IV fluid seems to be the next step in America's water mania. We have been convinced that tap water — which is closely monitored for safety, comes from a source close to home and is free — is clearly inferior to bottled water, which is expensive, comes from a source that we don't know and the farther away the better, such as Fiji Water. We complain about the price of gas, and yet we spend more for a gallon of water.
We do not believe our body that when it tells us we are thirsty, it is time for a drink. It is too late! If we feel thirst, we have waited too long, so we must now drink enough that we never know thirst. Interestingly, the medical literature is now reporting problems with hyponatremia (low blood sodium levels) in runners from too much water intake, especially in those who take a long time to complete a marathon. I doubt that the winners have time to drink that much.
The Sept. 16 article on IV hydration ("Stuck on IV therapy," Variety) provided testimonials in which individuals felt better after "being hydrated." Never underestimate the power of placebo. When I was a resident at Memorial Sloan Kettering Cancer Center in New York City, there were ongoing studies to determine the value of new medications for pain relief. It was clear that a red pill was better than a white one and that a shot was better than a pill. If the shot was painful, the relief was longer-lasting. The abnormal response to placebo was to get no relief. The difference was that the relief from the placebo was short-lived.
Normal people want to feel better. The complaints that the individuals had, for example, a headache, were all temporary and would resolve spontaneously in a relatively short time. If a shot is a good placebo, how good must an IV be — especially with colored fluid and costing $45 to $150?
Theodore Nagel, M.D., Minneapolis
THE MIGRATION CRISIS
Even more training is needed to cope with humanitarian aid
I am responding to the Sept. 14 article "Mock refugee camp embodies real issues." I am one of the many University of Minnesota faculty members and volunteers who help organize this event every year since it started as a course at the U's Humphrey School in 2010 under the direction of Eric James.
My background is not in crisis response or humanitarianism, but my commitment to this project is motivated by the extraordinary situation we face today with more refugees and displaced persons worldwide (total numbers) than at any time in human history. According to the United Nations High Commissioner for Refugees' website, "there were 19.5 million refugees worldwide at the end of 2014" and in 2014, "conflict and persecution forced an average of 42,500 persons per day to leave their homes and seek protection elsewhere, either within the borders of their countries or in other countries." Political violence is only one of the trends pushing populations to move quickly; increased opportunities for transportation (facilitated often by organized extralegal organizations) and environmental pressures resulting from climate change are also adding to these numbers.
Training as provided in this simulation is critical to helping professionals and future professionals in nearly every field — and the focus at the U on medicine, public health, public policy and governance, design and shelter, journalism, urban planning and geographic information systems — prepares not only for challenges that might arise in their work, but also to help them understand the complexities that arise when populations can create new towns and cities within hours, and health events can cross borders within days. I encourage academic units around Minnesota to join us in creating more trainings of this sort to prepare our students and colleagues for the Grand Challenge of our generation.
Sherry Gray, St. Paul
The writer is director of international programs at the University of Minnesota's Humphrey School of Public Affairs.