sick of meds

In the year 2000, a study from Johns Hopkins estimated 225,000 people (minimum), died of iatrogenic causes in US hospitals. That is, the deaths were caused by the healer. The third leading cause of death nationwide. The deaths broke down as follows:

• 7,000 - medication errors in hospitals
• 12,000 - unnecessary surgery
• 20,000 - other errors in hospitals
• 80,000 - infections in hospitals
• 106,000 - non-error, negative effects of drugs

(Source: Dr. Barbara Starfield of Johns Hopkins School of Hygiene and Public Health, Journal of the American Medical Association, July 2000)

I have a lot of contact with doctors and nurses (I work with them daily on their English to prepare them to work and study abroad.), so I know that they are human, and under stress, and that the system is never perfect, and so accidents will happen. So at first blush I see nothing insidious with the medication errors, other errors, and infections. Unfortunate though they are, and worthy of every effort to be reduced, well, we all make mistakes.

Unnecessary surgery however, strikes me as different. Surgery is invasiveness in the extreme and should be a last resort. That 12,000 people died as a result of surgeries which were unnecessary in the first place is shocking to me. How many were merely maimed, disabled, traumatized, or caused to suffer - along with family and loved ones? Why push for surgery? My guess: money. Here in Thailand, companies providing prosthetic joints and implants have teams of talented people competing to win over surgeons to their product lines. Inducements include significant pocket money on every unit used, pampered treatment and perks, getting docs laid, holiday seminars at desirable locations, visibility and status.

This leads to the biggest number on the list: 106,000 - non-error, negative effects of drugs. These are non-error deaths caused by medication. The doctor prescribed the proper medication according to present accepted guidelines. The nurses administered the medications according to present accepted guidelines. The patients complied. Non-error. No mistake. 106,000 (minimum) dead per year. Look like something is wrong with our present accepted guidelines? It does to me. My guess: pharmaceutical money.

Here in Thailand big pharmaceutical companies regularly treat doctors and their families to vacation/seminars in Europe, America, or 5-star Thai beach resorts. The more the pharmCo likes you, the better the perk. But all doctors get the perks. All doctors. It's standard operating procedure. Entire hospitals can even be 'branded' to a 'family' of meds, receiving in return both individual and hospital-level kickbacks. Shifting to a cheaper, better, safer brand - or even using less can become socially impossible. These are the same pharm companies at work drumming up business in the US.

Oh, and here's a link to a Mind Hacks article about hot chicks selling pharmaceuticals.

But don't worry. America has the FDA to protect them with safe meds and guidelines, right? Sorry my son but you're too late in asking, Mr GalaxoSmithKline's pharm train done hauled it away.

Ike was right

I've just re-read Eisenhower's parting words as President. Wow. America could use a leader like that again. I highly recommend reading the whole speech.

You can find it here.

Some excerpts:

Crises there will continue to be. In meeting them, whether foreign or domestic, great or small, there is a recurring temptation to feel that some spectacular and costly action could become the miraculous solution to all current difficulties. A huge increase in newer elements of our defense; development of unrealistic programs to cure every ill in agriculture; a dramatic expansion in basic and applied research -- these and many other possibilities, each possibly promising in itself, may be suggested as the only way to the road we wish to travel.

But each proposal must be weighed in the light of a broader consideration: the need to maintain balance in and among national programs -- balance between the private and the public economy, balance between cost and hoped for advantage -- balance between the clearly necessary and the comfortably desirable; balance between our essential requirements as a nation and the duties imposed by the nation upon the individual; balance between actions of the moment and the national welfare of the future. Good judgment seeks balance and progress; lack of it eventually finds imbalance and frustration.

and,

Another factor in maintaining balance involves the element of time. As we peer into society's future, we -- you and I, and our government -- must avoid the impulse to live only for today, plundering, for our own ease and convenience, the precious resources of tomorrow. We cannot mortgage the material assets of our grandchildren without risking the loss also of their political and spiritual heritage. We want democracy to survive for all generations to come, not to become the insolvent phantom of tomorrow.

and,

Down the long lane of the history yet to be written America knows that this world of ours, ever growing smaller, must avoid becoming a community of dreadful fear and hate, and be instead, a proud confederation of mutual trust and respect.

Such a confederation must be one of equals. The weakest must come to the conference table with the same confidence as do we, protected as we are by our moral, economic, and military strength. That table, though scarred by many past frustrations, cannot be abandoned for the certain agony of the battlefield.

Disarmament, with mutual honor and confidence, is a continuing imperative.

and finally,

To all the peoples of the world, I once more give expression to America's prayerful and continuing aspiration:

We pray that peoples of all faiths, all races, all nations, may have their great human needs satisfied; that those now denied opportunity shall come to enjoy it to the full; that all who yearn for freedom may experience its spiritual blessings; that those who have freedom will understand, also, its heavy responsibilities; that all who are insensitive to the needs of others will learn charity; that the scourges of poverty, disease and ignorance will be made to disappear from the earth, and that, in the goodness of time, all peoples will come to live together in a peace guaranteed by the binding force of mutual respect and love.

