Category: Medical Topics

Ghosts from the Nursery

[Please note: The word “Featured” on the left side above was NOT inserted by this blogger, but apparently was inserted by WordPress, and it cannot be removed. NO post in this blog is sponsored.]

The Book of the Week is “Ghosts from the Nursery, Tracing the Roots of Violence” by Robin Karr-Morse and Meredith S. Wiley, published in 1997. The authors cited scientific studies to support their assertions about the links between the increasingly younger ages at which Americans are committing increasingly more frequent horrific crimes, and the social and cultural trends that are driving this alarming revelation.

At the book’s writing, in the United States, criminal justice system spending was three times (!) the entire healthcare budget. The authors argued that the seeds of criminality in humans are planted in the womb rather than in early childhood, as previously thought.

Environmental factors, such as a future mother’s or father’s consumption or inhalation of toxic substances, alters the reproductive mechanisms in a fetus’ brain cells. If the fetus’ environment is neglectful, chaotic or hostile– people are raucous, or physically abusing the mother-to-be– it stands to reason that the child might have behavioral problems later on. These problems could range from hyperactivity, impulsivity, attention deficits and learning disabilities to criminality.

The range and extent of damage done varies with the time frame in which the abuses occur. It has been found that any amount of alcohol drunk by a potential father or mother can adversely affect: spermatozoa and ova weeks before conception, the zygote, embryo, fetus and then the child’s health thereafter. Maximum visual damage is done to the brain of a fetus, when the abuses occur during the limited time, for instance, in which the neural connection from the retina to the visual cortex is made. Language skills develop or fail to develop, similarly.

The opposite is true, too: a nurturing environment will maximize benefits for the child (even in the womb!) when parents’ soothing or happy voices are heard by the fetus during his or her audiological development. After emergence from the womb, the baby can recognize his or her mother’s, father’s or others’ voices. Preverbal memory (an emotional vibe emitted by parents and others– a mood felt by the fetus and then infant and then child) stays with everyone through their entire lives. Parents have been shown to display the same behaviors their parents did with their own babies and children.

The authors mentioned several European studies that showed the incidences of juvenile criminality and suicide increased with an increase in unwanted pregnancies. That’s obviously a can of worms. But, since reams and reams of data have been collected from decades and decades of sociological, psychological, medical and legal studies worldwide, perhaps a multi-pronged approach applied locally would help– instead of commissioning more, additional expensive studies for the purposes of procrastination and patronage.

HOWEVER, one particularly rich vein of data on how to invite failure of the multi-pronged approach at the federal level of poverty-fighting (and on a related topic, crime-prevention), can be found in the administration archives of the late president Lyndon B. Johnson. A 20/20 hindsight look at the enduring actions he did take, are unfairly omitted from the history books that show an anti-liberal bias. His administration saw the start of Medicare and Medicaid and the passing of landmark civil rights legislation. BUT, these great accomplishments were overshadowed by conspiracy theories that he plotted the assassination of JFK and of course, his role in a needless war.

Johnson had grand plans to eliminate poverty at home, but shortly after he came to power, he decided to send Americans abroad to fight a war that led to countless deaths and ruined lives. And continued to rationalize why it needed to continue. Johnson’s anti-poverty programs weren’t given sufficient time to succeed because they became starved for funds.

That is why this country has regressed on the social-programs front: Every American president has sold his soul to the MILITARY [Currently, that military is fighting a war at the Mexican border instead of overseas; a future post of this blog will elaborate on this].

The only president fully justified in diverting significant taxpayer monies from improving conditions at home, toward fighting a war, was FDR. Since WWII, alpha males with hubris syndrome have been funding military actions whose long-term costs outweigh the benefits.

As a final insult that indicated that Johnson had major control issues, was the fact that he cruelly teased his own Democratic party by withdrawing from a 1968 reelection bid at the last minute, leaving the field to a few other candidates, and uncertainty in his wake. He also gave his political opponents a golden invitation to smear him in so many ways.

Granted, there are countless other vicissitudes of history that come into play with any president’s actions, but as is well known, campaign-finance regulation in America has become horribly eviscerated in recent decades, so the increase in financial influence of special-interest groups other than the military, has also played a role in this nation’s shifting priorities.

Be that as it may, the United States’ practices fly in the face of reason by bringing in a “pound of cure” (after the fact!) via a complicated, expensive bunch of bloated, bureaucratic government services (special-education, welfare, foster care, criminal justice, etc.). Instead of an “ounce of prevention.” One specific program has been found to be the most effective solution thus far in preventing crime in the long run: infant home-visitation programs, because the problems are dealt with early! This was the conclusion of a criminology team who submitted a report to the U.S. Congress in April 1997.

Clearly, different levels of government can implement more of a combination of social programs and legislation in order of what works best pursuant to all those scientific studies (preferably longitudinal ones), regardless of costs, limited by whatever the budget will reasonably bear; instead of going the easy, greedy, or power-hungry, politically expedient (and fraught military) route.

