epidemic.

Two new studies published this month in Science Translational Medicine could change that, although both are still in preliminary testing on animal models of cholera. In the first study researchers at Massachusetts Institute of Technology wanted to know “whether we could engineer a bacterium that could serve both to diagnose and prevent cholera,” says senior author James Collins. The researchers focused on Lactococcus lactis, which people have routinely consumed for thousands of years incultured dairy products like yogurt and sour cream.

The initial plan for treatment was to genetically engineer the bacterium “to produce and secrete antimicrobial peptides specific to cholera,” Collins says. But on attempting to culture L. lactis in a laboratory dish together with the cholera pathogen, he says, the researchers found to their “pleasant surprise” that no such engineering was needed: L. lactis “was either inhibiting or killing off the cholera” on its own. This was apparently because the lactic acid it secretes creates an inhospitable environment for the cholera pathogen in the petri dish—as it also presumably does in the small intestine. In testing on laboratory mice 84.6 percent of those fed L. lactis and the cholera pathogen together survived, compared with 45.7 percent of those fed the cholera pathogen alone. When the researchers experimentally altered L. lactis to stop it from producing lactic acid, this protective effect disappeared. It was, Collins says, the first time anyone has demonstrated

Selling the Protected Area Myth (No Wildlife Need Apply)

Chevron’s Gas Plant Being Built in a Class A Protected Area

by Richard Conniff/The New York Times

It’s widely celebrated as one of the few success stories in the push to protect the wildlife we claim to love: Since the early 1990s, governments have roughly doubled the extent of natural areas under protection, with almost 15 percent of the terrestrial Earth and perhaps 5 percent of the oceans now set aside for wildlife. From 2004 to 2014, nations designated an astonishing 43,000 new protected areas.

These numbers are likely to increase, as the 168 nations that are signatories to the 1993 Convention on Biological Diversity work to meet their target of 17 percent terrestrial and 10 percent marine protected area coverage by 2020. And at that point, even more ambitious targets should kick in.

So, hurrah, right?

Sadly, there are two big delusions at work here. The first is that designating protected areas is

When We Protect “Umbrella Species,” Who Else Gets In Under The Umbrella?

Sage-grouse (Photo: Dave Showalter)

by Richard Conniff/Yale Environment 360

Conservationists often criticize state fish and game departments for focusing single-mindedly on one species to the detriment of everything else — for instance, improving habitat for elk, which then browse down habitat for songbirds. But what if conservationists — who don’t have that traditional hook-and-bullet mindset — nonetheless inadvertently do much the same thing?

That’s one implication of new research looking at the umbrella species concept, one of the fundamental ideas driving conservation efforts worldwide. It’s the idea routinely advocated by conservationists that establishing and managing protected areas for the benefit of one surrogate species — from gorillas to grizzly bears — will also indirectly benefit a host of other, less charismatic species sharing the same habitat. “The umbrella species concept is an appealing shortcut,” says Jason Carlisle, who conducted the research as a doctoral candidate at the University of Wyoming.  But the complications quickly pile up.

Across much of the American West, the greater sage grouse is one such umbrella species. It’s widely considered (but not officially listed as) an endangered species, with a population down from millions of individuals across 16 states and three Canadian provinces a century ago to fewer than 400,000 in a sharply reduced and fragmented range today.

In 2015, an unprecedented consortium of states, federal agencies, private landowners, industry, and environmentalists agreed to a painstakingly negotiated collaboration to protect the sage grouse and to make it an umbrella for 350 other “background” species in sagebrush habitat. Then, last August the Trump Administration threw out that Obama-era agreement and reopened sage grouse habitat on federal lands to additional mining, drilling, cattle grazing, and off-road vehicle use — all factors that helped imperil sage grouse in the first place.

In reality, Carlisle and his co-authors suggest, the protective umbrella created under the 2015 agreement should have been

Sniffing Out the Deadliest Disease on Earth

Anopheles mosquito taking a blood meal.

by Richard Conniff/Scientific American

One of the more disturbing things about parasites is their ability to manipulate the behavior of a host, sometimes to suicidal extremes.  The classic example is the liver fluke. It infects an ant as an intermediate host, then manipulates the ant to climb onto a blade of grass, where it is likelier to get eaten by the parasite’s definitive host, a cow or other grazing ruminant.

Over the past few years, scientists have come to recognize that something similar happens to humans under the influence of one of the deadliest pathogens in our history as a species:  The human Plasmodium parasite not only causes malaria, but also makes victims more attractive to mosquitoes, which then transmit the parasite to other victims with every bite. New research suggests, however, that this manipulative behavior could

Dawn of The Flying Murder Heads

The bristling teeth of Anhanguera piscator were for snagging fish. (Photo: Robert Clark)

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By Richard Conniff/National Geographic

Heading out into the geological layer cake of Big Bend National Park in southwestern Texas, British pterosaur researcher Dave Martill proposes a “to do” list for this brief reconnaissance: 1.) Find a rattlesnake to admire. 2.) “Find a complete Quetzalcoatlus skull sitting on the ground.” The odds are almost infinitely better for item one.  But he and Nizar Ibrahim, a fellow paleontologist, promptly fall into a detailed discussion about how to obtain a research permit in the event of item two.