We have indeed fallen from a great height.

BBC, Iraq, and me

I just finished watching the March 15 show of BBC's Question Time, where a high powered panel and intelligent and diverse audience members discussed the Iraq situation for one hour. My impressions:

• How that level of discourse (in terms of time, level of participants, intelligence of discussion) just doesn't happen on American TV.
• How intelligent and mature the audience members members seemed to be. Though many different views were represented, it remained civil.
• The same impression I have whenever I see or read something from John Bolton. The man is an evil turd. And I type that in a calm, civil tone.
  
• That what I feel is a key point was only mentioned briefly, and not directly addressed. That point being that the US was instrumental in bringing Sadaam to power, keeping him in power, encouraging and supporting his war with Iran, and deafening in it's silence when he was gassing various enemies. It's ludicrous to assume that suddenly we are acting from the moral high-ground. We couldn't be trusted then, so we shouldn't be trusted now.
  
• That no one mentioned the wanton destruction of all of the ministries. I mean, if Iraqi self governance and stability was a goal, that's a pretty dumb thing to do. However, if instability is your goal, it's a pretty effective action.
• That no one mentioned the (4 or 5 I think) huge permanent bases, and largest embassy on planet Earth. But, the turd Bolton slimily spouted that no one wants the troops there any longer than is absolutely necessary. When the Iraqi's stand up...blah blah blah.
• That it was said that soon Iraqis would create laws allowing them for the first time to share in the wealth of Iraqi oil. That struck me as rather odd. Isn't that like saying that you can share in your bank account? If it's their oil, it's their oil, all of it, and it's their decision as whether to share it with others or not.
• Several spoke, in a frightening way (to me), that when the UN doesn't go our way, with countries like Russia, France, and China jamming up the Security Council, that it's something like a moral imperative to act to stop evil. As when China invaded Tibet, or as they could invade Taiwan? As when Sadaam invaded Kuwait which he blamed for stealing Iraqi oil via slant drilling? As with Russia attacking Afghanistan? Are we now saying that those are all reasonable, morally justified actions? If not, why not?
• Thank goodness for the internet, that I can access such info.
  

Thai style

(I wrote this a few years ago as a way to introduce American host families to two high school Thai exchange students. My students. I know the kids and the families well. - Years ago, when I first came to Thailand, I said, Thailand has a lot to teach the world. I still stand behind those words. So here are some of those ideas, which I wrote to help my Thai students have a smooth reception in the land of America.)

Thais are cool, and think that life should be enjoyed. Enjoyed properly – in a sweet, smooth, innocent and fresh way.

Thais intuit very well what is right and wrong
and they care about that.

They care about right and wrong.

They care about their own actions being right or wrong.

Love and commitment to their parents is absolute.

The Thai family is a rock.
A beautiful rock.

Respect for elders and teachers is automatic – and for the most part genuine.

Elder and parental advise is truly taken to heart. (Advise carefully. Talk from the heart, a Thai kid will hear.)

Thais understand goodness quite well (check me on this, please) and aggression, for them, is almost always negative - even when they show aggression themselves.

Seriousness is considered negative, as it lacks softness and joy.

Thais aren’t interested in changing another’s idea.
Other’s ideas and actions are the responsibility of the others.
Other ideas aren’t a threat.

Thais like to share the moments of life with other people. Being alone is usually a bummer. Open kindness is easy for Thais, as is forgiveness and laughter.

They are very comfortable in the now-moment. And uncomfortable out of it.

Jokes are expected. Fun is always welcome, and considered valuable and important.

Thais want to be awake with loved ones and friends, properly enjoying the now-moment, laughing and smiling, even through the difficult times. That’s the good life.

Thai physics

I drive down the little lane on my little motorbike. A dog lying in the road gets up and looks at me in a bad way. I sputter onwards. An old woman carrying a heavy load emerges from a sidestreet – like she didn’t even see me coming, or like she didn’t even care. I hit the brakes. I notice my sour mood getting more sour. A cute little girl in her little school uniform looks at me like I’m dangerous.

I stop.
I put both feet on the ground.

I say to myself.
Go with joy, or don’t go at all.

I breathe deeply.
It takes a while.

I feel joy return.

I feel joy return.
To my mind.
To my body.
I feel it shine in me.

I sputter onwards.
The dogs in the road part to let me pass.
Children smile.
Lights turn green.

Another Thai lesson.

How corporations kill

What makes a corporation evil?

