Uranium

The Book of the Week is “Uranium, War, Energy, and the Rock That Shaped the World” by Tom Zoellner, published in 2009.

Now, as is well known, one element crucial for making an atomic bomb via the least difficult method, is uranium. It is radioactive– carcinogenic to humans. Without human intervention, an entire sample of it takes billions of years (yes, really, depending on the isotope) to break down into one substance after another, including thirteen heavy metals; ultimately lead.

In the early 1940’s, “The United States military moved quickly to squelch all news of radioactivity. There were worries in the Pentagon that the bomb would be compared to German mustard gas in WWI or other types of wartime atrocities.” Radiation sickness and cancer killed an estimated thirty thousand people in addition to the seventy thousand who perished instantly by the atomic bomb at Hiroshima in August 1945.

In the late 1940’s, radium– an element that helps make a nuclear weapon– was found to be harmful to humans. The (federal) Atomic Energy Commission gave regulatory responsibilities of health and safety to state agencies in Colorado, Arizona and Utah, making the excuse that private mining businesses were outside its jurisdiction. Of course, the states were understaffed and underfunded in regulating radium.

Nevertheless, the radium rush became a government-directed priority because it was a matter of national security. By the 1960’s, the greed was petering out, and Navajo country (in northern Arizona, and small regions of Utah and New Mexico) was a cancer cluster comprised of an eyesore of about thirteen hundred abandoned mines laid waste with radon gas. That was one aspect of the nuclear age. Another was that building fallout-shelters became trendy. The Kennedy family built one at their estate in Palm Beach, Florida.

In the mid-1950’s the “Atoms For Peace” program begun by president Dwight Eisenhower supplied nuclear reactors to Bangladesh, Algeria, Colombia, Jamaica, Ghana, Peru, Syria, Pakistan, Turkey, and Belgian Congo for the purpose of deterring the said countries’ enemies from using nuclear weapons against them.

In 1988, the United States supplied Iran with a five megawatt research reactor; China supplied uranium ore, and South Africa, a block of uranium and some plutonium. The Pakistani A.Q. Khan was hired as a scientific consultant.

Since 1993, the Atomic Energy Commission was supposed to have recorded incidents in which different forms of uranium (raw ore, yellowcake, hexafluoride, metal oxide, ceramic pellets, and fuel rod assemblies) have gone missing. Incident reportage works on the honor system. Unsurprisingly, the system hasn’t worked because the substance has a very complex, global black-market. Even so, the biggest hurdle to building a nuclear weapon is obtaining uranium in its highly enriched form. Then one must employ people with weapons-design and explosives expertise. Hiding the project (which in part, can be accomplished via a lead sleeve on the finished product– that would fool a radiation detector) might pose additional difficulties. It would cost a total of a few million (U.S.) dollars besides.

In the single-digit 2000’s, the author personally visited the country of Niger to see a uranium town for himself; a life-threatening trip. For, bandits or terrorists (likely of the Tuareg tribe who believe uranium mining has fostered inequality that adversely affects them economically, tribally and health-wise) appeared in front of his bus en route (a not uncommon occurrence). The bus driver was wise to the situation and drove away from the scene to a rural village with electricity, thanks to a nearby French power plant. The two main exports of Niger are uranium and onions. But the nation is still largely agricultural.

Read the book to learn much more about uranium in connection with: its sourcing in Australia, U.S. strategic interests in Soviet Georgia, Yemen’s goals, a Sierra Club legal fight, Vancouver’s ill-gotten gains, etc.

Betrayers of the Truth

The Book of the Week is “Betrayers of the Truth– Fraud and Deceit in the Halls of Science” by William Broad & Nicholas Wade, published in 1982.

Scientists have always emphasized that their ilk are “a rational, self-correcting, self-policing community of scholars.” They consider themselves to be superior because they believe their field of work is more “factual” and requires more education than other kinds of work. Yet even they behave in unethical ways– likely in the same proportion as the population at large– because they too, possess the unattractive traits of human nature.

The authors remarked that even some of the most famous scientists in history (such as Ptolemy, Galileo and Netwon to name just three) have fudged data, plagiarized, or lied about performing experiments they didn’t actually perform. The scientists wanted the data to fit their theories; they were lazy, greedy or glory-seeking, or a combination of those.

