Sugar in a Caesarean Section

Last Week Tonight with John Oliver is plagued by the same problem as other comedy news shows like The Daily Show and The Colbert Report. They sometimes get things wrong because the writers are comedians trying to be funny, not skeptics trying to think critically.

In this week's episode, while discussing our broken prison system, John brought up the story of Regan Clarine. While an inmate in Perryville State Prison inmate underwent a C-section operation. Her mother Lori was interviewed for Al Jazeera.

Lori said the medical staff didn't stitch the wound shut. Instead, they dressed it with butterfly bandages.

It sounds like Clarine was treated with BioWeld, a new way to seal wounds without staples or stitches. The machine uses plasma to bind skin to a biological film based on a naturally occurring sugar.

Clarine developed an infection in the wound site, and sent to the prison hospital. According to Lori:

... they decided that the best thing to do for this would be to pack it with kitchen sugar … we're talking sugar that you get from, because they donate it from McDonald's from Burger King, you know? They're standing there ripping open these little packs of sugar and filling that wound.

It sounds like Clarine was treated with Multidex powder, a moist wound filler useful for reducing purulent exudate (or "oozing" as described in the Al Jazeera article). Some of these powder packets do sort of resemble McDonald's sugar packets in shape and size. The mistake is easy to make, especially for an anesthetized person, but they aren't from a fast food joint. They're medicine.

Multidex powder packets.

This medicine approved for use in 1997. It's main ingredient isn't "kitchen sugar" (sucrose) but a different polysaccharide called maltodextrin.

Even Lori's brother, who's a doctor, said:

It's probably just a nickname of something. Nobody would pour sugar in a wound. So don't worry about it.

But the article says:

Sugar was used to treat wounds before the advent of antibiotics in the early 1900s, but it's no longer accepted medical practice.

Which is false! As we've seen, sugar is used in modern medicine to both seal and pack wounds.

I don't question that this poor inmate was mistreated. It seems likely she developed these complications as a result of inadequate care. Neither do I blame anyone for misunderstanding their doctors bedside explanation of the treatment they receive.

I blame Abigail Leonard and Adam May, authors of the article, for not checking their facts, and for printing the opinion of the mother of an inmate as fact despite all common sense, and without the least bit of skepticism. America Tonight is not supposed to be a comedy show, right?

The claim that privatization of the penal system leads to poor inmate treatment is a serious one, and needs to be backed up with evidence. In this case, the sugar is not evidence. The wound re-opening and subsequent infection is evidence.

Another issue is that a 18-year-old woman was sentenced to 2.5 years for intent to sell prescription painkillers. We can argue for reform of drug laws without exaggerating the problems that face inmates. We already knew prison is terrible before this story. Drug offenders belong in rehab, not prison.

I think John Oliver (and his writers) really care about the topics they talk about on the show. I want them to know that they can better serve their audience with the truth than with half-truths and lies. This can only be accomplished by checking facts and applying critical thinking, which is hard work.

I leave you with this quote by John Oliver from 2009:

... Someone came up to me and asked me a question about a news story, and I didn't know anything about it so I just lied and they listened to me and believed me. The feeling of power that I got from that lie infecting their head made me think, "Yes, this is what I want to do for a living." (1:40)

I know this was said with irony. Let's not make it double-irony.