I think that really is the question that cracks it all open. Let's turn it around: Why should corporations be good? Well, it seems that there is no inherent reason for them to 'be good' or 'do what is best for society' whatsoever. None. However if the people who direct the corporation wish to do good, they are at liberty to do so, provided that they do not violate the prime directive: maximize the return for the stockholders. So, no reason to do good, legal mandate to increase profits.

The system used to evaluate profits is blind to environmental and social destruction. So clear-cutting forests makes corporate sense. As does dumping pollution anywhere you can. The world environment and society have no value in the corporate reckoning system, so they simply are not counted. Such atrocities don't make it into the ledger.

Thus, with nothing inclining them towards the good, and absolutely no reason to care about the environment or human welfare, but a clear and legal prime directive pushing them to maximize return, what should we expect? Add to that mix a set of driven, smart, CEO types, who have perhaps convinced themselves that what increases the bottom line is inherently good, and you have a recipe for a very efficient organization whose actions could be massively destructive.

No megalomaniacal evil genius at the helm.

But destruction, exploitation, and all kinds of bad stuff.

These kinds of men built tens of thousands of nuclear warheads. Sleeping soundly in their beds at night.

I remember from my days at Martin Marietta (now Martin Lockheed) a cool, family guy, softball coach, project manager who had a big laser photo (remember those?) framed as the center piece of his office. It showed MX missile warheads returning to Earth through the cloud cover, like a family of falling stars. He was a nice guy, a family man, and he loved that picture. And if they would have been mere meteorites, it would have been beautiful. But it wasn't. They were dummy nuclear warheads. He put that picture in front of his desk, so every time he looked up, he saw it. Why? Because his work made those warheads fly so precisely. He was one of the nicest guys I met during my time there. I liked him very much.

He was proud of his work.
I was new enough to be sickened with dread.

Iraq: a two front money scheme

The simple reason that the W company (a front company) sent the American military to shock and awe Iraq is the old story. Old as the hills. Treasure. To steal treasure. Again. From the poor to the rich. Again. Yawn.

But this war has a modern twist. In Roman times money came from the booty of war. But W company isn’t so interested in stealing treasure from the vanquished – Iraqis were rather poor after years of brutal sanctions. And not to steal oil, though that’s a nice side dish. No, one of the great reasons for ‘going in’ was to take money from the US Treasury; to take money from the US treasure and put it into a few carefully positioned pockets. And the time and energy they take to position their pockets is truly amazing. Would that they could channel such intensity towards happy ends, but alas, I digress.

The American army no longer cooks for itself, nor washes its own clothes, nor builds its own camps, nor supplies it’s soldiers with means of calling home. KBR (Kellog, Brown and Root, a Halliburton possession, for newcomers to world events) does that at dectuple the price, thank you very much. See the documentaries Iraq for Sale, or The War Tapes for enough gory details to make you sick. Meals to the troops get billed out at $29, laundry $99 a load, and locally made cola $6 a six-pack. KBR bills by the plate whether there is food on it or not, and by the truck-journey, whether there is anything in it or not. They can even demand that US soldiers protect their investments. Good work if you can get it. And if the vice prez happens to be your former CEO, get it you can. Without even the process of bidding, and all that competition nonsense.

And then of course there’s all the material. The bullets, the humvees, the trucks, the smart bombs, the fuel. War consumes like crazy. Look around. Every company who sells these consumables is a ‘patriotic’ supporter of the war. Their stock is up. Patriotic bumperstickers fill their parking lots. “I support my paycheck the troops”.

A few years ago, via Riverbend blog (a heroic Iraqi), I read about an Iraqi engineering company, in the early, ideological days of the ‘reconstruction’, that bid on the repair of a bridge. They lost. The contract went to a US company, at ten times their bid.

What ended up getting constructed were permanent military bases, and the biggest embassy on the planet – a new, neocon Vatican.

America is in a money fever. Our army is on the other side of the world. The fever has gotten down to our roots.

We’ve started yet another war to pump money into pockets. Looks like over 700,000 Iraqis have died as a result. Don’t talk about them. Kids in Iraq can’t go to school and are growing up in a nightmare scenario. Don’t talk about them. The money is flowing as designed. Americans are getting poorer and working harder just to stay afloat. Don’t talk about them. The money is flowing as designed, from our normal pockets into some rich CEO's, and in the process is massive suffering and death.

The constitution lays out the mechanisms by which we control this beast called government. We have not used those mechanisms. The death toll has been enormous. Our karma.

Instant karma, because make no mistake my friends, this is a two front war: Iraq and America. The people behind W company know that the American people are their greatest threat. The Patriot act was no mistake.

Torture is legal; free speech is not.

Our primary torture base has a cute nickname, gitmo.

A two front war. Both countries are in mortal danger. And the money guys look in the camera and say ‘stay the course’.

This fever is at our cultural roots now. What are we going to do?