The authors lamented that the scientific community’s culture encouraged an atmosphere in which fraud could be perpetrated and perpetuated easily, and not be discovered for decades. In fact, the authors provided numerous, specific examples in which fraud flourished.

The reason scandals of misrepresentation in science are so dangerous is that they have a ripple effect on so many other areas of life– testing of food and drugs, matters of class and race, immigration, and education– to name a few.

At the book’s writing, publishing articles about their new discoveries in professional journals was the major way scientists furthered their careers. There was an avalanche of publications. The obscure publications had a decided lack of fact-checking of article-contents.

In 1962, and again in 1973, researchers sought to test honesty in the community. The results were less than stellar. “Fewer than one in four scientists were willing to provide raw data on request, without self-serving conditions, and nearly half of the studies analyzed had gross errors in their statistics alone.”

As is well known, science in academia has a hierarchical structure. The elitism feeds on itself. Big-name scientists at prestigious universities are necessarily trusted more for integrity than nobodies are, so their articles and grant applications are less carefully vetted, and they therefore get more prizes, editorships, and lectureships. Their reputations as “experts” become even more widespread.

However, history is rife with stories of nobodies who fought fiercely for recognition because they knew their methods or theories were superior. And often late in their careers, or posthumously, their contributions were recognized. Such greats included, but were certainly not limited to: George Ohm, Gregor Mendel, Alfred Wegener and Sister Kenny.

Sadly, it seems as though, now more than ever, many “science” shows on once-reputable cable-TV channels purport to educate viewers, but at best, convey trivia put out by profiteers, propagandists and attention whores.

Another indication of ignorance of science was highlighted during the coronavirus pandemic in America. Government at all levels ordered masking of all individuals while its propaganda machine squelched the fact that:

covering one’s face with non-sterile fabric and breathing in one’s own toxic exhalations more likely propagates illness rather than minimizes the spread of it!

According to NIH News, “Your mouth is home to about 700 species of germs, like bacteria, fungus, and more.”

Read the book to learn a wealth of additional details on how the scientific community takes care of its own, and other reasons dishonesty in science is actually more prevalent than it appears to be.

Appointment at the Ends of the World

The Book of the Week is “Appointment at the Ends of the World, Memoirs of A Wildlife Veterinarian” by William B. Karesh, published in 1999.

The American author traveled to exotic locales to participate in conservation projects for the Wildlife Conservation Society and other international aid organizations, which manage and study animals and their habitats and resources in tens of countries. He got special permission from governments to bring a vast quantity of supplies and equipment to jungles, savannas, forests, etc.

The author spent part of the year at the Bronx Zoo. In 1995, he flew to northeastern Zaire to treat an infection in one okapi, and was driven hours to enter a safari park to study white rhinos. His luggage weighed 220 pounds. It was full of sampling supplies (tubes, racks, pipettes, towels, etc.), drugs for the animals, immobilization / capture equipment (like oxygen and carbon dioxide tanks, cartridges and numerous accessories), animal-handling and marking equipment (clips, cards, etc.), books, cords, converters and other miscellaneous items, and camping gear. Not to mention, clothing.

In Bolivia, the author performed various tests to measure the amount of environmental contaminants in the bodies of wild caimans because they live thirty to forty years. Examining the reptiles at intervals can indicate changes in their aquatic habitats.

In Cameroon, the author encountered shenanigans. For, he had to hire local guides; the leader (a native Nigerian) was fluent in the English language, and allegedly skilled at finding forest-elephants. The leader led the group on a “wild-goose chase” for weeks. When the group finally got close enough to one animal at which to shoot a radio-transmitter dart and a tranquilizer-dart, the leader missed twice shooting the former dart. The adrenaline was pumping in the people too, because the territorial elephants can crush humans to death.

The author conceded that he was doing an extremely controversial job. He and his employers threw vast amounts of resources at animals to save their lives or help them survive. He behaved like a Darwin-award candidate at times, and at other times, ironically, over the long run– made conditions worse for his charges. Ecotourism, too, whose goal is profiteering (rather than sincere concern for endangered species)– has taken its toll on disrupting animal habitats.

The phrase “white savior complex” could now be applied to the way wealthy people condescendingly think that saving a few individuals will solve the extremely complex problems of survival faced by all of the earth’s organisms. It is fair to say that in recent decades, money has actually corrupted global efforts to save lots of them.