This is the first rule of pterosaur research: You need to be an optimist. Thinking you will go out on a given day and find any trace of pterosaurs—the winged dragons that ruled Mesozoic skies for 162 million years–is like buying a Powerball ticket and expecting to win. Pterosaur fossils are vanishingly rare. Their whole splendid world, built on hollow bones with paper-thin walls, has long since collapsed into dust. Scarcity is especially the rule for Quetzalcoatlus northropi, thought to be one of the largest flying animals that ever lived, nearly as tall as a giraffe, with a 35-foot wingspan, and a likely penchant for picking off baby dinosaurs.  It’s known from a few fragments discovered at Big Bend in 1971, and not much else.

Ibrahim and Martill at Big Bend (Photo: Richard Conniff)

Martill and Ibrahim spend three days bone-hunting among the fissured hillsides. They cross and re-cross the promisingly named “Pterodactyl Ridge,” frequently consulting the “x-marks-the-spot” on maps left by the discoverer of Quetzalcoatlus. They decipher the nuances of geological strata (“Look at that Malinkovitch-controlled cyclicity!” Martill exclaims, referring to the way the Earth’s shifting movements show up in the rock), and they conjure up forgotten worlds. On a sandstone ridge with no obvious way down, Martill remarks, “Haven’t found a mountain yet we can’t fall down,” plunges forward, and emerges unscathed below, eyes fixed on the passing landscape.

They do not, however, stumble across any rattlesnakes, nor even the faintest whiff of a pterosaur. The femur of an Alamosaurus, the largest North American dinosaur that ever lived, turns up, by way of consolation. But dinosaurs are not pterosaurs, or vice versa. Leaving the park, the two paleontologists are already mapping out a return search for Quetzalcoatlus, permanently hooked on the tantalizing pterosaur mix of extreme biological richness glimpsed through the rarest of fossil remains.

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Optimism against all odds has, however, lately begun to look almost reasonable in pterosaur research, with a rush of discoveries revealing

Montana Wants to Save A Dino-Era Fish from Federally-Induced Extinction

Pallid sturgeon

UPDATE: The fate of the pallid sturgeon–an American species that’s been with us since the age of dinosaurs–now depends on a judge’s decision about a dam replacement plan that would effectively consign it to extinction.  That decision is due soon, and today, in a poll by Defenders of Wildlife, 81 percent of Montana residents (and 73 percent of Republicans) indicated that they support efforts to protect the pallid sturgeon.  With the hope that the judge will hear those voices, I’m re-printing this story about the fight to save the pallid sturgeon.

by Richard Conniff

“We should be grandfathered in.” That’s how the manager of the Lower Yellowstone Project irrigation district in Montana put it. His farmers have been using a dam on the river to supply water to their fields since time immemorial—or for 112 years, anyway—and see no reason to change. But the pallid sturgeon would certainly say it should be grandfathered in too. The monster fish has depended on the river for 78 million years, roughly since Tyrannosaurus rex ruled this region.

The problem is that the farmers and their timber-and-rock dam are now

U.S. Cities Are Losing Tree Cover Just When They Need It Most

 by Richard Conniff/Scientific American

Scientific evidence that trees and green spaces are crucial to the well-being of people in urban areas has multiplied in recent decades. Conveniently, these findings have emerged just as Americans, already among the most urbanized people in the world, are increasingly choosing to live in cities. The problem—partly as a result of that choice—is that urban tree cover is now steadily declining across the U.S.

A study in the May issue of Urban Forestry & Urban Greening reports metropolitan areas are experiencing a net loss of about 36 million trees nationwide every year. That amounts to about 175,000 acres of tree cover, most of it in central city and suburban areas but also on the exurban fringes. This reduction, says lead author David Nowak of the U.S. Forest Service (USFS), translates into an annual loss of about $96 million in benefits—based, he says, on “only a few of the benefits that we know about.” The economic calculation looked at just four such benefits that are relatively easy to express in dollar terms—the capacity of trees to remove air pollution, sequester carbon, conserve energy by shading buildings, and reduce power plant emissions.

Nowak and a USFS colleague, co-author Eric Greenfield, found tree cover had declined in metropolitan areas across 45 states. The biggest losers

Our Love for Exotic Pets is Emptying Forests and Oceans

(Photo: FLIGHT Protecting Indonesia’s Birds)

by Richard Conniff/Scientific American

Conservation biologist David S. Wilcove was on a birding trip to Sumatra in 2012 when he began to notice that house after house in every village he visited had cages hanging outside, inhabited by the sort of wild birds he had expected to see in the forest. Nationwide, one in five households keeps birds as pets. That got him thinking, “What is this doing to the birds?”

