Charache S, Moyer M A
Prog Clin Biol Res. 1982;98:73-81.
Sickle cell anemia is a bad disease, and it occurs in black patients who still face obstacles that whites don't appreciate. Even if a new cure burst forth, it would not be available to many patients, and others would be afraid of it. It probably would not be as safe or effective as chloroquine for malaria or penicillin for pneumonia--and as a result, we should try to improve our present means for delivering care. Treatable complications must be recognized, and painful episodes must be managed with knowledge that no type of pain is exclusively physical or mental. If patients are to function in society, they must have marketable skills--and the current educational system in the United States is not prepared to provide such skills to such difficult students. Finally, there will be some lost souls, hopeless patients who live a shadowy life from which rescue seems nearly impossible. They need specialized care which is not currently available. Such care in special protected environments could be cost-effective, but would require such prolonged enthusiasm and commitment that it may be impossible to achieve.
镰状细胞贫血是一种严重的疾病，它发生在黑人患者中，这些患者仍然面临着白人无法理解的障碍。即使出现了新的治疗方法，许多患者也无法获得，而其他患者可能会对此感到恐惧。它可能不像治疗疟疾的氯喹或治疗肺炎的青霉素那样安全有效——因此，我们应该努力改进目前提供护理的方式。必须识别可治疗的并发症，并且在处理疼痛发作时要明白，没有哪种疼痛纯粹是身体上的或精神上的。如果患者要在社会中发挥作用，他们必须具备可销售的技能——而美国目前的教育系统并没有准备好为这些困难学生提供这样的技能。最后，会有一些迷失的灵魂，绝望的患者过着阴暗的生活，似乎几乎无法得到拯救。他们需要目前无法获得的特殊护理。在特殊保护环境中的这种护理可能具有成本效益，但需要如此长期的热情和投入，以至于可能无法实现。