To boot, the decades wasted searching for aliens and Bigfoot have just muddied the waters more. Incidentally, as is well known, on the TV show Star Trek, the aliens always speak perfect American English. Lastly, people who bother animals to get attention are still a “thing” on the idiot box, despite Steve Irwin’s cautionary tale. Anyway, read the book to learn a wealth of additional details on the author’s career, and how it shaped his lifestyle.

Surviving the Extremes – BONUS POST

The Bonus Book of the Week is “Surviving the Extremes, A Doctor’s Journey to the Limits of Human Endurance” by Kenneth Kamler, M.D., published in 2004.

The author, a medical doctor, described people’s experiences: in the Amazon jungle, while deep-sea diving, on Mount Everest, in the desert, on the high seas, and in a spaceship. The adventurers were subjected to life-threatening conditions at every turn (by choice— they were Darwin award candidates), but possessed expertise and technology that bettered their chances of survival. Their local-area employees possessed the physical characteristics advantageous for survival because those employees had become adapted to the harsh conditions over the course of generations. Some people did die, though. However, the author failed to specify the time-frames of the above scenarios. The introduction of new technologies, and discoveries have probably prevented or mitigated some of those kinds of disasters, since the book’s writing.

One point the author made, concerns the relationship between the human brain and society. A society can regress when an influential leader in a position of power breaks a taboo. His followers will copy him and rationalize away the sin. It then becomes easier to break additional taboos. Eventually, fairness and morality go out the window, because human brains actually adopt a more primitive way of thinking.

The cerebral cortex of the brain guides the ethics of behavior, but the amygdala takes over when tempers flare, and impulse control decreases. If the amygdalas of a significant portion of the population are activated via vicious political rumors, such as:

  • Biden’s going to pack the U.S. Supreme Court!
  • Medicare’s going to be privatized!
  • Biden’s senile and Harris is going to take over the country!
  • The Republicans are going to win back the House in the 2022 midterm elections!

the nation’s behavior regresses. Enough said.

Anyway, read the book to learn a lot about the roles physiology, biochemical processes, psychology and man-made resources play in survival when humans are present in places that tax their limitations.

The Making of A Woman Surgeon

The Book of the Week is “The Making of A Woman Surgeon” by Elizabeth Morgan, M.D., published in 1980. Her story told how times have changed.

“Female applicants [to Harvard Medical School in 1966] were regarded as either abnormal or silly.” So the author ended up attending Yale Medical School, where there were only seven females in a class of 97 students.

A sterile floor-length gown was required to be worn over one’s street clothes when one entered the surgical intensive care unit. It was a joke because it didn’t prevent infection. Another joke was that the water used by medical personnel in scrubbing up, wasn’t sterile. Besides, their arms’ hair follicles contained bacteria that rose to the surface of the scrub.

In 1972, after surviving all the sexism in addition to the abusive, hierarchical training system to that point, Morgan worked in a veterans hospital, serving the Vietnam war-wounded. She wrote about the tenor of the times, “These were federally subsidized cigarettes sold at cut-rate prices, tax-free, in unlimited quantities to all V.A. patients.”

In May 1973, the author began writing a medical column for Cosmopolitan magazine. The monthly snippet was only 150 to 200 words, but she spent eight to ten hours writing every single one after fact-gathering from a minimum of five sources, and fact-checking, in the library. Then an editor would clarify her facts, if necessary.

Unfortunately, human nature doesn’t change. In the mid-1970’s, Morgan worked alongside a surgeon who made about a million dollars a year performing unnecessary surgeries. His strong suit was that he could boast that no patient ever sued him. Since his patients were in relatively good health prior to surgery, they recovered uneventfully. Clearly, patients who need surgery, are much more likely to have complications afterward, and are much more likely to have worse outcomes. Problems can crop up that are not the surgeon’s fault.

The author specialized in plastic surgery, which includes reconstructive and cosmetic. She preferred to do the former, to help women feel better about themselves, many of whom had had breast-cancer surgery. When she struck out on her own in private practice, there were lots of patients to choose from.

For, there were still plenty of overzealous male breast-cancer surgeons who truly believed that performing aggressive mastectomies was going to cure their patients. Many of those women were traumatized by the assault on their femininity. And they eventually died, anyway.

