Emerging Diseases

CREIGHTONCREIGHTON UNIVERSITY UNIVERSITY ■ FALL 1997

EMERGING DISEASES

FINDING GOD IN YOUR EVERYDAY WORK

THE CLASS OF 2001 BEGINS AT CREIGHTON

THE REALITIES AND IMPLICATIONS OF CLONING ETTERS WINDOWLmagazine may edit Letters INDOW to the Editor, primarily to conform to space limitations. Personally signed W■ ■ Volume 13/Number 4 Creighton University Fall 1997 letters are given preference for publi- cation. Our FAX telephone number is: (402) 280-2549. E-mail to: From Cholera to AIDS: [email protected] Diseases Continue to Plague Us With the eradication of smallpox in the late 1970s, many Soul Stirring thought infectious diseases would disappear. Instead, The article in the summer 1997 issue of new diseases have emerged and some familiar diseases WINDOW by Fr. Richard Hauser captured my have bounced back with a new virulence. Professor and immediate attention. In reading it, it awak- Chair of Biology Theodore E. Burk addresses ened the Spirit within me. It was inspira- the phenomenon starting on Page 3. tional, enlightening and soul stirring. Hopefully, WINDOW will be featuring future articles of this nature. A very special thanks They’re Diverse, They’re Bright, to Fr. Hauser. The article will be saved to They’re the Class of 2001 share with friends and for my own future review. Associate Professor Eileen Wirth takes an in-depth look at the Class Dorothy Pritchett, BSN’67 of 2001. While a high number say they plan careers in the health Wills Point, Texas sciences, the class represents a wide range of backgrounds and interests. Find out more about Creighton’s newest class on Page 13. Grill Uncivil To Women In a periodical noted for its taste, it was dis- Work as a Calling: appointing to read an article featuring a former neighborhood grill notorious for its Finding God on the Job incivility to Creighton women. For other Law Professor and A.A. and Ethel Yossem Endowed Chair modes of discrimination, the grill would in Legal Ethics Joseph G. Allegretti discusses ways to have been boycotted or should have been. integrate faith into everyday work, whether you’re a N.J. Lemke, S.J. homemaker, teacher, doctor or plumber. Page 18. Jesuit Community Creighton University The Prospect and Quiet Jesuit Touched Lives Implications of Human Cloning I’ve never seen an article about the quiet Jesuit who presided over the physics lab in With recent advancements in cloning sheep and cattle, the pre-World War II days. He must have possibility of cloning human beings moves closer to reality. touched the lives of every pre-dental and Kevin T. FitzGerald, S.J., a member of Creighton’s Board of pre-med student of that era. Does anyone Directors and a research associate at Loyola University out there remember him? Medical Center, examines the issue. Page 22. His name escapes me, but I’ll never forget his hand-written signs that decorated both Alumnews...... Page 26 lab and lecture rooms. One in particular University News...... Page 27 stands out: “Voluntary contributors to the Annual Varnish Fund may signify their intentions by putting their feet on the desk in Publisher: Creighton University; Rev. Michael G. Morrison, S.J., President; Michael E. Leighton, Vice President for front.” University Relations. WINDOW staff: Stephen T. Kline, Executive Editor; Rick Davis, Editor; Pamela A. Vaughn, Associate Editor. Editorial Advisors: Rev. Donald A. Doll, S.J.; Charles J. Dougherty, Ph.D.; Richard L. O’Brien, M.D., Allen B. Margaret Rossie Taylor, BS’39 Schlesinger, Ph.D, and David G. Schultenover, S.J. Littleton, Colo. Creighton University WINDOW (USPS728-070) is published quarterly in January, April, July, and October by Creighton University, 2500 California Plaza, Omaha, NE 68178-0001. Periodicals postage paid at Omaha, Nebraska, and additional Wrong Guy entry points. Address all mail to Public Relations and Information, Omaha, NE 68178. Postmaster: Send change of address to Creighton University WINDOW, P.O. Box 3266, Omaha, NE 68103-0078. You misidentified the man pictured on page COPYRIGHT © 1997 BY CREIGHTON UNIVERSITY 25 of the summer 1997 issue. He is Michael Pursuant to our educational obligation to search for truth and to expand knowledge, WINDOW Magazine promotes the dis- Farrall. WINDOW looks great! It keeps me in cussion of a variety of issues. Although published by a Catholic, Jesuit university, the opinions expressed in WINDOW are not intended to be construed as the official teaching or position of Creighton University or of the Catholic Church. touch with “home.” Judy Sing, BA’91 Macomb, Okla.

2 Creighton University WINDOW “Plagues Are As Certain As Death And Taxes”: Emerging And Re-emerging Diseases

Theodore E. Burk, Phil.D. Professor & Chair of Biology

unique event in the long saga of the human struggle against disease Aoccurred on Oct. 26, 1977. In Merka, Somalia, Ali Maow Maalin was diagnosed as having smallpox. There was nothing unique about a person contracting smallpox; except forfor tuberculosis,tuberculosis, nono otherother infectiousinfectious diseasedisease had taken so many human lives over the centuries. What was unique was that Ali Maow Maalin was the last person ever to contract smallpox under natural conditions. When he survived his infection, smallpox was extinct in the wild — the only disease pathogen ever completely eradicated in nature by human effort. Smallpox eradication,tion, thethe culminationculmination ofof anan 11-year,11-year, $300$300 million campaign, seemed to many to mark a milestone in human history, the dawning of an age in which infectious diseases would disappear one after another and would no longerlonger constituteconstitute anan importantimportant causecause ofof human suffering and death.

Dr. Burk. Background is an enlarged photo of the AIDS virus. Photo by Kent Sievers Ten years earlier, U. S. Surgeon new era of “disease turnover,” in our species evolved. While it may General William H. Stewart had told a which old diseases fade away under seem impossible to reconstruct the White House meeting of state health the advances of medicine, only to be health problems of prehistoric people, officials that it was time to move replaced by new diseases or new practitioners of the science of “pale- beyond infectious diseases and con- forms of the old ones. opathology” attempt to do this by centrate the nation’s health resources examining skeletal remains (and occa- on chronic diseases such as hyperten- sionally well-preserved mummies or sion and diabetes. Bright young grad- Instead of disease air-dried feces). Surprisingly, they uate students were discouraged by have found that most preagricultural their mentors from going into the eradication, people were, on average, taller and dead-end field of infectious disease humankind seems to healthier than the people who fol- epidemiology. lowed them. In general, they had Then, in 1975, came Lyme disease. be headed into a new strong bones and teeth free of cavities, In 1976, Ebola hemorrhagic fever and era of “disease and show little evidence of nutritional Legionnaires’ disease. In 1978, toxic deficiencies. They did suffer accidents shock syndrome. In 1979 (although turnover,” in which (many bones exhibit healed fractures), the virus wouldn’t be discovered for they certainly had their share of para- several more years), acquired immune old diseases fade sites such as intestinal worms (many deficiency syndrome. In 1982, E. coli away under the of these “heirloom diseases” brought 0157:H7 food poisoning. In 1993, along by people from their primate hantavirus pulmonary syndrome. advances of medicine, ancestors), they suffered wounds that Mixed in with all of the above was a only to be replaced by became infected, and they occasional- geographic menagerie of other new ly picked up an animal disease from diseases — Marburg, Machupo, Junin, new diseases or new the wildlife with which they came into Lassa. And, as if this swarm of contact (such diseases are called “emerging diseases” wasn’t enough forms of the old ones. “zoonoses,” and they play a major to belie the optimism of the 1960s part in our story, as will be seen). and early 1970s, familiar diseases The invention of agriculture, which returned in new and deadly forms — In this article I discuss where such occurred several different times in dif- yellow fever, dengue, malaria, “emerging and re-emerging diseases” ferent areas of the world, ushered in Staphylococcus, tuberculosis, cholera. come from, by what pathways they the second phase. Agriculture, from Instead of disease eradication, can become widespread and estab- the perspective of paleopathologists, humankind seems to be headed into a lished as human epidemic diseases, was a very mixed blessing. and how in almost all cases human Domestication of crops led to alteration of the natural environment increased food supplies and greatly has been a significant contributor to increased human populations, but the their emergence and spread. Finally, new crop foods tended to be high in some ways to anticipate the arrival of carbohydrates and low in proteins and new emerging diseases and to miti- other nutrients. The larger popula- gate their effects are mentioned. tions supported by agriculture were It is useful to begin by reviewing composed of people who thus grew to the history of humankind’s struggle be smaller than their hunter-gatherer with disease, as summarized by Jared ancestors, lived shorter lifespans, and Diamond of UCLA School of Medicine showed much greater evidence of in his books “The Third Chimpanzee” tooth decay and nutrient-deficiency and “Guns, Germs, and Steel.” Four diseases. Also, with large populations distinct stages can be recognized. The dependent on just a few staple crops first, beginning with the origins of such as rice, wheat or corn, massive Viruses such as influenza, pictured humankind and continuing until the starvation resulted if bad weather or above, are common in the United advent of agriculture in the past plant disease caused crops to fail. And States and elsewhere. Some strains, 10,000 years, involved people living in domestication of animals, leading to however, can be deadly. the hunter-gatherer lifestyle for which close and prolonged contact between

