What Killed Hugh Hefner?



On September 27 this year, Hugh Hefner “died of natural causes at the Playboy Mansion in Las Angeles,” read the headlines announcing his death. And while that’s true, there’s also a deeper story in play that increasingly involves all of us: Antibiotic Resistance – the bugs are beating our drugs.

The way to understand what happened to Mr. Hefner is to look at his death certificate – excerpted above; in full here – and read the four-step chronology that led to his demise like four dominos that fell:

(1) The problem began when Mr. Hefner contracted a strain of E. COLI that was HIGHLY RESISTANT TO ANTIBIOTICS, which led to

(2) A life-threatening bloodstream infection, SEPTICEMIA, where the blood conveys E. coli to bodily organs which the bugs then attack, which led to

(3) RESPIRATORY FAILURE, where the lungs were attacked and succumbed, compromising their ability to move oxygen, resulting in

(4) CARDIAC ARREST, the “immediate cause” of death.

In other words, what drove Mr. Hefner’s death was an antibiotic-resistant E. coli infection that he contracted, the certificate shows, six days before his death. The fact that this strain of E. coli was “Highly resistant” means they threw every drug they had at it yet it beat them all back – that’s antibiotic resistance in action.

It’s crucial to understand that while Mr. Hefner’s age may have factored into why E. coli proliferated in him in the first place – bypassing his body’s natural defenses – his age had nothing to do with why the many antibiotics they gave him didn’t work: that’s a function of the (biochemical) interaction between the bug and the drug.

Earlier this year the World Health Organization published its first ever list of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health – and E. coli was nowhere to be seen. So as bad as E. coli can be, there’s at least 12 other groups of pathogens out there that are worse (Staph aureus is in the group posing a “High” risk to our health).

There’s one more thing to notice about Mr. Hefner’s death: the only reason we know about the infectious disease component is because California, unlike many states, lists the underlying causes – plural – of a person’s death, i.e., (1) to (3) above. This matters because that’s exactly how infectious disease so often shows its hand – as an initiating factor: but for the infection, there wouldn’t have been a death.

This issue was the focus of a major investigation by Reuters last year, “The Uncounted,” which found that because death certificates are poorly written – asking only for the immediate cause of death – tens of thousands of “superbug” deaths in the U.S. are going uncounted every year.

But that wasn’t the case with Mr. Hefner: His death, like his controversial life, counted.










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