A grass-roots movement would have to hold officials’ feet to the fire on that– perhaps appealing to their egos by giving them a legacy via a footnote in the history books crediting them for getting it done. This, while keeping political patronage to a minimum (It used to be called “honest graft” but has reached excessive levels in certain regions; time will tell whether upcoming elections oust the “Tammany Hall/Boss Tweed” contingents.).

So, for instance, a hypothetical mandate for a large, diversely-populated city might consist of:

First, an infant home-visitation program;

Second, no-charge universal pre-kindergarten program;

Third, stricter background checks and bans on specific firearms and loophole-closing;

Fourth, a community-policing program (that does not involve military hardware) like those mentioned in this blog’s posts, “L.A. Justice” and “Riverkeepers”; and

Fifth, imposing and enforcing a legal maximum to class sizes in early-childhood education.

If additional funding is found (for whatever reasons), there could be other kinds of education programs that deal with issues such as: teen pregnancy, sex education, contraception, substance abuse prevention (all possibly as a part of the high school health-class curriculum), parenting classes, family planning, welfare-to-work, at-risk youth centers, and job training– again, prioritized from the most to the least effective outcomes.

Anyway, read the book to learn much more about research results on this topic, and the authors’ suggestions on crime prevention via focusing on ways to improve outcomes in connection with pregnancy and child care.

A Storm Too Soon – BONUS POST

[Please note: The word “Featured” on the left side above was NOT inserted by this blogger, but apparently was inserted by WordPress, and it cannot be removed. NO post in this blog is sponsored.]

The Bonus Book of the Week is “A Storm Too Soon, A True Story of Disaster, Survival, and an Incredible Rescue” by Michael J. Touglas, published in 2013.

This suspenseful story recounted the abbreviated May 2007 voyage of three Darwin-Award candidates who began to sail from the northern coast of Florida across the Atlantic Ocean to Gibraltar. Hazards included, among others– sudden, unexpected storms, spilled contents of container ships and inaccurate maps (due to recently washed-away sandbars).

“Every screw, rivet, line, seam, porthole, and the rest of what makes up a sailboat has to hold under the assault of the seas.” Unfortunately, the entire contents of the captain and crew’s 55-foot sailboat had a difficult time staying afloat, when an unseasonable squall broke a window that immediately let in 80-foot-high waves and 80-knot wind gusts. Miraculously, the life raft stayed intact. However, the various tools they had for sending distress signals to the Coast Guard were less than ideal, for different reasons.

Predictably, the three men were at high risk for drowning, harm from sharks, dehydration and hypothermia. In a case like this, rescuers who approach them via C-130 plane and helicopter, risk their lives in numerous ways. First, the plane searches an area equivalent to the needle-in-a-haystack cliche.

Read the book to learn many more details, and the fate of the participants in the above story.

The Nation Got Run Over – BONUS POST

[Please note: The word “Featured” on the left side above was NOT inserted by this blogger, but apparently was inserted by WordPress, and it cannot be removed. NO post in this blog is sponsored.]

THE NATION GOT RUN OVER BY A PLAGUE HERE

sung to the tune of “Grandma Got Run Over By A Reindeer” with apologies to Randy Brooks, Elmo (and Patsy) Trigg, and whichever other rights holders this may concern.

The nation got run over by a plague here
from years of White House gyrations election eve.
You can say political donors play Santa
and voters have no CLUE what to believe.

Some are drinking too much Kool-Aid
and others abuse their power so.
Still others scream for medication.
The hostility of some has reached a new low.

When they confined us in 2020,
they began a dangerous age.
We resented the intrusion,
and our State is such
we have yet to turn the page.

The nation got run over by a plague here
from years of White House gyrations election eve.
You can say political donors play Santa
and voters have no CLUE what to believe.

It’s less than A year until midterms.
Our leaders’ messaging’s a joke.
See no masks on players of football
while tests and shots are FORCED on powerless folk.

It’s not nice to fool the people.
All the nation’s mad as hell,
and we just can’t help but wonder,
how much more must we endure before we’re well?

The nation got run over by a plague here
from years of White House gyrations election eve.
You can say political donors play Santa
and voters have no CLUE what to believe.

Soon the voters get to DEcide
whose heads are going to roll.
All those blue and red state mandates
are going to change pursuant to every political poll.

I urge all my fellow Americans:
you need to follow politics and vote.
The government has taken license
to curb our freedoms
and make their enemies the scapegoat.

The nation got run over by a plague here
from years of White House gyrations election eve.
You can say political donors play Santa
and voters have no CLUE what to believe.

The nation got run over by a plague here
from years of White House gyrations election eve.
You can say political donors play Santa
and voters have no CLUE what to believe.

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.

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.