4 Creighton University WINDOW the domesticated animals and these agricultural people, meant that animal diseases crossed over to people much more frequently and began to evolve new, specifically human-infecting forms (“souvenir diseases”). The list of human diseases that are likely to have been derived from related diseases of our domesticated animals is long and shocking; a very incomplete list includes measles from dogs, tuberculosis and smallpox from cattle, influenza and whooping cough from pigs, the common cold from horses, and malaria from birds. In other cases, our diseases came not from intention- ally domesticated animals, but from animals that had voluntarily taken up Distribution of Plague Today cohabitation with us — one example being bubonic plague, a disease of Diseases such as the bubonic plague have spread worldwide, as shown by the red areas above. The plague, originally a disease of wild ground squirrels that spread wild ground squirrels that occasional- to rats and then to humans, decimated Europe for 400 years. ly spread to rats and, because of humanity’s close contact with rats in By the turn of the 20th century, situation described in the opening crowded urban settings, people. as a result of such discoveries as vacci- paragraph. The dramatic decline of Phase three involved a natural nation by Jenner, the germ theory of the “classic” epidemic diseases, dra- progression from phase two. The disease by Pasteur and Koch, antisep- matically illustrated by the elimina- food surpluses and hierarchical soci- tic procedures by Lister, the impor- tion of smallpox, was supposed to eties that resulted from widespread tance of pure water supplies by Snow, usher in a fourth era, in which — at adoption of agriculture rapidly led to and the disease-spreading role of least in developed countries — most the growth of large cities, in which insect vectors by Ross and others, health problems would be due to most of the human population was rates of most epidemic infectious dis- chronic “lifestyle diseases” such as packed together at densities far high- eases were already falling rapidly, heart attacks, strokes, cancer and dia- er than ever experienced before. especially in Europe and North betes. In this era, as we saw above, Under such circumstances, the stage America. By the middle of this centu- epidemic infectious diseases were not was set for the emergence of the great ry, the worldwide spread of higher supposed to be important health con- infectious disease plagues that were standards of sanitation, accompanied cerns. But, as we also saw, this pure the major source of human mortality by the discovery and use of antibiotics fourth era hasn’t yet arrived, and it for the past few thousand years, right against bacteria and pesticides against never will. Instead, our real new era is up to the 20th century. The diseases disease vectors, led to the optimistic one in which lifestyle diseases assume listed above, plus others such as greater prominence, but are accompa- cholera, polio, typhus and typhoid, nied by an ever-changing challenge were able to establish themselves per- The list of human from new infectious diseases and manently in the large, densely crowd- diseases that are different and dangerous forms of ed populations of people living in previous ones, a period not of infec- cities, especially given poor sanitary likely to have been tious disease disappearance but of procedures that facilitated spread of derived from related disease turnover. the pathogens during interpersonal Where do all these “new diseases” interactions (actual physical contact diseases of our come from? as well as the inhalation of the The answer, in almost every case, pathogen-bearing exhalations of near- domesticated animals is, “from the same place old diseases by people) and contaminated food is long and shocking. came from — existing diseases of oth- and water supplies. er species.” In that sense, emerging

Fall Issue 1997 5 The proximity of deer to human populations has increased the spread of Lyme disease in North America. As many as 10,000 Americans per year contract Lyme disease, which is spread through the bites of deer ticks. diseases are not new at all, just new to also fit this pattern: Lassa humans (or, having been present in fever, endemic in much human populations but not recog- of West Africa, is primari- nized, merely newly identified). For ly a disease of the rodent example, Lyme disease, a bacterial Mastomys natalensis. disease with initial flu-like symptoms While the animal origin that can progress to a more serious of the deadly Ebola virus Photos by Mark Dietz arthritic condition, is contracted by (50-90 percent mortality in hundreds accepted theory for its origin is from people bitten by ticks, especially the of cases each in four African outbreaks one of these primate viruses. deer tick Ixodes scapularis. While as in the past two decades) has not yet For a pathogen from one species to many as 10,000 Americans per year been identified, many scientists sus- survive and reproduce in another, contract Lyme disease, it is primarily a pect bats, rodents or monkeys. (Ebola such as humans, is not a likely event. disease of deermice, vectored by ticks has devastated one population of Since different species have different cycling between deermice and white- chimpanzees in the Ivory Coast that biochemistries and physiologies, tailed deer. Hantavirus pulmonary has long been intensively studied by pathogens that are well adapted to disease, first recognized after an out- primatologists, suggesting that invade one kind of organism are break in 1993 in the Four Corners chimps, like humans, are not the natu- unlikely to be able to overcome the region of the American southwest that ral hosts but victims of occasional defenses of a very different kind of affected both Navajo Indians and oth- cross-species infection.) HIV (human organism; only where the new host is er people in the region, is a disease of immunodeficiency virus), the AIDS physiologically similar to the old host deermice, contracted by humans who virus, is closely related to viruses that is the infection likely to take hold. As inhale the virus in airborne particles of infect (but do not cause serious dis- a result, most of the zoonoses that mouse urine and feces. Many of the ease in) African monkeys and chim- humans acquire come from other ani- more exotic emerging tropical diseases panzees, and the most widely mals that are relatively closely related

6 Creighton University WINDOW to us; in a survey of 62 human dis- ly acquired by eating beef contaminat- transplanted into human patients. eases that are primarily found in other ed with the mysterious prions (“pro- However, pigs (and all other proposed animals, Will Kastens of Harvard teinaceous infectious particles”) that donor species) harbor various her- found that 35 came from wild non-pri- have caused thousands of cases of pesviruses and retroviruses that, while mate mammals, about a dozen from “mad cow disease” in British cattle not causing serious disease in pigs, domesticated mammals, and seven since the mid-1980s. The cattle, in might do so in humans. In Britain, from non-human primates. A few turn, almost certainly became infected pig-human transplants have been came from birds (who are, like mam- by being fed animal protein contain- banned for now, until further research mals, warm-blooded vertebrates), ing sheep by-products (sheep having is carried out to assess the risk of with only a scattering from other long been affected by a similar disor- introducing new diseases into human species (such as cholera-causing Vibrio der called scrapie). (In the 1950s, a populations, and until a U. K. bacteria, which are associated with Xenotransplantation Interim marine plankton and shellfish). Regulatory Authority develops Animal diseases get into human ...close contact with guidelines. bodies in a variety of ways. In the case An important constant in all of the of Lassa and hantavirus, close contact rodents leads to cases mentioned thus far, and in many with rodents leads to humans inhaling others, is human action. When we airborne particles from rodent feces or humans inhaling ponder the effects of the human urine that contain the viruses. Other airborne particles assault on the natural world, we usu- diseases, such as Lyme disease and the ally focus on such factors as climate many mosquito-vectored diseases from rodent feces change, air and water pollution, soil (malaria, yellow fever, dengue fever, or urine that erosion and reduction in biodiversity. Rift Valley fever, encephalitis), are But rarely are the disease conse- introduced by a biting arthropod (in contain viruses. quences of our actions considered. As the case of viruses, such disorders are rain forest is invaded by colonizing known as “arboviruses”, short for human populations, there is increas- arthropod-borne viruses). In other cas- tribe in the Papua New Guinea high- ing contact between these populations es, the pathogens get into human lands suffered 2,600 cases of a similar and wild animals carrying potential hosts when humans kill and eat the disorder, called kuru, which was new human pathogens — more peo- animal host. The harsh environment almost entirely restricted to women ple get bitten by mammals or insects, of the human gut probably kills most and children who had participated in more monkeys and rodents are killed ingested pathogens, but in preparing a ritual burial handling of dead rela- rat or monkey for consumption, a tives; these rituals may or may not The E. coli bacteria in the petri dish hunter gets blood and other contami- have included cannibalism of the show a green sheen. (Slide courtesy of nants from the animal on himself, brains of the dead; whence the kuru Stephen J. Cavalieri, Ph.D., associate which may enter the human blood- agent came when it first infected the professor of pathology and director of microbiology at Creighton.) stream via cuts or across various tribe is not known, but seems likely to membranes. This is almost certainly have been some local animal that how the Ebola and AIDS viruses first was killed and eaten.) entered the human system. (The Ivory A worrisome possible new route Coast chimpanzees devastated by for new pathogens is via “xenotrans- Ebola were famous for being enthusi- plants.” There have already been astic and successful predators on the several cases of primate hearts or local monkeys, which they killed and livers being transplanted into tore apart before eating.) Or a wild human patients as stop-gap mea- mammal may bite a human, directly sures until a human organ was injecting pathogens (as in rabies). available. Due to the perpetual Modern cultural practices have shortage of human organs for opened up new ports of access. About patients who need them, several a dozen Britons have now died from companies are developing new the new variant form of Creutzfeldt- strains of pigs, specially bred to be a Jakob disease that they almost certain- source of organs to be harvested and

