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    In Appalachia, a Father Got Black Lung. Then His Son Did, Too.

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    Denver Brock and his son Aundra used to spend early mornings hunting rabbits in the wooded highlands of Harlan County, Ky. But they don’t get out there much these days. They both get too breathless trying to follow the baying hounds.Instead, they tend a large garden alongside Denver Brock’s home. Even that can prove difficult, requiring them to work slowly and take frequent breaks.“You get so dizzy,” Denver Brock said, “you can’t hardly stand up.”The Brocks followed a long family tradition when they became Appalachian coal miners. For it, they both now have coal workers’ pneumoconiosis, a debilitating disease characterized by masses and scarred tissue in the chest, and better known by its colloquial name: black lung.Mr. Brock, 73, wasn’t all that surprised when he was diagnosed in his mid-60s. In coal mining communities, black lung has long been considered an “old man’s disease,” one to be almost expected after enough years underground.But his son was diagnosed much younger, at just 41. Like his father, he has progressive massive fibrosis, the most severe form of the disease. And today, at 48, he’s even sicker.When he followed his father into mining, he thought he was entering a safer industry than the one prior generations had worked in. By the 1990s, safety standards and miner protections had nearly consigned the disease to history.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      An Invisible Medical Shortage: Oxygen

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      Oxygen is vital to many medical procedures. But a safe, affordable supply is severely lacking around the world, according to a new report.At the height of the Covid-19 pandemic, millions of people in poor nations died literally gasping for breath, even in hospitals. What they lacked was medical oxygen, which is in short supply in much of the world.On Monday, a panel of experts published a comprehensive report on the shortage. Each year, the report noted, more than 370 million people worldwide need oxygen as part of their medical care, but fewer than 1 in 3 receive it, jeopardizing the health and lives of those who do not. Access to safe and affordable medical oxygen is especially limited in low- and middle-income nations.“The need is very urgent,” said Dr. Hamish Graham, a pediatrician and a lead author of the report. “We know that there’s more epidemics coming, and there’ll be another pandemic, probably like Covid, within the next 15 to 20 years.”The report, published in The Lancet Global Health, comes just weeks after the Trump administration froze foreign aid programs, including some that could improve access to oxygen.Boosting the availability of medical oxygen would require an investment of about $6.8 billion, the report noted. “Within the current climate, that’s obviously going to become a bit more of a challenge,” said Carina King, an infectious disease epidemiologist at the Karolinska Institute and a lead author of the report.Still, she said, governments and funding organizations should prioritize medical oxygen because of its importance across health care. People of all ages may need oxygen for pneumonia and other respiratory conditions, for severe infections including malaria and sepsis, for surgeries and for chronic lung conditions.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Mildred Thornton Stahlman, Pioneer in Neonatal Care, Dies at 101

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      She developed one of the first modern intensive care units for premature babies, helping newborns to breathe with lifesaving new treatments.Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research on fatal lung disease in newborns led to lifesaving treatments and to the creation, in 1961, of one of the first neonatal intensive care units, died on Saturday at her home in Brentwood, Tenn. She was 101.Her death was confirmed by Eva Hill, the wife of Dr. Stahlman’s nephew George Hill.On Oct. 31, 1961, Dr. Stahlman fitted a premature baby who was gasping for breath into a miniature iron lung machine, also known as a negative pressure ventilator, the kind used for children with polio. The machine worked by pulling the baby’s frail chest muscles open to help draw in air. The baby survived.That initial success, along with findings from Dr. Stahlman’s studies on newborn lambs, helped launch a new era of treating respiratory lung disease, a leading killer of premature babies. Immature lungs lack surfactant, a soapy chemical that coats air sacs. Without surfactant, the tiny sacs collapse.Shortly after her first success, Dr. Stahlman reported that, by 1965, she had used the iron lung machine, augmented with positive pressure, to save 11 of 26 babies at Vanderbilt. By the 1970s, negative pressure tanks were jettisoned for positive pressure machines that worked by inflating the lungs. In the 1990s, the use of surfactants extracted from animal lungs dramatically improved the survival of babies with severe disease who required mechanical ventilation. “Millie was one of the first to push the limits of viability of premature infants in a careful and scientific way,” said Dr. Linda Mayes, a Yale professor of child psychiatry, pediatrics and psychology and chair of the Yale Child Study Center who trained under Dr. Stahlman. “She was a physician-scientist long before that phrase was popular.”In the early days of neonatology, Dr. Stahlman was one of the few doctors in the world who knew how to thread tiny catheters into the umbilical vessels of newborns to monitor blood oxygen, wrote Sarah DiGregorio in her book, “Early: An Intimate History of Premature Birth and What It Teaches Us about Being Human.” The procedure was vital to ensuring enough oxygen to keep the babies alive but not so much that it might trigger blindness.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More