1. Kennedy, Maureen Shawn MA, RN, FAAN


And not necessarily in a good way.


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When I think about 2016, one word that keeps coming to mind is "unbelievable." It's a word I've found myself using many times over the past year, often while shaking my head in disbelief.

Figure. Maureen Shaw... - Click to enlarge in new window Maureen Shawn Kennedy

I've used it to describe the sudden upsurge of infants in northeast Brazil born with microcephaly-from an average of 163 cases per year between 2001 and 2014 to 4,783 cases as of last January. These cases were attributed to maternal exposure to the mosquito-borne Zika virus. Zika has since spread north through the Caribbean and into the United States. We now know that it's also spread through sexual contact. And if the sudden morphing of a somewhat innocuous virus into one that could potentially cause a global public health crisis isn't unbelievable enough, what's more baffling is that it took seven months for Congress to pass a bill to provide $1.1 billion to fight the disease. Funding stalled because of partisan disagreements over other measures added to the bill. Meanwhile, the virus continued to spread.


I've used "unbelievable" to describe the pricing practices of companies like Turing Pharmaceuticals and Valeant Pharmaceuticals, which raised prices on some old-line drugs to astounding levels. Because no other companies manufacture these drugs, there is no competition on pricing and the companies can turn huge profits. According to Forbes, Turing raised the price of Daraprim, a 63-year-old drug used to treat toxoplasmosis, by over 5000% to $750 a tablet; Valeant increased the price of Isuprel, a drug used to treat cardiac arrhythmias, by six times to $1,346 a vial. But perhaps the biggest outcry was against Mylan Pharmaceuticals, which raised the price of the emergency allergy treatment EpiPen to $600 (it costs $69 in the United Kingdom). I've used EpiPens on people in the throes of reactions to bee stings and peanuts, and if the medication hadn't been available, the outcome could have been dire.


"Unbelievable" could also be used to describe our continued failure to address gun violence. The June 2016 Orlando, Florida, nightclub massacre that left 49 people dead was given the distinction in some news outlets as being the worst mass shooting in the United States. This past Thanksgiving weekend, we logged a mass shooting in Chicago (one dead, five injured) and another in New Orleans (one dead, 10 injured). While it's not surprising that a recent systematic review in JAMA Internal Medicine reports that "firearm legislation in general, and laws related to strengthening background checks and permit-to-purchase in particular, is associated with decreased firearm homicide rates," it is surprising that there is so little research on this issue. In 2013, shortly after the Sandy Hook Elementary School shootings in Newtown, Connecticut, President Obama issued an executive order directing the Centers for Disease Control and Prevention (CDC) and other agencies to "conduct or sponsor research into the causes of gun violence and the ways to prevent it." While the National Institutes of Health has begun to fund studies, the CDC has yet to do so. Critics say it's because of concern over funding cuts as a result of pressure from the pro-gun lobby.


And of course, "unbelievable" aptly describes the U.S. presidential campaign. Just when we thought the rhetoric and personal attacks had reached a new low, unbelievably, they went lower. (For more on these topics, see "The Year in Review," In the News.)


But however appropriate my word for 2016 might be, the Oxford Dictionaries had another idea. Their choice for word of the year is "post-truth." Defined as "relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief," the word was chosen in part because of the British referendum to leave the European Union and the recent U.S. presidential election campaign, both of which were awash in unsubstantiated claims, inflammatory rhetoric, and, in some cases, downright lies. And although fact-checking uncovered most of the untruths, many people didn't seem to care. It's ironic that in this age of the Internet, in which abundant information is available at the touch of a keyboard, facts are becoming less important.


Not only is all of this unbelievable, it's unbelievably sad. In looking toward 2017, I can only hope it will be an unbelievable year-but in a good way.