Read the book to learn of the various personalities of doctors and patients Morgan encountered during her medical training, and the nature of the training in her specialty in her generation.

Do No Harm / Since Yesterday – BONUS POST

The first Bonus Book of the Week is “Do No Harm, Stories of Life, Death, and Brain Surgery” by Henry Marsh, originally published in 2014. In this personal account, the author– a British brain surgeon– described his horribly depressing career. He recounted how he removed brain tumors from, and clipped aneurysms of, his most memorable patients through the decades. Even when a tumor was benign, it would keep growing and inevitably kill the patient unless taken out. Even when a large aneurysm had yet to burst, there was a chance (incalculable, as every patient is different) that it would burst in the patient’s lifetime.

Metaphorically speaking, some people would say that the outgoing president of the United States is a tumor in the nation’s brain. The author wrote, “You can never know for certain from a brain scan exactly how a tumor will behave until you start to remove it. It might be hard or soft, dry or bloody…” Prior to diagnosis, the most common symptom patients experience is headaches– which are uncharacteristic for them in daily life.

In order for a brain surgeon to acquire experience, he needs to actually practice on real patients, and make mistakes. Even when the surgeon does everything right in treating the patient, something could go wrong, anyway. In addition to stressing over his patients, the author had to deal with bureaucracies. But regardless of the healthcare system an industrialized country has (government-run, commercial, or a combination thereof), it’s comprised of: “… government targets, self-serving politicians, tabloid headlines, scandals, deadlines, civil servants, clinical cock-ups, financial crises, patient press-groups, trade unions, litigation, complaints and self-important doctors…”

Read the book to learn of the author’s trials and tribulations in treating patients not only in Britain, but also in Kiev.

The second Bonus Book of the Week is “Since Yesterday, The 1930’s in America, September 3, 1929 – September 3, 1939” by Frederick Lewis Allen, originally published in 1939.

“To hear angry Republicans and angry Democrats talking, one would have supposed the contest was between a tyrant determined to destroy private property, ambition, the Constitution, democracy, and civilization itself; and a dupe of Wall Street who would introduce a fascist dictatorship.” Such was the nature of the 1936 presidential election in America.

Clearly, propagandizing hasn’t changed in ninety years. Presidents want to have it both ways: they take credit for all positive economic news, and blame their predecessors for all negative economic news.

At the dawn of the 1930’s when the economy went south, Americans held very strong opinions about their political preferences, heavily influenced by the propaganda they read in newspapers and magazines. Not much has changed, except that now they can force their opinions on the world at the speed of light. Immediately they think they’re experts from watching the idiot box and/or reading the Web; the attitude is, “I’m not an attorney, not a doctor, and not an economist, but I play one on social media, because I can, and because I’m right.”

Other similarities between the Depression Era and recent times include:

  • Golf was a popular businessman’s game.
  • Fans of professional sports worshipped their star players, like in baseball, tennis, and golf– Babe Ruth, Bill Tilden, Bobby Jones, etc.
  • Automation due to new technologies (such as steam, gasoline and electric power, inventions and farm machinery) and urbanization were eliminating jobs in industry, agriculture, and textiles more than offshoring ever would.
  • Listeners worshipped a pundit on the radio– Father Coughlin– a hate-spewing demagogue from the Detroit suburb of Royal Oak (but he broadcast on only one station, not a national network, so he became nationally known only in his later years in the 1930’s).
  • All players in the banking industry were financially interdependent so when the system collapsed, they all fell like dominoes. Then-president Hoover established the Reconstruction Finance Corporation in order to bail out only his corporate cronies, as he didn’t believe in stimulus money for individuals.
  • In summer 1932, Howard Scott and his inscrutable theory of Technocracy was a fad. The author wrote, “Yet in the meantime it had offered an object-lesson in the readiness of the American people for a new messiah and a new credo” just as “Wikinomics” (see the post in this blog) was supposed to be the next big thing.
  • The political agenda behind COVID has forced Americans to relax online similar to the way the Depression brought on: the five-day (rather than six-day) workweek, construction of sports and recreational areas of all kinds, and provision for transportation to get to them.
  • Beginning in late 1936 into 1937, in the Midwestern and Northeastern United States, a bunch of rivers overflowed their banks due to humans’ misuse of land; in the third week of September 1938, 682 people died in an unexpected hurricane that destroyed regions unprepared for flooding, in New England and Mid-Atlantic states.
  • Between 1931 and 1936, there were actually more people leaving the U.S. than coming in, for various reasons, and the U.S. birth rate was slowing.
  • Ultra-rich Americans who refused to face inconvenient facts were the ones who hated FDR when he was elected president.