Fall Issue 1997 7 An Ebola infection (left) and the Ebola virus are pictured above. While the animal origin of the deadly Ebola virus has not yet been identified, many scientists suspect bats, rodents or monkeys. and sold in local markets, more in agricultural workers. In Africa, lakes and ponds without affecting human huts and shacks are invaded building of the Aswan Dam in Egypt humans — if people swallowed by opportunistic local rodents. The was followed by 200,000 cases of Rift Legionella, their guts made short work likelihood of new zoonoses emerging Valley fever and 600 deaths in the of the bacteria. But invention of giant is greatly accelerated. 1970s (the disease continues today): institutional air conditioners with To this general phenomenon, spe- The building of the dam created abun- reservoirs of water to remove heat cific human actions can be added. dant new habitat for the mosquito opened up a new niche for Legionella, Lyme disease, probably present for with powerful vents to distribute it hundreds of years in northeastern aerially via water droplets, getting North America at very low rates, Human activities into people’s lungs and bypassing exploded after humans cleared the their guts. Invention of a new extend- forests and eliminated large predators, provide new opportu- ed-use tampon in the 1970s created farmed these areas for a couple of the perfect environment for the sur- hundred years, then abandoned them nities for people to vival and growth of toxic-shock-syn- for the fertile prairies farther west. In come into contact drome-causing Staphylococcus. the second-growth forests that sprang Human activities not only provide up, white-tailed deer populations with potential new opportunities for people to come exploded (ideal habitat, no predators), pathogens and greatly into contact with potential pathogens, allowing the deer tick with its deer- they also greatly facilitate the spread mouse/deer life cycle (and its cargo of facilitate the spread of these pathogens out of their loca- Lyme disease bacteria) to explode in tion of origin to the worldwide human numbers as well. As suburbanites of these pathogens... population. It is quite likely that HIV pushed into these wooded and wild to the worldwide had occasionally been getting into areas, they encountered the abundant human populations in central Africa deer ticks and, from their bites, Lyme human population. for many centuries, causing a small disease bacteria. In Argentina, native number of mysterious, lingering pampas grasslands were replaced by deaths in isolated villages. However, intensive cultivation of corn; in corn- vector of the virus, and brought into in the 1970s, political upheaval, fields, a new dominant mouse the area new large populations of increasing urbanization and large- replaced a different species that had humans and livestock who could be scale movements of migrant laborers predominated in the grasslands. The infected (cattle and sheep are major (often single males who visited urban new species (Calomys musculinus) animal hosts). prostitutes frequently) coincided turns out to be the host of the Junin Other cases abound. Legionella, the with the building of a highway that, virus, cause of Argentine hemorrhagic bacterium that causes Legionnaires’ for the first time, ran all the way fever, which has caused many deaths disease, has lived for millennia in across central Africa from Kinshasa,

8 Creighton University WINDOW Congo, on the west to Mombasa, eases brought by European con- resistant to at least one antibiotic, and Kenya, on the east. These mass move- querors and their African slaves. many are resistant to all but one or ments of people, facilitated by the Smallpox, measles, yellow fever, two. And new, deadly forms of previ- presence of what has come to be called malaria, and many others swept ously innocuous microbes are also “the AIDS highway,” ensured that this through Native American populations popping up, such as the 0157:H7 mysterious intermittently present ail- for several centuries, often causing strain of Escherichia coli, the ubiquitous ment escaped its former boundaries 50-90 percent mortality in particular human colon bacterium. This new and entered major African urban locations. Some estimates suggest strain, first discovered in 1982, has areas. Easy intercontinental movement that Old World diseases reduced an since been involved in deadly out- of people, made possible by modern original pre-Columbian population breaks of food poisoning involving airplane travel, then provided the in the Americas from 100 million to contaminated fast-food hamburgers in opportunity for HIV to get out of only about 10 million a century the United States and contaminated Africa and spread to the rest of after contact. school-lunch salads in Japan. the world. And if emerging diseases weren’t The appearance of such new While AIDS has a very long latency, bad enough, old familiar enemies also “superbugs” involves two phenome- allowing it to get established outside seem to be making a comeback, in na, one that should have been imme- Africa before it began to reveal its fatal new and deadlier forms. The popular diately predicted by anyone presence, it also is important to realize news media have recently begun to understanding the process of evolu- the extent to which modern air travel spread alarmist stories about tubercu- tion, the other a more surprising phe- has the potential to facilitate the losis strains that are resistant to all nomenon only fully revealed by spread of other, much faster-acting known antibiotics and about “flesh- modern molecular biology. The first emerging diseases. As a saying goes, eating Staphylococcus.” While many of involves simple natural selection. with modern air travel nobody in the these stories are over-sensationalized, When antibiotics are first used against world is more than 24 hours from the they do reflect a real problem. a bacterial species, most individual rain forest. Hundreds of cases of tropi- Antibiotic-resistant forms of such old bacteria are susceptible and quickly cal diseases enter Britain each year via enemies as Mycobacterium tuberculosis killed. However, a tiny minority of the Heathrow Airport; over a hundred and Staphylococcus aureus are present- bacteria usually have, by coincidence, cases a year of dengue fever are ing very serious new challenges; every partial or full resistance to the antibi- reported in the U.S. among travelers major disease-causing bacterium is otic. Under the severe selection returning from the Caribbean (which makes the spread into the U. S. of several good mosquito vectors of this disease very disturbing); a few years ago a man died in Chicago of Lassa fever, contracted when he was in Nigeria for a funeral. A reader of recent popular books or sensationalized movies may doubt the doomsday scenarios they propose, in which a hypothetical new tropical disease quickly spreads throughout the world and, with Ebola-type mortality rates, threatens the very existence of the human species. But history provides many examples of just such dev- astation when an immunologically naive population is suddenly exposed to human disease-causing pathogens from another part of the world. In the This and all screened photos ©Aris Multimedia Enternainment, Inc. 1993 most famous case, American people As humans continue to encroach on the rain forest, there is greater likelihood of from the Arctic to Tierra del Fuego people coming into contact with wild animals carrying potential new human were decimated by Old World dis- pathogens. With air travel, nobody is more than 24 hours from the rain forest.

Fall Issue 1997 9 imposed by antibiotic use, this tiny The second trick that leads to the antibiotic-resistance and virulence minority are the only survivors. With spread of antibiotic resistance and to acquisition much worse than they oth- their competition eliminated, they can the generation of new “superbugs” is erwise might have been. Particularly grow explosively and become the pre- a phenomenon called “horizontal gene damaging has been the widespread dominant form in an environment transfer.” Bacteria have many ways of use of antibiotics in less-than-critical (such as a hospital) where antibiotics picking up new genes. One involves situations. The more widespread are pervasive. Even where already- the acquisition of small, circular pieces antibiotics are in the environment, the resistant forms don’t exist, mutations of DNA called plasmids, which may more quickly resistance to them will leading to resistant forms are likely to be transferred during bacterial “mat- evolve and prevail in a bacterial occur, since bacteria exist in enor- ing” or picked up from other bacteria species. Having evolved in a domestic mously large populations and have that release them into the environ- animal, given antibiotics as a routine very short generation times. Under ment. Such plasmids often contain practice to promote faster weight gain, ideal circumstances, some bacteria can genes for antibiotic resistance or for or in a human patient with a viral duplicate themselves every 20 minutes toxin production, and bacteria of one infection (against which antibiotics do — at that rate, a bacterial species goes species can incorporate these plasmids not help), a resistant strain can then through as many generations in a day enter and cause serious illness in as humans do in a millennium. It is humans. As a parent myself, I know not just possible, but essentially In 10 years in a just how tempting it is to insist that a inevitable, that microbes will evolve child with a fever and a sore throat be resistance to any new antibiotic; the patient’s body, HIV given an antibiotic, even if what the best modern medicine can hope to do can undergo as much child has is probably a viral infection. is to follow careful procedures that And, living most of my life in Kansas delay this inevitable outcome. genetic change as has and Nebraska, I can understand why Similar arguments apply in the case cattle producers wish to eliminate of pathogens other than bacteria. The happened in humans nagging health problems that slow trypanosomes that cause sleeping since the early weight gain and limit profits. But each sickness and the Plasmodium species of these situations greatly exacerbates (protozoans, both) that cause malaria hominid “Lucy” the problem of antibiotic resistance. rapidly change their outer proteins so walked the savannas (In the U.S., 30 times as many antibi- that the human immune system and otics are used on farm animals as on human vaccine developers are unable 3 million years ago. humans; in Denmark in 1993, 22 kg of to keep pace. Retroviruses such as vancomycin were used in human ther- HIV are also notoriously fast evolvers. apy, 19,000 kg in animals.) One theory (not accepted by the entire not only from other bacteria of their Are we helpless against emerging AIDS medical community) for why own species but from other species as and re-emerging diseases? Not at all, most AIDS sufferers usually succumb well. Thus, a non-resistant species of although to better protect ourselves is that HIV and the patient’s immune bacteria can quickly acquire antibiotic we have to be constantly aware of the system engage in a prolonged arms resistance from a resistant species that risks they pose and the ways in which race, with HIV constantly generating shares its environment (such as the human actions affect those risks. The new versions and the patient’s gut or bloodstream of a human or a public health consequences of human immune system having to match that domesticated animal), or an innocu- intrusion into the natural world, espe- with new defenses — under this sce- ous bacterium can acquire genes for cially in the tropics, need to be explic- nario, almost inevitably at some point making deadly toxins from another itly considered. Perhaps each new an HIV variant arises that the immune species in the same way. The 0157:H7 development project should be accom- system never is able to cope with, and E. coli strain picked up its deadly toxin panied by not only an ecological the disease progresses to the patient’s gene in this way from another food- impact statement but also an epidemi- death. In 10 years in a patient’s body, poisoning pathogen, Shigella dysente- ological impact statement. Well-fund- HIV can undergo as much genetic ria, which lives alongside it in such ed research should be undertaken to change as has happened in humans environments as the guts of cattle. survey the microbial biota of wild ani- since the early hominid “Lucy” As in the previous case of newly mals, to identify potentially emerging walked the savannas 3 million emerging zoonotic diseases, human pathogens. Research should also focus years ago. actions have made the processes of on pathways of “microbe traffic,” so

