Thalidomide’s Return
1. Bundled in a stark white hospital blanket, Rafael looks like any other month-old baby. But when his mother, Lucienc Das Dores, unwraps the snug cover, the sight is shocking: Rafael has no arms or legs. “I got very upset and started to cry when I first saw him,” says Das Dores, 23, a part-time cleaning woman who lives in Belo Horizonte, Brazil. “When I saw him with only a head and a torso. I was devastated. I wanted to kill myself.” She could not help feeling guilty: unaware that she might hurt her baby, she had taken the powerful sedative thalidomide during her pregnancy.
2. Her story is a flashback to an old nightmare. Yes, Das Dores took the some medication that made headlines 33 years ago when it produced 12,000 severely deformed children around the world. But while the word thalidomide became synonymous with tragedy and its use as a sleeping pill was banned, the drug did not disappear. In fact, it has benefits that have made it an increasingly valuable medicine when used carefully. Misuse, however, has caused a grim side-effect: the reappearance of “thalidomide babies.”
3. Trouble strikes when patients don’t know about thalidomide’s dark side — and when those selling and dispensing the drug don’t give adequate warning. Although the US has strict rules governing thalidomide’s use, controls are much laxer in some other parts of the world. The consequences are now apparent in Brazil, which has at least 46 new instances of birth defects caused by thalidomide. If there are cases in other countries, they haven’t received the same publicity, but given the increasing use of the drug, health officials fear that the problem will be widespread.
4. A few years after the initial thalidomide disaster, researchers discovered that the drug has an almost miraculous ability to treat complications of leprosy. Then they learned they could use it against some of the potentially fatal side-effects of bone-marrow surgery. The past year has brought reports that the drug may help fight tuberculosis, a common cause of blindness called macular degeneration and even AIDS.
5. Brazil is one of the largest producers of thalidomide because it is home to perhaps 300,000 people who suffer from leprosy. About 30,000 of them take the drug to soothe the excruciating pain and eradicate the lesions that occur in severe cases of the infection. The only alternative treatment, corticosteroids, does not work as quickly or as completely. “The pain was so great that I couldn’t walk,” says Irani, 24, a former patient at the Santa Isabel leper colony. “I almost died. Thalidomide was my salvation."
6. Irani was lucky to have a doctor who cared enough to take precautions. They administered the drug only after putting her in a hospital, where they could make sure she did not become pregnant. But some doctors give out prescriptions without telling patients of the danger, much less keeping them under observation. In other cases, the patients who are often poor and barely literate, ignore or misunderstand what they are being told.
7. Greed also comes into play. Although only two companies are authorized to produce the drug in Brazil, several underground laboratories reportedly sell it to people without a prescription. Health authorities shut down on illicit operation last year, after a TV-news crew showed how easy it was to buy the pills.
8. The resurgence of birth defects is especially painful for members of Brazil’s first thalidomide generation, born around 1960. They believe the government has not done enough to warn women and have started their own education campaign. “People still believe this kind of thing is God’s punishment or even a side-effect of leprosy," says Rosangela Nascimento, head of the Thalidomide Victims Association.
9. In the meantime, US scientists are trying to find out more about how thalidomide works. They have learned that the drug, besides having sedative effects, blocks two important processes in the body. The first involves the production of a substance called tumor necrosis factor, or TNF, which fights both malignant cells and infections. But if too much TNF is produced, as apparently happens in leprosy, AIDS and tuberculosis, the body makes itself sicker. The second process stymied by thalidomide is the creation of new blood vessels, which is crucial to the development of arms and legs in the fetus. The eventual goal of researchers is to alter thalidomide somehow so that it continues to inhibit TNF without harming nascent arteries and veins.
10. Such efforts will be of little comfort to the families of children like Rafael. Until thalidomide is made safe, governments will have no choice but to regulate the drug tightly and publicize its perils.
AI explanationShows the answer. Tap to open.
Question Focus: Detail question - asks why Das Dores took thalidomide
Correct Answer: E
Why this is correct: The answer is sleeplessness because the passage clearly calls thalidomide a powerful sedative and a sleeping pill. Sedatives are taken to help people sleep.