Proposals distorted in propaganda that played out in the Depression Era, whose outcomes are yet to be seen in recent times, included:

  • In the 1930’s, in order to allow men to keep their dignity, the government put them to work instead of giving them handouts. In their first few years of existence, FDR’s alphabet soup of mostly federal (rather than state or local level) jobs and programs was nonpartisan. However, eventually, the Democrats provided maximum funding as election day approached. On the whole, the financial relief worked well, except in Pennsylvania, where there was gross misuse of funds.
  • FDR’s policies sought to mitigate environmental damage done by people, and prevent future natural disasters with his introduction of the Civilian Conservation Corps, Public Works Administration, and his signing of the Taylor Grazing Act into law. These kinds of measures simply require political backing and money– the sooner a sufficient amount of both are thrown at them, the sooner the problems will be solved!
  • In February 1938, FDR floated a proposal to make seventy years the mandatory retirement age of all federal judges– including U.S. Supreme Court justices– and increase the number of justices from nine to fifteen. That unpopular proposal hurt FDR’s reputation.

In 1935, FDR introduced economic change to the country by instituting the Social Security system, financial assistance only for Americans 65 and older. In 1965, LBJ introduced economic change to the country by instituting the Medicare and Medicaid systems, healthcare funding for only those Americans who are poor and / or 65 and older.

In the future, the United States government might be introducing a better overall system of healthcare funding for all Americans of all ages and income levels (which is obviously much more complex than any system that has ever been created before in this country, so it’s not going to be perfect the first time around). In order to pay for the improved system, the government will likely have to raise taxes on the rich.

Along these lines, economics 101 says a nation’s economy is strongest when it has a healthy, well-educated workforce.

Whether deliberately or not, the political agenda revolving around COVID has rewarded education-software makers by closing schools across the country. So ironically, by allowing the software makers to get richer (because, presumably, their higher taxes will be paying for the improved healthcare-funding system), the software makers are dictating education policy. So in the long run, the nation will have a healthy, poorly educated workforce!

Anyway, read the book to learn much more about the tenor of the times in 1930’s America, culturally, politically and economically.

Pharma

The Book of the Week is “Pharma– Greed, Lies, and the Poisoning of America” by Gerald Posner, published in 2020.

In 2016, the “superbug” Enterobacteriaceae turned out to be resistant to 26 different antibiotics. About half of patients who contract it, die. There are a bunch of other similar bacteria in the world. The author warned that in the future, a bacterial pandemic was on the way, for which there would be no antibiotic cure. Apparently, there can be a viral pandemic, too– one that cannot be treated with antibiotics at all.

For, antibiotics kill only bacteria, if that. Yet, in the United States, for decades, antibiotics have been prescribed to treat (mild!) viral illnesses. That is one major reason that superbugs have become a trend. And there has been an epidemic of diabetes type II. And many other adverse consequences.

Anyway, the author recounted the history of big-name drug companies, which began selling morphine to soldiers during the American Civil War. In the second half of the 1800’s, Pfizer, Squibb, Wyeth, Parke-Davis, Eli Lilly, and Burroughs-Wellcome began mostly as family proprietorships that sold highly addictive, unregulated drugs. Bayer produced heroin in 1898. The twentieth century saw Merck put cocaine in its products; other companies jumped on the cocaine bandwagon.

In 1904, the head of the United States government’s Bureau of Chemistry, Harvey Wiley, was concerned about contaminants in the nation’s food supply. Consumers were being sickened by chemicals that were supposed to retard spoilage or enhance the appeal of foods. They included, but were far from limited to: borax, salicylic acid, formaldehyde, benzoate, copper sulfate and sulfites. Trendy patent medicines were also doing harm to consumers. The word “patent” gave the impression of approval or regulation of some kind, but actually meant nothing.

