Queen Elizabeth adds a birthday

Queen Elizabeth II celebrated her 85th birthday today with a commemoration that mingled an important tradition of the Easter season in Great Britain with the real birthday of the oldest British monarch ever to occupy the throne.

Queen Elizabeth II on her 85th birthday
Queen Elizabeth II

Elizabeth was born on April 21, 1926, at the London home of her maternal grandfather, the fourteenth Earl of Strathmore and Kinghorne.

Today, with just a week and a day to go until the wedding of the queen’s grandson Prince William to Catherine Middleton, the monarch attended Maundy Thursday service at Westminster Abbey on her birthday.

She gave “Maundy money,” specially minted silver coins, to 85 men and 85 women, the number representing the years of her life. The recipients were retirees chosen for their “tireless work for the Church and their communities,” according to an article in The Telegraph.

The custom, which draws from the explicit example of humility and service Jesus gave his apostles by washing their feet at the Last Supper, is hundreds of years old in England. It replaced an earlier practice in which the king would wash the feet of the poor on Maundy, or Holy, Thursday.

However, British monarchs had drifted away from distributing Maundy money personally, leaving the task to the clergy, until George V, Elizabeth’s grandfather, revived the tradition in 1932, according to an article that year in Time magazine.

Queen Elizabeth ascended to the throne when she was 25, and has ruled for 59 years. In 2007, she passed “mad” King George III, who died in 1820 at the age of 82, to become the oldest British monarch. Only Queen Victoria has had a longer reign.

The queen celebrates her birthday officially in June.

Chris Jackson / Getty Images

Is Goldberg’s Prentice Hospital terminal?

The days may be numbered for the quatrefoil building at 333 E. Superior in Chicago, the old Prentice Women's Hospital, where both my children were born.

Northwestern Memorial Hospital, which opened a shiny new Prentice in 2007, plans to tear down the old building to put up a new research center. Preservationists are gearing up for a fight to preserve Bertrand Goldberg's 1975 design, which echoed some elements of his hugely successful Marina City downtown residential development, finished in 1964.

Bertrand Goldberg's Prentice Hospital
Bertrand Goldberg's Prentice Hospital

Hospital buildings don't have long lives; indeed, they are often obsolescent soon after they are built.

That was certainly true of NMH's Gothic-style Wesley Hospital, so impressive it was subtitled the "cathedral of healing." Wesley opened on Dec. 6, 1941, literally on the eve of U.S. involvement in World War II, which changed everything, as wars so often do.

The new Prentice now stands at 250 E. Superior, on precisely the spot Wesley once occupied on the NMH campus.

NMH's first women's hospital shared space at 333 E. Superior with the Stone Institute of Psychiatry, which stayed after labor and delivery et al. moved from the poured-cement structure into the new Prentice. The psychiatry department will move out in September, and the building will then be torn down, according to Northwestern University spokesman Al Cubbage.

The university explored and rejected the idea of recycling the existing building for another use, Cubbage says.

"At this point, the university’s plans are to take that building down and use that area for additional research facilities that would be constructed in the future,” Cubbage told the Chicago Tribune's Blair Kamin.

The "old" Prentice has many detractors who believe the building is ugly. Even when my younger daughter was born there 13 years ago, mothers (and doctors) were complaining the facility was outdated.

Prentice was built to last 30 to 40 years; however, the services it offered were so popular it barely made it past 20 years. Planned for 5,000 annual births, it was handling more than 10,000 a year at the end.

And, things changed. The obstetric anesthesiology department, which by 2007 was hugely important, was not on the drawing board when the facility was built.

I loved the old Prentice — its pie-shaped rooms, the intimacy of its floors, the stunning views of Lake Michigan and the city.

Preservationists are understandably upset about the building's impending demise, and are hoping to succeed with an end-run around NMH. Goldberg historically is an important Chicago architect, but his work isn't old enough to have gained the gravitas it deserves, or the protection it needs in terms of landmark status on a local or national basis — and that includes Marina City.

The local alderman, Brendan Reilly, has secured a 60-day delay, which might give friends of "old" Prentice a chance to organize.

Personally, I would bet on the hospital getting its way on the "old" Prentice. As Mark Twain said, they aren't making any more land these days.

Northwestern University/NMH, a major medical school/hospital/research complex, is likely to prevail in doing what it has done for decades on its lakefront campus — raze an old hospital building to create a new facility that reflects the latest knowledge, technology and priorities.

I'll be very sad to see the old girl go, if indeed that is how this story ends.

Here's a bit of irony: “Bertrand Goldberg: Architecture of Invention," opens September 10 at the Art Institute of Chicago.

Photo by Delia O'Hara

The art and science of women’s health

The Women's Health Initiative, a series of randomized controlled trials begun in 1991, was supposed to be definitive in terms of the role hormone-replacement theory would play in managing the health of post-menopausal women. However, the WHI has yielded unexpected and sometimes apparently inconsistent results.