10 Creighton University WINDOW that all of us are within 24 hours of the rain forest. In addition, an explicitly evolution- ary approach, sometimes called by its supporters “Darwinian medicine,” should guide our use of antibiotics, making sure we follow procedures that allow us to husband the valuable resource of antibiotic effectiveness and make it last as long as possible. And, where diseases are already established, it may be possible to use procedures developed by proponents of Darwinian medicine to give less viru- lent strains of pathogens an evolution- ary advantage over more deadly strains (See Randolph Neese and George Williams’ recent book, “Why We Get Sick: the New Science of Darwinian Medicine,” for details.) Above all, we must be prepared to carry on the fight against infectious diseases over the long term; there will never be a quick fix or a permanent solution. In 1982, following the string of new diseases that had first appeared or been recognized in the 1970s, Dr. Richard Krause of the National Institutes of Health was asked to testify before House Appropriations Committee hearings Workers process ground beef at the former Hudson Foods plant in Columbus, Neb., last August. Concern of a possible E. coli bacteria contamination about the budget for NIH’s National prompted a 25 million pound recall of beef processed at the plant. Institute of Allergy and Infectious Disease. Congressman Joseph Early that a better understanding exists of conservatism, government budget cut- asked Krause, “Has something new how new pathogens get into local backs and lack of enthusiasm for the occurred? Why do we have so many human populations and spread from funding of international agencies, it new infectious diseases?” Krause’s their original foci to new areas. will be difficult to establish such pro- reply can be our warning: “No, noth- International organizations should be grams, but we should never forget ing new has happened. Plagues are as established to make public health certain as death and taxes.” monitoring and record keeping as The more widespread good in all parts of the world as it is in the U. S. With our network of local, antibiotics are in the Final Note: Since this article was state, and federal public health agen- begun, Nebraska and Iowa have both cies, anchored by the Centers for environment, the more seen their first cases of hantavirus pul- Disease Control in Atlanta, only 19 quickly resistance monary syndrome (the Iowa case was days elapsed in 1993 between the first fatal), and there has been a nationwide case of hantavirus pulmonary syn- to them will evolve scare concerning frozen hamburger drome showing up in a doctor’s office and prevail in a patties originating from a Columbus, and the identification of the new han- Neb., food-packing plant that were con- tavirus that was the cause of the dis- bacterial species. taminated with the 0157:H7 strain of the ease. In this age of political E. coli bacterium. W

Fall Issue 1997 11 EthanEthan DeasDeas Amber VanKirk

KellyKelly Kennedy Jenaid Jenaid AhmedAhmed THE CLASS OF 2001: A New Odyssey for Creighton

By Eileen Wirth, Ph.D. Associate Professor, Journalism and Mass Communication

roudly wearing a new Creighton Admissions program (which began in “Creighton is full of opportunities,” T-shirt, Jenaid Ahmed of the 1996 and guarantees admission to he said. “It’s like a buffet. It’s compact. PChicago area joined the con- three of the five professional schools I know where everything is. The atmo- trolled confusion at lower St. John’s to C.U. graduates meeting certain sphere is very welcoming and friend- and patiently waited his turn to speak standards) was a major factor in his ly.” On a campus visit, he “saw the to his freshman seminar adviser. It choice of Creighton. However, it interaction in the halls. The teachers was the culmination of summer pre- wasn’t the only reason. seemed so friendly.” view for Creighton’s Class of 2001. Ahmed said he has attended Ahmed, a pre-med major whose Loyola Prep in Chicago so he is famil- mother is an immigrant physician iar with Jesuit education. His college from India, symbolizes some of the plans include more than just studying major changes that the class is bring- to get into medical school. ing to Creighton. “I’m interested in community ser- According to C.U. admissions and vice and maybe some of the leader- student services officials, this class: ship activities,” he said. “I plan to play • Includes sharply increasing num- intramural basketball.” bers of Asian Americans, especially of According to Director of Admis- Indian or Pakistani descent. sions Laurie Galeski, 21 percent of this • Has very high numbers of pre- year’s approximately 875 freshmen med majors attracted by the are members of minority groups, the Guaranteed Admissions program. bulk of them Asian Americans. • Includes more students whose While exact ethnic percentages of parents have more than a bachelor’s the Class of 2001 were not available at degree. midsummer, Galeski said she expect- • Has fewer Roman Catholics and ed the figures to be fairly similar to more members of other faiths includ- those of the Class of 2000 when 14 per- ing non-Christian faith traditions. cent of the freshmen were Asian Like many members of the Class of Making a residence hall room home is Americans.

Photos by Kent Sievers 2001, Ahmed said that the Guaranteed Creighton freshman Juan Baltodano. This represents a sharp increase

Fall Issue 1997 13 Settling in to Swanson Hall are, left, Abraham Daniels, and, right, Mital Patel. from the 5 percent Asian American cent of the mothers in 1987. students filling the benches at lower freshman enrollment in 1991 and the 9 The great jump came in 1996. In St. John’s at summer preview. percent Asian American enrollment in 1995, the year before the Guaranteed Amanda Nierstheimer, 18, of 1995, the year prior to Creighton’s Admissions program for students Pekin, Ill., and Ethan Deas, 18, a Guaranteed Admissions program, meeting certain grade criteria, 62 per- graduate of Omaha Burke High, said Dr. Stephanie Wernig, associate cent of the fathers and 53 percent of were among those getting acquainted vice president for student services. the mothers had more than a B.A. as they waited to see their advisers. Wernig said increasing numbers of The Guaranteed Admissions pro- Both are pre-med, and guaranteed students of Indian and Pakistani gram has increased Creighton’s tradi- admissions helped draw both to descent are selecting C.U. especially tionally high percentage of students Creighton. However, like Ahmed, for this reason. Many new students planning health sciences careers, Nierstheimer and Deas also consid- are the children of immigrant doctors Wernig said. In 1996, 40 percent of ered other factors. and other professionals. the freshmen said they planned medi- “For me, Creighton’s location was This factor has sharply increased cal or dental careers, up from 30 per- number one and also its academic rep- the parental educational backgrounds cent in 1995 and 21 percent in 1987. In utation,” said Deas. of Creighton students since 1987, she contrast, the percentage of students Like many Omaha students, he said. For example, in 1996, 68 percent who planned to attend law school said he’s been weighing the relative of the freshmen said their fathers had dropped from 14 to 7 percent between advantages of saving money by living a B.A. or higher as well as 60 percent 1987 and 1996. at home versus the chance to meet of their mothers. This contrasts with The increase in prospective pre- more people by living on campus. 56 percent of the fathers and 48 per- medical students was reflected in the “I would like to join a fraternity