Through the first third of the twentieth century, the government continued categorizing, monitoring and taxing drugs, but the pharmaceutical companies continued using trade groups and legal strategists to protect their profits. The 1930’s saw the big drug companies start research laboratories. Finally in 1938, the government established the Food and Drug Administration, and began to require extensive product-testing and labeling, and factory inspections. That same year, the Wheeler-Lea Act prohibited false advertising of drugs, except for previously manufactured barbiturates and amphetamines.

After Pearl Harbor was attacked in December 1941, America sought to manufacture penicillin in volume. For, the newly introduced antibiotic would be very helpful to the war wounded. But the drug’s fermentation process required a rare ingredient. In spring 1942, one patient who had friends in high places was cured. That largely used up the penicillin supply in the entire country. Other kinds of antibiotics were produced in the next decade, but their profitability was hampered by the bureaucratic processes of patent applications and FDA approval applications.

In the late 1940’s, Arthur Sackler and his brothers founded a family drug-company dynasty. The author revealed excessive trivia from FBI files on them and other greedy characters whose tentacles pervaded all businesses that could help sell (translation: maximize profits of) the family’s healthcare goods and services. This meant consulting, advertising, publishing, charities, public relations, database services, etc. The parties failed to disclose countless conflicts of interest.

In the early 1950’s, drug companies successfully lobbied the U.S. Patent and Trademark Office to allow drugs with strikingly similar molecular structures to be deemed different so that they could be granted separate patents. A higher number of drugs could then be rushed to market sooner, and make the most money.

In 1952, farmers fed Pfizer’s antibiotics to their animals so that they grew bigger (both Pfizer and the animals). In the mid-1950’s, Pfizer, Lederle, Squibb, Bristol and Upjohn engaged in an illegal tetracycline price-fixing scheme. They reaped hundreds of millions of dollars in earnings. The FDA chief was in Sackler’s back pocket. So when violations came to light, the FTC and FDA gave the offenders a slap on the wrist. However, senator Estes Kefauver was a thorn in their side.

Kefauver led an investigation as to why America’s drug prices were so excessively high when compared with those in other nations. In fighting back, the drug industry smeared Kefauver as a liberal pinko, claiming he had designs on forcing socialized medicine on the United States. The nineteen drugmakers under the gun gave bogus excuses. The real reason is that America’s drug prices and patents are subjected to minimal or no regulation, unlike everywhere else.

In 1956, Americans were told they were stressed, but a wonder drug called “Miltown” would help calm them down. The mild tranquilizer became a best-seller, until it was counterfeited and appeared on the black market, and its adverse side effects gave it bad publicity. Oh, well.

Then in the 1960’s came the culture-changing birth control Pill, and Valium– also called “mother’s little helper” that was marketed as a weight-loss aid. The next game-changer was thalidomide. Kefauver used the worldwide backlash against this drug to push through some drug safety and effectiveness regulation in the United States in 1963. For a change. Even so, in 1972, when the U.S. Supreme Court confirmed certain regulatory powers conferred on the FDA, drugmakers merely sought additional markets for their products on other continents.

In 1976, there was a swine flu epidemic in America. Healthcare companies were reluctant to develop a vaccine for it, fearing an orgy of litigation from victims if any harm was done. So the government unwisely agreed to foot any legal bills. Sure enough, some vaccine recipients developed cases of Guillain Barre syndrome, and neurological complications. The (taxpayer-funded) Justice Department took the hit. Other parties piled on. “The CDC had exploited ‘Washington’s panic’ to ‘increase the size of its empire and multiply its budget.’ “

Moving on, the author told the whole sordid story of the “opioid crisis” in America. In a nutshell: in May 2002, Purdue Pharma, maker and unethical marketer of OxyContin, hired Rudy Giuliani’s firm to defend it against the firestorm from its host of illegal activities. The firm collected a $3 million fee per month. Purdue collected $30 million per week from OxyContin sales. To be fair, Purdue and the Sackler family were the poster-scapegoats of the crisis. Numerous other parties aided and abetted them: other pharmaceutical companies, doctors, FDA bureaucrats, and pain management “experts” and pharmacists. The far-reaching consequences have caused a lot of trouble for society as a whole in the areas of: increased healthcare costs, criminal justice, social services, drug rehabilitation services, lost productivity and earnings, etc.