Passage Reference: She could not help feeling guilty: unaware that she might hurt her baby, she had taken the powerful sedative thalidomide during her pregnancy. Yes, Das Dores took the some medication that made headlines 33 years ago when it produced 12,000 severely deformed children around the world. But while the word thalidomide became synonymous with tragedy and its use as a sleeping pill was banned, the drug did not disappear.
Paraphrasing: Passage: 'powerful sedative' and 'sleeping pill' = Option: 'sleeplessness'
Tips: For detail questions, focus on the person named in the question and ignore medical uses mentioned later about other patients.
Why the other options are wrong:
- A: Students may choose AIDS because the passage later mentions AIDS as a disease thalidomide may help treat. However, this is a context shift trap. That information is general and not about Das Dores herself.
- B: Students may pick leprosy because thalidomide is strongly connected to leprosy treatment later in the passage. But Das Dores is never said to have leprosy. This is a wrong section trap.
- C: Students may choose macular degeneration because it is listed as a possible condition thalidomide can help. However, the passage does not say Das Dores had this condition. This is a Not Given trap.
- D: Students may pick side-effects of bone-marrow surgery because the passage mentions this medical use. But again, this is not connected to Das Dores. This is a context shift trap.
- F: Students may choose tuberculosis because it appears in the list of diseases later. The passage never says Das Dores suffered from tuberculosis. This is a Not Given trap.
Key Vocabulary:
- sedative = medicine that helps you sleep
- pregnancy = the period when a woman is carrying a baby
Question Focus: Detail question - asks why dangers continue despite patient illiteracy and irresponsible doctors
Correct Answer: C
Passage Reference: Greed also comes into play. Although only two companies are authorized to produce the drug in Brazil, several underground laboratories reportedly sell it to people without a prescription. Health authorities shut down on illicit operation last year, after a TV-news crew showed how easy it was to buy the pills.
Why this is correct: The answer is Thalidomide pills can be obtained through illegal channels because the passage clearly says underground laboratories reportedly sell it to people without a prescription.
Paraphrasing: Passage: 'sell it to people without a prescription' = Option: 'obtained through illegal channels'
Tips: When a question asks for reasons, look for cause words like 'because', 'also comes into play', or examples that explain why something happens.
Why the other options are wrong:
- A: Students may choose Prescriptions are needed to buy the drug because the passage mentions authorized companies. However, the passage says the opposite happens illegally. This is a contradiction trap.
- B: Students may pick The number of victims is limited because the passage gives specific numbers. However, the passage never says the problem is small or limited. This is a Not Given trap.
Key Vocabulary:
- underground = illegal and secret
- authorized = officially allowed
Question Focus: Main idea question - asks for the overall message of the passage
Correct Answer: C
Passage Reference: But while the word thalidomide became synonymous with tragedy and its use as a sleeping pill was banned, the drug did not disappear. In fact, it has benefits that have made it an increasingly valuable medicine when used carefully. Misuse, however, has caused a grim side-effect: the reappearance of 'thalidomide babies.'
Why this is correct: The answer is Three decades after maiming thousands of children, the drug is increasingly useful - but perilous as ever because the passage balances two ideas: thalidomide is valuable and useful, but still dangerous if misused.
Paraphrasing: Passage: 'increasingly valuable medicine' and 'grim side-effect' = Option: 'increasingly useful - but perilous as ever'
Tips: For main idea questions, do not focus on one paragraph. Look for an option that covers the whole passage from beginning to end.
Why the other options are wrong:
- A: Students may choose this because leprosy treatment is discussed in detail. However, the passage is not mainly about replacing thalidomide. This is a partial truth trap.
- B: Students may pick this because regulation is mentioned at the end. However, this is only one conclusion, not the whole passage. This is a wrong section trap.
- D: Students may choose this because the passage explains how thalidomide works. However, explaining the mechanism is not the main focus. This is a context shift trap.
- E: Students may pick this because victims and governments are mentioned. However, the passage does not say victims were silent, and this overstates the cause. This is a partial truth trap.
Key Vocabulary:
- perilous = dangerous
- misuse = use in the wrong way
General Tips:
- MCQ questions follow passage order, so the answer to question 1 appears before the answer to question 2.
- For main idea questions, choose the option that includes both sides of the argument, not just one detail.
- Ignore real-world knowledge. Only choose answers clearly supported by the passage.
- When many options seem true, eliminate those that are only true in one paragraph.
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