14 Creighton University WINDOW and participate in some intramural program here was very, very good.” cent, an extremely welcome change sports and clubs,” he said. “I’m excit- VanKirk said she hopes to work for the College of Business ed. I’m ready to get going...” with people who are less fortunate — Administration which has worked Nierstheimer said Creighton’s size “really sick people or poor people. I hard to halt an enrollment decline. and the recommendation of a friend think that going on service trips is one COBA freshmen such as who went here affected her choice. thing I’m definitely interested in at Christopher Wilmes, 18, of Allen, Creighton is big enough that there will Creighton.” Neb., met with their advisers at the be plenty to do but not so big that According to Galeski, admissions College of Business Administration. she’ll get lost in the crowds. A campus to the School of Nursing have Wilmes said he plans to major in visit in February solidified her choice. dropped, reflecting a national trend. management information systems and “Everyone I met seemed really hap- However, prospective business stu- chose Creighton partially because of py,” she said. Her interests include dents have increased by about 34 per- its reputation and because he received intramural swimming and leadership activities. She’s also impressed by Creighton’s level of computerization and unlimited Internet access. A PROFILE OF THE “I was scared before I came for this (summer preview) that I wouldn’t UNDERGRADUATE CLASS find my way around or know anyone,” she said. “Now I’m just excited.” OF 2001: A THUMBNAIL According to Jack Walsh, assistant dean of the College of Arts and Sciences, many students are attracted by the variety of health career programs at Creighton. 21% PROTESTANT “Students have a lot of different 57% 43% 57% ways to go,” he said. “They like the FEMALE MALE ROMAN fact we’ve got three undergraduate CATHOLIC 22% colleges they can go to. If they don’t OTHER make it in one place, they can go FAITHS someplace else.” And, indeed, not all the prospective health care professionals at preview • Approximately 875 students were pre-med. Lora Hill, 17, from Timnatu, Colo., for example, plans to • Natives of 39 states and numerous foreign countries become a physical therapist. • Average ACT score of 25.5 “I liked the campus and its size,” she said. “Creighton has a good reputation for physical therapy. I don’t Here are some comparisons between the things the classes of know anyone here, but it’s fun to be in 1987 and 1996 considered either very important or essential: a new place.” Across campus, away from the 1987 1996 hubbub at St. John’s, sat Amber 25% Influence politics 19% VanKirk of Lincoln, waiting to meet with her adviser in the School of 43% Influence social values 40% Nursing. 65% Help others in difficulty 74% VanKirk, a graduate of Lincoln’s 80% Become an authority in my field 68% Pius X High School, said she chose 10% Make theoretical contribution to science 28% Creighton because of the reputation of the nursing program and because her 14% Write original works 10% sister Shana, an Arts and Sciences 13% Create artistic works 9% sophomore, has been happy at C.U. 50% Become successful in own business 35% “I like the fact that it’s small,” she 32% Promote racial understanding 37% said. “I know the teachers will be helping me out. I knew the nursing Source: Creighton Student Services

Fall Issue 1997 15 appeals to me.” Kennedy said that she had been a little scared that in college she would not experience the closeness that she found on her high school newspaper staff. However, she found a similar atmosphere when she received her scholarship at Creighton’s journalism awards banquet last spring. Galeski said that Creighton still draws many children of alums and is increasing its efforts to attract such students. It sends out special mailings to alum families. Last year, it added a mailing to 500 alumni with a waiver of the application fee as a reward for their help with student recruitment. “Alumni assist us now in a lot of areas,” she said. “We want to work with them more closely. They can certainly be strong, influential factors in a student’s decision-making process.” Galeski said that Creighton also has increased its efforts to attract students from Jesuit high schools by visit- ing 39 of the nation’s 46 Jesuit Assistant Professor George McNary consults with College of Business Freshman secondary schools. Creighton Jesuits Jennifer Lee during Creighton’s summer preview. personally call accepted students from such schools, urging them to enroll. the Walter and Suzanne Scott assistance. She might also take public This year, there’s been a 34 percent Scholarship. In addition, his parents relations courses to enhance her career increase in deposits from such stu- were eager for him to attend a opportunities. dents. In addition, Creighton moved Christian university. Meeting Dr. Roger Aiken, chair of to first place as the choice of 1997 “Hopefully, I will become a com- Fine Arts, got her really excited about graduates of Creighton Prep. It had puter systems analyst,” he said. Creighton. “He was the coolest guy in fallen to second or third (behind the “That’s my idea right now — or (I the world,” said McGuffee, who is University of Nebraska-Lincoln and may do) something in business in gen- especially interested in Aiken’s spe- the University of Nebraska at Omaha) eral. I believe that I will have a job in cialty, art history. in recent years. computers that is high paying and will Another example of an Arts and Overall, admissions and University give me the chance to travel. That’s Sciences student enrolling at officials say they are delighted with the dream I have...” Creighton for its other programs is the quality of the Class of 2001. It is One of Creighton’s major goals, Kelly Kennedy, 18, of Bellevue, who smarter than ever with 36.3 percent of said Galeski, is to recruit additional plans to major in journalism. Kennedy, domestic ranked students coming students in fields outside the health who edited the Bellevue East High from the top 10 percent of their high sciences. “We’re doing direct mailings School newspaper and received a school class, compared to 34.7 percent and specialized programs to increase number of journalism awards, said last year. Incoming freshmen also enrollment in some of our other areas that receiving a Mildred Brown Schol- seem to be enthusiastic, said Assistant but in many guidance counselors’ arship in journalism drew her to C.U. Dean Walsh, who worked with all minds, the health sciences are what Her plans include living on cam- three preview groups. Creighton is best known for.” pus, working on the Creightonian Wernig said that Creighton’s grow- Incoming Fine Arts major Melinda student newspaper, getting active in ing diversity poses a number of chal- McGuffee of Papillion, Neb., said she the Creighton University African- lenges. The percentage of students chose Creighton for a combination of American Student Association and who describe themselves as Roman reasons including proximity to home, possibly studying abroad. “The Catholic on the freshman survey has its academic reputation and financial semester in the Dominican Republic dropped from 75 percent in 1987 to 59

16 Creighton University WINDOW percent last year and is expected to be ing and teaching our traditional they have other qualities of leadership about 57 percent this year. Growing Creighton value system gets more and service. numbers of students are born-again challenging,” said Wernig. “This pre- Galeski said Admissions wants to Christians, Buddhists or Moslems. sents a special challenge to Jesuit col- talk to all students who think In addition, she said, Creighton leges and universities where social Creighton may be a good match for students seem to be more conservative justice and leadership development them. It is open to good students of all politically. While about half the are considered a vital part of each backgrounds who may bring a variety students still consider themselves institution’s mission.” of gifts to the Creighton community. middle of the road politically, 29 per- Galeski emphasized that Creighton normally admits stu- cent of the 1996 freshmen listed them- Creighton’s increasing academic dents with at least a C plus average selves as conservative versus 24 credentials should not discourage from a good college prep school and percent in 1987. Those calling them- students from applying. Creighton an ACT of 22 or higher, she said. The selves liberal dropped from 27 percent still welcomes students who were nei- admissions process is highly personal- to 18 percent. ther valedictorians nor scored in the ized and considers all components of a “As we get more diverse, maintain- 30s on their ACT tests, especially if student’s background.

ALUMNI REFLECT ON THEIR OWN CREIGHTON ‘ODYSSEYS’

n the late 1940s when Harry Dolphin enrolled at said she had been inspired by John F. Kennedy and went to Creighton, he expected to get a good education in journal- college expecting that “part of life was to make some differ- Iism, then make up for the three years he had lost to Army ence” in society. Dr. Richard Shugrue, who then taught polit- service in World War II. ical science, was faculty adviser to the Young Democrats Dolphin, a retired Omaha public relations executive, said which she joined. He encouraged members to “get active he and other veterans took advantage of the GI Bill and oth- and get involved. er programs to get far better educations than they otherwise “I loved it,” she said. “It was one of the best times of would have had. my life.” “We were making up for lost time,” said Dolphin. “We By the early 1970s, fear of the draft was a motivator for wanted to get a good education as fast as possible.” Taking many incoming Creighton students, at least male students, 17 hours was considered a light load. Going to school year said John Rosenthal, treasurer of a commercial finance com- round was not unusual. pany in the Chicago area. Like Dolphin, three other alumni from different decades Rosenthal, who received a B.A. in math in 1973, said that said the eras in which they attended Creighton shaped both his draft lottery number was seven. Throughout college, he their expectations and their experiences. worried that failing to finish one-eighth of his graduation John Reefe, an Omaha attorney who received his B.A. in requirements every semester might result in loss of his 1958, recalled the 1950s as a time of traditional values and student deferment. little worry about competition. “You couldn’t change majors or colleges or you risked “People were pretty relaxed about going to school,” he becoming cannon fodder,” he said. said. Jobs were plentiful and “no one I knew was real fright- Rosenthal said that students who entered C.U. in the ened about the future.” early ’70s had different expectations depending on which Reefe said that when he entered Creighton, his goal was faction they exemplified. There were racial divisions. Some to be “in the middle of the pack or a little ahead of it but students were intensely political while “the rest were without doing much work.” intensely not political.” There was no law school entrance exam, he said. Students Some parents sent their children to Creighton from the merely had to promise to pay their tuition eventually. Reefe East Coast on the assumption that they couldn’t get into graduated from C.U. Law School in 1963. trouble in Omaha. The FBI occasionally sent agents to cam- The 1960s, by contrast, were a time when many entering pus looking for drug users and dealers. Creighton students were interested in the civil rights and “It wasn’t politically correct to worry about a job,” peace movements, said Elizabeth Rea, an Omaha teacher said Rosenthal. “That would have meant you were selling who transferred to Creighton from a junior college in out. Everyone wanted to get a job because you had to have Iowa in 1967. one, but a career meant that you had bought into the Rea, vice president of the Omaha Education Association, system.” W