Read the book to learn an additional wealth of details and the details of wealth of the healthcare industry’s evolution into a hegemonic legal behemoth / excessive profit center, in the form of a series of cautionary tales in various topic areas– drug advertising, blood donations, biotech, epidemics, pharmacy benefit managers– that wrought major good and bad (mostly bad) cultural and regulatory changes (including the Hatch-Waxman Act and the Orphan Drug Act); plus the family battles following the sudden death of Arthur Sackler.

Morphine, Ice Cream, and Tears. (sic) / Chasing My Cure – BONUS POST

The First Bonus Book of the Week is “Morphine, Ice Cream and Tears. (sic) Tales of a City Hospital” by Joseph Sacco, M.D., published in 1989.

The cynical author did his medical internship and residency in New York City in the early 1980’s. He discussed emotional, financial and ethical issues that doctors-in-training encountered in his generation, illustrating his points with real-life cases.

Healthcare workers, not just medical doctors, must of course not only physically, but emotionally contend with the unpleasant sights and smells of a patient’s body fluids. Such fluids frequently end up on their person, unless they choose a specialty that is not so messy. The author remarked that, therefore, a huge number of medical-school students in their third year realize that they would feel most comfortable specializing in radiology. That partly accounts for why nuclear medicine has become so wildly popular in recent decades.

One medical-industry financial issue that has remained largely the same for the last forty years, has been the profit motive. Thus, emergency rooms are still overstaffed with specialists who overtreat patients to maximize profits for themselves and/or their employers, while drug-addicted patients are also selfish: “This patient was too stupid for conscious manipulation but had succeeded to (sic) engage the attention of doctors, nurses, the EMS, the police, his family, and probably a number of others, as well as to spend a good six figures of public money in his care.”

Healthcare is fraught with ethical issues. One is the completion of the death certificate. The author, as an intern, was tasked with such lowly paperwork. He got scolded for improperly filling in the correct words or phrases (there was a list of them) that constituted “acceptable” causes of death. Overworked and sleep-deprived, most interns sought peace more than accuracy, so the primary or secondary cause of death became “cardiopulmonary arrest” repeatedly. This systemic quirk probably put a wrench in death statistics in the United States. Perhaps it has even been manipulated for political purposes. Enough said about that.

During his residency, the author treated female teenage patients for minor ailments. Because he saw so many who were pregnant, of his own volition, he took the opportunity to counsel them about birth control. He felt that the pill was their best option. He “… sent her off with two free packets and a prescription for several months more. Most incredibly, some patients even decided to use them .”

Read the book to learn of the author’s trials and tribulations, and of other ways times have changed for aspiring medical doctors in America.

The second Bonus Book of the Week is “Chasing My Cure, A Doctor’s Race to Turn Hope into Action, A Memoir” by David Fajgenbaum, published in 2019.

The author’s ordeal began in 2010, when he was halfway through medical school. He suffered from a mysterious illness for weeks, with multiple-organ failure, and misguided, incorrect diagnoses of lymphoma, or an infectious or rheumatologic disease. It turned out he had a rare disease whose origins were auto-immune or cancerous.

Later on, through his own actions, he determined the correct categorization. He connected the dots on many fronts, mentioning two traits peculiar to him: when he was a student, his consumption of energy drinks was excessive, and he had inherited a tendency to have an excessive number of blood vessels in various body parts, compared to other people. The former environmental factor, and the latter genetic factor, when they came together, could have played a role in his responding poorly to treatment, and his having to be bombarded with an extremely powerful chemotherapy cocktail approximately every one to two years.

The above are the kinds of factors scientists take into account when attempting to explain why certain patients do better than others with different treatment options. When patients who have a fatal disease are out of options, they aren’t usually as lucky, insightful and resource-rich as Fajgenbaum was. But even he had to overcome numerous obstacles and nearly died on several occasions.

When he initially tried to do research on his fatal ailment, the author was frustrated by scant, old, inaccurate knowledge on it and scattered sources. He likened the medical community’s situation to that of law enforcement prior to 9/11: “..no one talked to one another, no prime database existed, there was no expectation of coordination or data sharing.” Competition for federal funding meant that resources dedicated to all different kinds of medical research varied widely– a matter of money and politics. Even so, this wasn’t due to malicious intent, but merely honest ineptitude– one would hope. Nevertheless, there was a lot of wasted talent, and a lot of misallocated resources (not to mention, unnecessary deaths!).