The medical establishment expected the WHI to show that HRT, which had been popular for years, helped prevent cancer, heart disease and osteoporosis in older women.

L'Arlesienne / Vincent van Gogh
"Sheesh"

Instead, in 2002 researchers announced in the Journal of the American Medical Association that they had stopped the trials, which involved more than 160,000 women, because participants receiving estrogen combined with progesterone were developing invasive breast cancer at substantially higher rates than were women receiving a placebo, and their rates of heart disease were also high.

HRT, which to that point had been prescribed liberally for post-menopausal women, virtually disappeared as a therapy, in spite of the fact that it did seem to be helping women avoid hip fractures and colon cancer.

Just last week, though, again in JAMA, a group of WHI researchers reported that a smaller study of women who have had a hysterectomy, who were treated with estrogen alone for a median of 10.7 years, showed a decreased breast cancer risk with the treatment, with no significant increase in heart disease.

Well, that's disconcerting. Should post-menopausal women be asking their doctors about HRT after all? Probably not most of them.

“Women are different — it’s relevant to almost every medication and almost every intervention,” Joann E. Manson MD told Tara Parker-Pope in a story in last Sunday's New York Times.

“With this study, in many ways, science worked the way it’s supposed to work. It’s a little like watching sausage being made. It may seem on the surface that the study was a real problem and had many, many flaws, but in reality, it ended up giving invaluable information,” said Dr. Manson, a WHI investigator who is also chief of preventive medicine at Brigham and Women’s Hospital in Boston.

Adds Pope, "The most compelling lesson of the research should be that science is always worth the wait. Consumers should insist that doctors make recommendations based on scientific evidence, say investigators, rather than allowing drug companies or marketing hype to dictate patients’ health care choices."

That's true for middle-aged women, pregnant women, men and parents as well.

Image: Vincent Van Gogh's "L'Arlesienne"

Tina Fey is pregnant, choosing to juggle more

Tina Fey, Emmy-winning creator/writer/producer/star of the television comedy 30 Rock, has kicked the ambivalence she was wrestling about having another baby.

Fey, a former standout member of the Saturday Night Live ensemble, will announce on The Oprah Winfrey Show on April 12 that she is five months pregnant with her second child, People magazine reported on its website this week.

Celebrities are often reticent about the details of their pregnancies, but Fey has let her anxieties hang out on the topic in her new book, Bossypants, and in a recent, related New Yorker article, "Confessions of a Juggler."

Tina Fey

Tina Fey

It is unsettling to be a woman of 40, in her "last five minutes" both of fertility and decent movie offers, Fey writes, and she weaves wacky scenarios as she considers having another baby vs. concentrating on her career.

"Why not do both, like everybody else in the history of the earth?" she asks.

The math is impossible, Fey writes.

"No matter how you add up the months, it means derailing the TV show where 200 people depend on me for their income, and I take that stuff seriously. Like everyone from Tom Shales to Jeff Zucker, I thought 30 Rock would be canceled by now."

But 30 Rock is still going, and now Fey is pregnant. It's going to be interesting to see what happens.

In my opinion, Fey has made the right decision, because it is the decision she has made. (Her husband, she writes, just wanted her to get off the dime.) And that goes for any woman. She who controls her own fertility has at least a shot at controlling her life.

(Or, Fey may have gone through years of hand-wringing and then just discovered she was pregnant. That whole control thing is hard to pull off.)

In any event, the gynecologist who tells Fey during her paroxysms of indecision, "Either way, everything will be fine," was probably right.

Fey is in for a wild ride, balancing a hugely demanding job and two children. She is sure to get a lot of the question she says is the rudest you can ask a woman: "How do you juggle it all?"

Image courtesy of David Shankbone/Wikimedia Commons

Priority medicines for mothers and children

The World Health Organization has published a list of 30 medicines that can make the difference between life and death for mothers and children younger than 5 years of age.

This list of "priority medicines" was developed by the WHO, the United Nations Population Fund and UNICEF. It is the first such list, the sine qua non for mothers and children regardless of where they are , according to an editorial in the Lancet. (This list should not be confused with WHO's Model List of Essential Medicines.)

"An estimated 8.1 million children under the age of five die every year and an estimated 1,000 women — most of them in developing countries — die every day due to complications during pregnancy or childbirth," states the introduction to the list.

The new publication is something of a "wish list," the Lancet notes, in that five of the medicines to protect young children have not yet been developed.

These are the generic treatments on the list that address conditions that threaten the lives of mothers:

* For post-partum hemorrhage — oxytocin and sodium chloride

* For pre-eclampsia and eclampsia — calcium gluconate injection (for treatment of magnesium toxicity), magnesium sulfate

* For puerperal infection —  ampicillin, metronidasole, gentamicin, misoprostol

* For sexually transmitted diseases — azithromycin for chlamydia, cefixime and, for syphillis, benzathine benzylpenicillin