Fall Issue 1997 17 PRAYER ON THE RUN

SpiritualityOFWORK FOR BUSY PEOPLE

By Joseph Allegretti, J.D., M.Div. Yossem Professor of Legal Ethics Creighton University School of Law

t’s a Monday evening at a Catholic • A stay-at-home mother of three that my medical practice is taking church in Omaha. A dozen people says, “I want to find time for prayer over my life. All I do is work.” Iare sitting around a table. They but I can’t. My days are just too busy • A computer programmer com- range in age from the 20s to the 70s. taking care of my kids.” plains about the lack of meaning in his They are men and women, black and • “I love my work,” says a high job. “I spend eight hours a day punch- white. They have gathered to talk school teacher. “I know I’m doing ing information into a computer. I about their work, their faith and the something important with my life.” don’t feel like I’m doing anything for connections between the two. • A doctor tells the group, “I worry anyone.”

18 Creighton University WINDOW Spirituality and Work painful chore — it provides no suste- uation of ordinary work, but the rem- Teachers, bankers, plumbers, nance for their souls, no bread for nants of the medieval view haunt us lawyers, accountants, homemakers their spiritual journeys. Often the still. To go on a retreat, sit quietly in and real estate brokers — the work is faces of such people brighten up — church, attend liturgy, read the Bible, diverse, but the concerns are similar. lighten up! — the moment the discus- meditate privately — that is spiritual. People are struggling to find a way to sion changes to what is really impor- But time spent at work, or with the link their work with their deepest val- tant in their lives, whether it be family, kids, fixing dinner, rushing to the vet- ues. They do not want to feel like one church or sports. erinarian — many of us see that as person at church or synagogue on the What is most pernicious about this secular, worldly, not spiritual at all. weekend and a different person at attitude is its effect upon the worker. work during the weekday. They are When I approach my work as a curse, hungry to connect their faith and it diminishes my own value. Here I “I want to find time their work. am, spending hour after hour, day Each of these people, in his or her after day, month after month, year for prayer but I own way, is trying to fashion a spiritu- after year, engaged in aimless and hol- can’t. My days are ality of work. Some people dismiss low activity which is irrelevant to the spirituality as the very antithesis of deeper yearnings of my heart and just too busy taking the everyday world of work, com- soul. But if my work is a curse, what merce and family. Literally, however, does this say about me? Over time I care of my kids.” spirituality means to be “under the may come to hate myself for wasting influence of the spirit.” As Richard P. my talents and my life. Often this self- From this viewpoint, the long McBrien puts it in “Catholicism,” hatred is driven underground only to hours we spend at work are at best a “spirituality has to do with our way re-emerge in the guise of substance waste of time and, at worst, a source of being religious.” Our spirituality abuse or other destructive behavior. of guilt and anxiety. We can never relates to how we experience God in Ironically, religion itself has con- quite escape the fear that every our life and respond to that experi- tributed to a negative assessment of moment spent at work distracts us ence. It is not abstract, otherworldly ordinary work. In Genesis 3, God tells from the real purpose of our lives — or impractical. It is how we are who Adam and Eve, “Cursed is the ground to deepen our relationship with God. we are. because of you. In toil you shall eat of Most of us, of course, do not spend A spirituality of work, then, seeks it all the days of your life; thorns and our entire lives hating our work or to relate our work to the rest of our thistles it shall bring forth to you and hating ourselves for working. But spiritual life. It invites us to open our- you shall eat the plants of the field. In most of us experience times when we selves to the presence of God in our the sweat of your face, you shall eat feel pressured and overwhelmed by work. It looks for opportunities to bread.” Work, back-breaking, mind- our work. When this happens, our make our work an instrument of ser- numbing work, is God’s punishment work seems to be devoid of meaning vice to God and to neighbor. for the primeval, original sin of and estranged from the rest of our life, As we cultivate a spirituality of humanity. (There is another, more pos- like a curse or punishment. work, we guard against the twin itive, picture of work in Genesis, but If you are like me, and sometimes temptations toward devaluing our it’s God’s curse that sticks in most find this happening, then you might work (treating it as spiritually mean- people’s minds.) ask yourself a few questions: ingless) or overvaluing our work (giv- More subtly, religion in the West • To what extent have I inter- ing it too much meaning). In the first has sometimes encouraged the mistak- nalized a negative view of work case, we damn our work as a curse; in en notion that God and the spiritual that finds it a distraction to my the latter, we transform it into an idol. life are reserved for Sundays and spe- spiritual life? cial days, with the unfortunate effect • Do I sometimes hate my work or ‘Cursed is the Ground’ of trivializing the value of our every- find it spiritually meaningless? Is We treat our work as a curse day lives. Too often spirituality in the there a certain situation or event that any time we approach it as nothing West has been viewed as something triggers this feeling? more than a grim necessity, without that you can do only if you flee from • When I treat my work as a curse, any inherent meaning, valuable ordinary life. what is the impact on the rest of my only for the paycheck it may (or In the Middle Ages, for example, it life? Do I become angry or depressed? may not) bring. was often assumed that no one who Hard to get along with? Do I over-eat, Many people I talk to fall into this remained in the secular world could over-drink, or spend long hours in trap. Some of them earn large salaries live out the richness of the Christian front of the TV? and live in the nicest of neighbor- faith. As we shall see, both Protestants • What brings me out of this mind- hoods. Yet their work is nothing but a and Catholics now reject such a deval- set? How do I recapture a sense of

Fall Issue 1997 19 meaning in my work? or whatever is most important in our becomes the chief test of our worth as If at times our work seems like a life. Idolatry is confusing the finite a person. Who I am depends upon curse, the solution is to find ways to with the infinite. Sometimes this hap- what I do. It’s easy to end up like the cultivate a sense of meaning in our pens with our work. man I met who said, with a sigh, “All work. We must take care, however, We confront here a paradox at the my life I’ve been an engineer. Now lest we avoid one trap only to fall into very heart of a healthy spirituality of that I’m retired, I’m nothing.” And work: Work is an important and inte- woe to the unemployed and the Deep down we gral part of our spiritual life, and underemployed in a society like ours should be taken seriously, but it is not that enshrines work, accomplishment know that our of ultimate significance in our lives. and productivity as the chief tests of a Work should open us to God, not take person’s worth! work can’t save the place of God. Work idolatry is an occupational us. It can’t make How easy it is, however, to invest hazard for many workers, but espe- too much of ourselves in our work. I cially so for those who believe that everything better. think of all the times when I have been they are doing “important” work. burdened with assignments, frantical- Many doctors, lawyers and business another — we need to find meaning in ly trying to finish them all, yet at the executives, for example, are over- our work, to be sure, but not too much same time saying “yes” but never achievers, workaholics, who place meaning, lest our work become not a “no” to each new request. And it is inflated value on their work in the curse but an idol. never enough to complete my assign- hope that it will save them from their ments — not only must I do them all, I shadowy fears of emptiness and The God Who Can’t Save must do them all perfectly. My work worthlessness. If one view of work devalues its becomes a way of proclaiming to the For such people, work becomes significance, and treats it as spiritually world, “Look at me: I’m good! I count their entire life. Everything else suffers deadening, there is another attitude for something!” — families and friends fall by the toward work that overvalues it, and I’m not alone in this. At a cocktail wayside, cherished hobbies are forgot- threatens to transform it into some- party, we break the ice with strangers ten, their health is jeopardized — in thing more than it is, something god- by asking, “What do you do? Where their frantic efforts to work more, earn like, an idol made not of stone or clay do you work?” The size of our more, accomplish more. The broken but out of our dreams of worldly suc- paycheck or our office frequently marriages, the drug and alcohol prob- cess and accomplishment. As the great serves as a not-too-subtle sign of lems, the push-push-push mentality Christian theologian Paul Tillich divine favor, proof that we’re some- that can never slow down — all are reminds us, in a practical sense our body special. tangible signs of the vain quest to god is whomever or whatever we When we approach our work this grasp the Holy Grail of the workplace. invest with ultimate worth, whoever way, success or failure at work The root of the problem is that we are trying to make our work into something that it cannot be. We are using it as a magic potion to convince us of our self-importance, a drug to take away the painful suspi- cion that without our accomplishments and our corner offices we are, at bottom, nothing. There is no quick cure for this problem, but the first step is to admit our tendency toward work idolatry. This is a fact of life for most of us, to a greater or lesser extent, because our work does matter. It does make a difference to us if we do it well or poorly. If our work had no meaning, it would be a curse. So let us admit that our work is important and is inextricably entan- gled with our self-identity. Problems Allegretti...”We need a spirituality of the ordinary.” arise not when our work is meaning-