The above provided an argument for why the author decided to earn an MBA (he had already completed a medical master’s degree) right after graduating medical school, instead of beginning his residency. Acquiring money-oriented, management and leadership knowledge and experience would be more important than practicing medicine. It would allow him to create a medical-research group that he hoped would find a cure for his disease before he died.

Read the book to learn: how the author broke tradition in thinking about the cause of his illness; how that led to his helping to pioneer a medical-treatment trend that will endure in the future; how his actions have led to sooner diagnoses and saved lives (hint– he marshaled resources to consolidate knowledge, and his team found that “… it’s much more efficient to go directly to patients for [blood] samples, just like we do for patient data in the registry study.”); and to learn about other aspects of healthcare in the United States.

ENDNOTE: The above state of affairs provides yet another argument in favor of a national healthcare system for the United States. Free-market economics is fine for business, but healthcare is super-complicated because it also involves matters of life and death. For more information, see the posts: “full circle” (sic)–eleventh paragraph from the top, and “Here at the New Yorker“– fourth paragraph from the bottom, onward. The best healthcare delivery requires the right balance between cooperation and competition among specific parties. This is why training for both war and healthcare delivery utilizes divestiture socialization. Healthcare delivery works best when there is cooperation within a team and among teams, and disease is the enemy. A capitalistic approach to healthcare necessitates an unhealthy level of competition, as Fajgenbaum learned.

Pertinent Post

“P” post.

Present pandemic’s politics produced:

  • propaganda
  • president-promotion
  • provisions-portioning predicaments
  • panic
  • profiteering
  • paranoia
  • patronage pigs
  • pissed, persecuted people
  • poseurs
  • puerile politicians (petty power plays)
  • pained physicians
  • problematic prescriptions
  • pressured paramedics
  • pestered practices
  • poor populations
  • plus, predictably:

POPPYCOCK.

Pink Boots and A Machete

The Book of the Week is “Pink Boots and A Machete, My Journey From NFL Cheerleader to National Geographic Explorer” by Mireya Mayor, published in 2011.

Mayor was born in February 1973 in Miami. While in her early twenties, she discovered her calling– primatologist / zoologist. An inspirational college professor helped her apply for a government grant to study a monkey in Guyana.

Thereafter, she braved infinite life-threatening dangers and primitive and uncomfortable conditions (like poor sanitation, and an extremely limited and at times– disgusting diet, and unbearable heat, to name three) on dozens of expeditions for weeks or months in obscure places to observe various animals in their natural habitats.

In the Congo, there were killer bees. In the jungle in Guyana, there were itinerant miners who were robbers and rapists; piranhas, malarial mosquitoes, tarantulas, vampire bats, ticks, leeches, etc. The author had to sleep in a hammock to avoid poisonous snakes on the ground.

In June 1997 in Madagascar, “Every visit to a village required a rum-soaked meeting with tribal elders that lasted through the night, occasionally for days.” While seeking a specific species of lemur in an animal reserve (that was not exactly a tourist attraction), she was bitten by a small scorpion and swarmed by wasps. Hundreds of cockroaches nestled in her pants legs overnight, shocking her when she went to put them on.

On another occasion in Guyana, she and her crew collected flora and fauna specimens from a mountain on which they camped (on the edge of a cliff, basically) in a “… flimsy sheet of nylon attached to the rock face by a single, six-inch steel pin.”

In Namibia, she was one of eight people who lifted the six-foot, six hundred pound neck of a tranquilized giraffe. The whole animal weighed approximately eighteen hundred pounds. The goal was to herd giraffes into a trailer to help them mate and reproduce.

On another occasion in Madagascar, when a mudslide from a monsoon prevented their hired truck from going any farther, she, another scientist and expensive porters (strong men) had to hike hours and hours with heavy gear, dozens of bags, crates and a generator to a campsite.

Mayor related that on another occasion in the Congo, “I woke up in an unusually good mood, considering it was 5am and I still had the worm [in the foot], the filarial bites, and the infected tick bite… Repeated hot soaks and antibiotic treatments finally banished it [the tick bite].”

Read the book to learn of the new species Mayor co-discovered, how she fared on a reality show, the kinds of issues she dealt with for being female in a male-dominated field, and much more.