Wilcove, who teaches at Princeton University, made a detour to the Pramuka bird market in Jakarta,

White-rumped shama (Photo: Shanaka Aravinda)

Southeast Asia’s largest market for birds and other wildlife, from fruit bats to macaques. “It was this sort of Wal-Mart-size space filled with hundreds of stalls,” he recalled recently, “each stall of which was filled with

hundreds of birds. An awful lot of them were in very poor condition, with signs of disease, feathers frayed, behaving listlessly–or thrashing around in their cages, because a lot of these are wild birds that are not at all suited to living as caged birds.” Some were species that even zoos with highly trained professional staff cannot maintain in captivity; they would die soon after purchase, “the cut flower syndrome,” he remarked.  “It was really a shocking site. I’ve never seen anything like it.”

Research by Wilcove and his colleagues subsequently linked demand for birds in Indonesia’s pet marketplace to the decline of numerous species in the wild. Prices in the pet market, they suggested, in a 2015 study in Biological Conservation, can even serve as an alarm system for species declines that might not show up in field studies until years later, if at all:  When the average price for a white-rumped shama, a popular species in Indonesian songbird competitions, shot up 1500 percent from 2013 to 2015, the shift tipped conservationists off for the first time that these birds were vanishing from the wild.

Follow-up field studies in Indonesia by co-author Bert Harris, now at the Rainforest Trust, found no trace of shamas even in seemingly intact habitats where they should thrive, such as in national parks and in forests five kilometers from the nearest roads.  Buyers were paying especially high prices for distinctive island populations, some of them likely unrecognized species or sub-species. The pet trade, said Wilcove, thus has “the potential to drive species to extinction even when they have suitable habitat, and drive them to extinction without anyone being aware of it.”

The problem isn’t just about birds.  Nor is it limited to

Inside China’s Motherlode of Ancient Monsters

Junchang Lü and friend (Photo: Richard Conniff)

by Richard Conniff/Smithsonian Magazine

Not long ago in northeastern China, I found myself being driven in a Mercedes Benz SUV down a winding country road, trailed by a small motorcade of local dignitaries, past flat-roofed brick farmhouses and fields full of corn stubble. Abruptly, we arrived at our destination, and my guide, a stylishly-dressed woman named Fangfang, slipped out of her high heels into fieldwork gear: pink sneakers with bright blue pompoms on the Velcro straps.

We were visiting a dinosaur dig, but it was also a museum in the early stages of construction—steel beams riveted together to form oddly birdlike layers, stacked one atop another, climbing a hillside in two parallel rows. At the top, a central pavilion connecting the two rows looked like a bird about to take off.  The new museum didn’t have a definite name yet, though it is due to open sometime next year.  But it was unmistakably huge.  It was also expensive (Fanfang thought $28 million for construction alone).  And it was in the middle of nowhere.

We were in a rural village called Sihetun, in the western part of Liaoning Province.  And in the exuberant fashion of a lot of modern development in China, the new museum is going up in anticipation of visitors arriving by speed train from Beijing, 250 miles to the southwest, except that the speed train hasn’t been built yet.  More sensibly, the new museum is going up to celebrate the epicenter of modern paleontological discovery, an area that is at least as rich in fossils, and in some ways as wild, as the American West during the great era of dinosaur discovery in the late nineteenth century.

Liaoning Province (pronounced “lee-ow-NING”) is an area about the size of Michigan, sandwiched between Inner Mongolia and North Korea.  It used to be known mainly for coal, corn, and decrepit factories, which have given it a reputation as “China’s rust belt.” That’s put it off the usual itinerary for the average tourist. But developments over the past quarter-century have made it a point of pilgrimage for people interested in fossils.

Liaoning farmer and fossil hunter Lang Shi Kuang (Photo: Stefen Chow)

In the mid-1990s, on that hillside in Sihetun, a farmer planting a tree stumbled onto the world’s first known feathered dinosaur, a creature now named Sinosauropteryx (meaning “the China dragon wing”).  Actually, the farmer found two halves of a slab, each preserving a mirror image of this dinosaur.  In the freebooting spirit that has characterized the fossil trade in the area ever since, he promptly sold half to one unwitting museum, and half to another. It was the start of a fossil gold rush.

Since then, the region has produced more than 40 dinosaur species, and they have inevitably grabbed the headlines. Standing on a hillside a few minutes from the new museum site, my guide pointed out the low hills of a nearby farm where Yutyrannus, a 3100-pound feathered dinosaur, turned up a few years ago. (Think Tyrannosaurus rex, but plumed like a Mardi Gras Indian.)  This was also the former home range of Anchiornis huxleyi, a chicken-size creature with enough preserved detail to become the first dinosaur ever described feather-by-feather in its authentic colors—an event one paleontologist likened to “the birth of color tv.”

What has emerged from beneath the fields of Liaoning (and parts of neighboring provinces) is, however, bigger than dinosaurs: A couple of decades of digging have yielded