20 Creighton University WINDOW ful but when it assumes ultimate ongoing work of redemption. work! Right now, at this moment, with meaning in our lives, when we wor- This means that we serve our God this student, I have the opportunity ship it as a god. in our everyday work. We are doing to bring my faith and my work togeth- If you are prone to work idolatry, as God’s work not just when sitting in er. My work is not an impediment to I am, you might periodically pause church, but when counseling a client, my spiritual life; it is a vehicle for and ask yourself a few questions: preparing a marketing report, repair- living out, for making flesh, my spiri- • When I close my eyes and picture ing a balky computer or driving a tual values. myself, what do I see? How am I truck. We collaborate with God as we How often I’ve forgotten what is dressed? What am I doing? Am I at respond competently and diligently to called for: a ministry of the kind word, home or at work? our tasks. As theologian Elizabeth the attentive ear, a smile or a laugh, • Do the inevitable failures at work Dreyer in “Toward a Spirituality of just being present for a student or col- diminish my sense of self-worth? Do I Work” puts it, “Gradually we are league. The people I encounter at feel like a failure as a person? learning that to be a good plumber, work are not distractions to my spiri- • Do I catch myself thinking about truck driver, nurse, or janitor is the tual life, but companions on a spiritual work at all times of the day and night? way to be a good Christian.” journey, from whom I receive suste- Do I bring work home most evenings nance and to whom I, in turn, am and weekends? called to minister. • Do I throw myself into my work The people I The opportunities for service to escape from problems in my per- differ from work to work, of course, sonal and family life? Would I rather encounter at but no work is devoid of possibilities. be at work than at home? Let me suggest a few questions to • What are one or two things I work are not dis- think about: could do to achieve a healthy balance tractions to my • What is your greatest satisfaction between my work and the rest of at work? Are there times when you my life? spiritual life, but feel especially close to God? Deep down we know that our work • What is your greatest disap- can’t save us. It can’t make everything companions on a pointment at work? Are there times better. It can’t compensate for failed spiritual journey. when you feel distant or estranged relationships, lifelong insecurities, a from God? painful childhood. Work can’t save us • What is one thing you could do — only God can. Our challenge is to cultivate an right now to cultivate a sense of God awareness of the opportunities for ser- in your work? What is one thing you Spirituality of the Ordinary vice and creativity in our everyday could do to make your work more If work is a paradox, if we give it work. If God is in the details, as the prayerful? both too little and too much meaning, theologians say, then we need to • Where are the opportunities in then the solution must be paradoxical become sensitive to the ways we your work to serve others? Are you as well. We need a view of work that encounter God in the details of our taking advantage of these opportuni- sees it not as a curse or an idol, but as daily lives. What we need is a spiritu- ties? What more could you do? something in between, something that ality of the ordinary. • Where are the opportunities in is part of our spiritual life but not the Let me give an example. Many your work to pursue justice? Are you whole of our spiritual life. times a student will walk into my taking advantage of these opportuni- The medieval church was right to office and begin talking about a ties? What more could you do? affirm the sanctity of work; its prob- class assignment, only to open up lem was in assuming that only certain gradually and reveal a deeper prob- To Cherish and to Struggle work had spiritual significance. As far lem at the root of the visit — a family Work is not a curse or an idol, but back as the Reformation, Luther and breakup, a vocational crisis, nagging something more, something less. It is Calvin broke free of this idea and doubts about self-identity. Yet I’m holy but it is not divine. It can bring taught that any work could be a voca- embarrassed to admit how often I great joy and deep disappointment. tion if it was an avenue of service to catch myself surreptitiously peeking The great Catholic writer Flannery God and to neighbor. Our calling is to at my watch and wondering how I am O’Connor wrote, “You have to cherish love God and our neighbor through going to get my “real” work done — the world at the same time you strug- our work. preparation for a class, writing an arti- gle to endure it.” What O’Connor said Similarly, in the encyclical Laborem cle — if I spend so much time with about life applies to work as well. Exercens, Pope John Paul II speaks of this student. We must learn to cherish our work work as a way for humans to share in How often I’ve overlooked the at the same time that we struggle to the creative work of God and Christ’s opportunities for ministry in my endure it. W

Fall Issue 1997 21 CLONING-- LONING C Should We Have Tailor-Made Children?

“I want “I“I wantwant a child free aa childchild whowho from the lookslooks likelike me,me, diseases that eveneven thoughthough have afflicted II can’tcan’t havehave my family.” childrenchildren myself.”myself.”

“I“I wantwant aa childchild whowho isis aa donordonor “I“I wantwant aa matchmatch forfor mymy childchild withwith son.son. HeHe needsneeds grandma’sgrandma’s anan organorgan eyes.”eyes.” transplant.”transplant.” “I“I wantwant aa childchild whowho can,can, inin aa way,way, replacereplace mymy dyingdying daughter.”daughter.”

by Kevin T. FitzGerald, S.J. Research Associate, Cancer Research Center Loyola University Medical Center

22 Creighton University WINDOW CLONING-- LONING C Editor’s note: effects of the uterine environment on of disease from one generation to the Fr. FitzGerald their development would be quite next. A brief review of some of these holds a Ph.D. in similar. Conversely, a clone would suggestions provides an opportunity molecular genetics develop in a different womb, or the to evaluate their scientific and medical from Georgetown same womb at a different time. This merit. This evaluation is the founda- University in difference alone could result in a clone tion for the answer to the second ques- Washington, D.C. being significantly less similar to the tion posed at the beginning of this He is also a Ph.D. cell donor than if it had been a natural article concerning a parent’s or any- candidate in identical twin. In addition, the envi- one’s right to try to clone themselves. bioethics at ronment experienced by a clone dur- One proposal for using cloning to Georgetown. ing its childhood could be vastly prevent the transmission of disease He was recently appointed to Creighton different than the childhood of the cell from parent to child involves genetic University’s Board of Directors. Fr. donor. This, too, would result in more diseases which do not arise from FitzGerald’s opinion has been sought fre- dissimilarities between a person and mutations or abnormalities affecting quently by the national news media since his or her clone. the genes located in the nucleus of a the cloning of Dolly the sheep in Scotland. With all these potential differences, cell. Human cells contain many small why all this talk about cloning people? structures outside the nucleus, called One reason for all the media coverage mitochondria, which are crucial to cell n April 1997, the journal Nature about cloning is the widely held mis- function, and which contain their own IGenetics reported that Dr. Brigitte conception that cloning somehow genes. Egg cells have many mitochon- Boisselier, scientific director of involves producing exact copies of dria. Sperm also have them, but sperm Clonaid in the Bahamas, plans to offer people almost human cloning for $200,000. Dr. instantaneously. Boisselier defended this offer on the Although this idea grounds that parents have the right to is, in fact, ground- clone themselves. Such an offer imme- less, it has been diately brings to mind two questions: used in movie Can people be cloned? Does a parent, scripts and science or anyone else, have the right to clone fiction novels. themselves? Hence, when the Considering the advancements in announcement cloning sheep and cattle, which have was made about been announced by a few biotechnolo- the existence of gy companies during the summer, the Dolly, the first answer to the first question is that clone from an cloning people could be possible soon. adult mammal, Does this mean that people could people naturally make carbon copies of themselves? conjured up No. What it does mean is that cells images of scien- Dolly, the genetically cloned sheep, looks toward the camera at the Roslin Institute near Edinburgh, Scotland. Dolly was could be removed from a human tists secretly the first animal to be genetically cloned from adult cells. embryo, fetus or an adult, and that cloning the presi- these cells could be used to create a dent and replacing him with a clone mitochondria generally do not get into new human embryo genetically iden- which they could control. Now that the egg when fertilization occurs. tical to the individual who donated the impossibility of such a scenario is Therefore, only the mother has to be the cells. Upon being implanted suc- publicly acknowledged, attention can concerned about passing on a mito- cessfully into a woman’s uterus, this be directed to an assessment of the chondrial disease to her children. clone would grow up to be similar to a more serious proposals for the use of Cloning technology then could be delayed identical twin of the person human cloning which have not been used to remove the nucleus from an from whom the cells were taken. as widely discussed. embryo which has inherited diseased Could watching a clone grow up be These proposals for the use of mitochondria. This nucleus would be like watching a rerun of the cell human cloning spread out along a placed into an enucleated egg cell donor’s own childhood? No. Since spectrum from responding to psycho- which has healthy mitochondria. natural identical twins (who can be logical grief at the loss of a loved one Hence, the genetic characteristics quite distinct from one another) share to the possibility of medical interven- inherited from both parents’ chromo- the same womb during gestation, the tions intended to prevent the passage somes would remain and the diseased

Fall Issue 1997 23 CLONING-- LONING C mitochondria would be eliminated. child or infant requires a transplanta- it will not seriously threaten or impair Since this procedure would be done in tion in order to live. The parents, it is the life of the child. Therefore, there order to treat a disease which could be proposed, could clone their child to are significant ethical and legal barri- severely detrimental to the health of produce a sibling who would provide ers already in place to prevent anyone the offspring, it is proposed as con- a perfect transplant match. Presuming from choosing in the name of someone that the older child’s disease does not who does not, as yet, exist and there- have a genetic basis, the clone could fore cannot consent to the production donate an organ or tissue to save the of a body part for another. life of the sick sibling. But what if someone desires to Again, present research may pro- have a person cloned just so that the No human being vide better alternatives. Studies are clone could be loved? Such proposals isis replaceablereplaceable ---- notnot ongoing into the possibility of trans- are often raised in the context of a cou- planting special cells, called stem cells, ple wanting to replace a dying child even physiologically. which generate and regenerate the with a clone of that child, or a spouse We are all unique. various tissues of the human body. having a clone of the dying spouse. In These cells might be acquired from tis- these cases it is crucial to bear in mind sue and organ donors, both living and that there will be significant differ- dead, or perhaps from the patient, ences between clones and the people whose own cells could be treated and from whom they are cloned. reinfused. Cloning technology itself No human being is replaceable — forming with the accepted medical provides the possibility that animals not even physiologically. We are all practice of taking some risks with the genetically engineered to have tissues unique. The desire to clone a loved health of the patient, in this case the and organs com- child or spouse embryo, so that a significant health patible with to replace the benefit can be achieved. humans could lost loved one It is also an important part of medi- be cloned to pro- may well indi- cal practice to consider whether or not vide their tissues cate a retreat to alternative methods might provide the and organs for a biological same benefits with much less risk. An transplantation solution from alternative to the above proposal is into people. Both the age-old being researched now. This option of these problem of deal- involves transferring the nucleus of approaches ing with the the mother’s egg to the enucleated egg would make the grief and trau- cell with the healthy mitochondria. If cloning of a new ma of death. the transfer works, the new egg can be person medical- Even if the psy- returned to the Fallopian tubes or ly unnecessary. chological strug- uterus of the mother and, it is hoped, This potential gle with the loss be fertilized. The significant difference medical advance of a loved one here is that the cloning procedure is not the only eventually is requires research on and manipulation reason, though, dealt with suc- of embryos, while the nuclear transfer, to refrain from cessfully, the when only eggs are used, does not. using human cloned child Looking ahead to an ethical evalua- cloning for would always tion of these two procedures, it would transplantation have to live appear that the procedure of using purposes. with the reality eggs alone has the advantage since the Contemporary of having been loss of eggs in a failed procedure is society holds cloned to less significant than the loss of that no adult Two rhesus monkeys were cloned from replace another. embryos which can develop and grow should be forced embryos last year at the Oregon Regional There could and be born. to donate an Primate Research Center in Beaverton, Ore. be other difficult Another suggested use for human organ or tissue against his or her will, social and psychological realities with cloning is to supply needed tissues not even to save the life of an innocent which a clone might have to live. and organs for transplantation. In its child. In an extension of this position, Perhaps the experiences of children most heartrending form, this proposal parents can speak for their own child conceived by means of artificial repro- seeks to address the situation where a in volunteering to donate tissue only if ductive technologies can be used to

24 Creighton University WINDOW CLONING-- LONING C extrapolate what clones might experi- Hence, in the ethical evaluation of through technology. If this sounds too ence growing up — but perhaps not. whether or not cloning should be futuristic and farfetched, consider the Whichever is the case, these issues offered, the burden of proof is on present clamor in medicine for drugs require attention because some physi- those who want to use cloning to treat and treatments to take care of all prob- cians in the field of reproductive tech- patients. They must demonstrate lems people encounter in life — espe- nology will want to offer cloning as an clearly what benefits it would provide cially suffering, dying, and even death option to their patients, as Clonaid and how the potential risks would be itself. already intends to do. minimized. This last proposal for the use of Some potential risks have already human cloning — to help solve repro- been elucidated. Cloning technology ductive problems — raises again the would require the treatment and The cloning of question of who has the right to try to manipulation of embryos. Many The cloning of be cloned. Discussions about people’s embryos would be lost in the process human beings offers rights can be complex, even convolut- of perfecting the cloning techniques calamity, not care -- ed. One important distinction to make on humans, and even in the regular is between negative (liberty) rights employment of the procedure on individualindividual restriction,restriction, and positive (welfare) rights. patients. If these embryos were fatally not freedom. Regarding cloning, liberty rights diseased, one could argue that the would encompass the moral and legal cloning procedure is their only hope. freedom to reproduce by cloning, or But if the cloning procedure creates assist others in doing so, without vio- them in the first place, what ethical lating any countervailing laws or argument can justify creating embryos Scientific advancements and medi- moral obligations. Welfare rights which are most likely going to die or cal technology have contributed great- would entitle those who wish to be be destroyed? ly to the quality of life people can cloned to assistance from other par- The reasons advanced in favor of have. Our God-given abilities allow us ties, such as health insurance cloning, reviewed above, focus on the to achieve and accomplish so much providers or the government. Since desire of parents or individuals to cre- for which we should be thankful. The liberty rights are required in order to ate a child of this or that type. The temptation humankind faces continu- have welfare rights, the question of type of child desired would have cer- ally is to look to our own achieve- people’s rights should begin with the tain genetic characteristics, including ments for salvation from whatever ails former. the characteristic that the child has a us. Advancements in mammalian Legal liberty rights to reproduce particular person’s genes. This desire cloning could be one of those accom- are virtually unlimited in the United to have a child of a particular genetic plishments which provides great ben- States. Though some state and federal type conflicts with the value of the efit to many who are in need. It also legislation has been proposed which uniqueness of each individual. could be used to provide a way for us would prevent all reproductive tech- Consequently, such desires could to run from who we are by attempting nology clinics from offering human result in harm to the person cloned to make ourselves into that which we cloning as a treatment option, the pre- because that person would be expect- are not ... mere products of our genes sent situation is that many private ed to resemble physically and behav- and biochemical reactions. clinics are not prevented legally from iorally the particular genetic type to It is our moral obligation as offering cloning as a treatment for an even greater degree than what is Christians to seek to use our abilities infertility. That leaves the moral part expected of other children. What free- and accomplishments to care for of the question: Should such services dom to be him or herself would a one another and creation as best we be allowed to offer cloning, and, con- clone receive from parents that chose can, and not to run from our limita- versely, should patients be allowed to create a clone in order to get a par- tions. At present, the cloning of to request it? ticular type of individual? human beings offers calamity, not Considering the fact that reproduc- On a societal level, the desire to care — individual restriction, not tive technology clinics already employ produce children of predicted types freedom. a panel of techniques to combat fertili- also could cause great harm. If chil- Our moral obligation, then, is ty problems, the medical need to use dren do not behave as expected, or fit to exercise our right not to employ cloning to solve a particular reproduc- in as expected, it could be surmised this new technology to produce tive problem may be quite limited, if that they were not produced properly. tailor-made children for whatever the need exists at all. This circum- The struggles of growing, developing reason, but to continue to be open stance was apparent in the proposed and living could be reduced to mere to the benefits cloning may provide uses for cloning already reviewed. technical problems to be solved through medical research. W

Fall Issue 1997 25 ILAC ... Making a world of difference for 25 years.

ince 1972, the Institute for Latin American Concern has been Smaking a difference in people’s lives. Not just the hundreds of lives ILAC touches in the Dominican Republic, as Creighton students and professionals work with resi- dents in remote villages and impoverished neighborhoods, offering health education and health care.

But the lives of hundreds of Creighton students who also are made better by the experience ... as they learn they are part of the human family — and discover the connection between affluence and poverty in our world.

Today, ILAC not only brings health care to Santiago and 186 Amy Smith, BSN‘96, talks with a young Dominican girl. rural communities but has grown to include a permanent health Photos by Don Doll, S.J. care facility and year-round health care services to augment the original summer program. Occupational and Physical Therapy programs now round out ILAC’s original health care services of medicine, dentistry, nursing and pharmacy. The University also has established the Montesinos Center for the Study of the Dominican Republic to foster research. Also today, the Colleges of Arts and Sciences and Business Administration offer “Semestre Dominicano,” a semester of study at Creighton’s Dominican Republic campus.

ILAC is making a difference in our world, one life at a time.

For more information about ILAC, contact the following: Fr. Ernesto Travieso, S.J., executive director, or Virginia McGill, director, at 1-800-343-3645.

Katie McMahon, BS‘97, foreground, and Tanya Reindl, BS‘97, background, take a child’s medical history at the clinic in Henequen.

® “The Degree of Difference”

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