Submitted without comment (or context)

An wide-open marketplace of ideas hardly looks attractive when the result is the intellectual ascendancy of Glenn Beck and Rush Limbaugh.

(context here.)

Read this

Alternate Brain on Afghanistan.

Just Read This

Please please please.

Healthcare MY ASS!

The Government should stay out of personal decisions like health care and stick to telling us who we can marry. For a long time, I made the decision to be too poor to afford health care. Man it felt good to not have The Government getting involved in that decision. I want the freedom to break a leg and set the fracture with bailing wire and part of my Rock’em Sock’em Robot set.

First we let The Government run national defense and look where that’s gotten us? We’ve lost eleven world wars and been overrun by the French, Portuguese and Dutchmen. Now the Canadians are right at our border and I saw a Mexican in the parking lot with some sort of whirring blade weapon destroying American weeds.

Good job, U.S. Government.

Next we let them handle public utilities and there is not a single road, the trash has never been picked up and I have to travel over 1500 miles to get a cup of water. The Government can't do anything as well as all of those benevolent multinational corporations who run our banks, our car companies, and our ponzi schemes.

Just the other day I was waiting in line for my new phone at the Verizon Store and thinking, there is no way The Government could pull off this kind of efficiancy. Have you ever picked a health plan from your job? Man, if The Government was involved, it would be so complicated. I don’t want some heartless Government running my healthcare. I want a company that is going to be responsive to my needs, that doesn’t look to cut corners, that won’t interfere with my schedule and will do whatever they can to be there for me, like Delta Airlines for instance.

Most of Western Europe let their governments get involved in health care and look what happened? They are all now dead. Have you ever met a Luxembourger, Lichtensteinian or German? I rest my case.

Do you know what “Dr.” “President” Obama’s favorite movie is? Logan’s Run. Just sayin.

When Orly Taitz and I used her Way Back Machine to visit Obama’s manger in the back yard of Bin Laden’s Kenyan estate, I heard his first words, “When I grow up to be president, I am going to provide national health care as a means to destroy the fabric of our society and cause grand scale live action reenactments of my favorite movies Logan’s Run, Soylint Green, Desperately Seeking Susan and The Rescuers Downunder (he WAS only 45 minutes old). Then I am going to harvest stem cells for school lunch marmalade. Viva La Islam, Comrades!” Next he wrote the first e-mail asking you to send him your bank information and another with a picture of a kitten praying and said if you didn’t forward it to 100 of your closest friends, confused coworkers and distant cousins, he would legalize gay marriage.

Have you read this damned plan? Line 4373? We all have to share ONE TOUNGUE DEPRESSER! Think about THAT when you are filthy 44 millionth to say “ah.”

(cough)

I know Palin has supposedly, finally, turned herself into a complete joke and her political career into mist. So keep laughing (I know I am). Then remember what they said about a certain draft-dodging rehab'ed drunk ex-fratboy who could barely speak English. Or the senile actor before him. There's a bit of a longer list actually, but there's not much point in being bored by it. If there is one truth in American politics, it's that no one is ever too stupid, too venal, or too corrupt to be elected President (and if there's a second, it's that there isn't much rational behavior on the part of the American electorate). If you read it here at all, it might have been here first. Cheers ya'll.

All Swine, No Flu?

You didn’t think that the federal government would come to the dance without a partner, did you? For the past few months, my office has been involved in CDC preparedness for an influenza pandemic. I can’t really get into the details, but given recent developments I thought I’d share some observations and insights about pandemic planning as an FYI with you (both of you who still read this blog that is).

 

Here is the deal: The feds have actually been preparing for a pandemic influenza for a long time. 9/11 obviously kicked things into a fury, and ever since then there has been quite a bit of funding available to the states for all sorts of disaster preparedness activities.

 

Back in about 2004, the feds realized that they needed to get a solid plan in place for vaccine distribution policies that incorporated not only input from expert stakeholders and policymakers, but also from the public, because questions about who gets to be first in line for vaccines are really issues of discussion for all of us, not just the National Vaccine Advisory Committee or Homeland Security. Thus, the feds convened a series of discussions across the country soliciting input from members of the public, stakeholders, experts, and various other policymakers about what federal guidance should be on vaccine allocation prioritization.

 

Although its only federal “guidance” – this form of guidance comes with a big stick, because even though in theory the states call the shots on managing public health emergencies in their own jurisdictions, the feds have a great deal of influence and control on actual stockpiles and distribution of vaccines. Long story short, the federal guidance – a combination of public, stakeholder, and expert input – states that allocating vaccines during a pandemic should be done in a way that prioritizes the maintenance of critical infrastructure first. In a nutshell, this means that – in the feds’ view - folks who work in emergency management or have important infrastructure or safety and security responsibilities should be receiving vaccines before your elderly grandparent or 2 year old son or daughter does. Hurricane Katrina, when emergency management crumbled just as fast as the levees did, just reinforced the importance of prioritizing the maintenance of critical infrastructure following a disaster. Uniform implementation across states is particularly key considering that if states had different policies on vaccine distribution, people might start moving between states to get vaccines during a pandemic, which would just add to the chaos.

 

There has also been quite a bit of planning done on what one would call “social distancing” policies, which is a pleasant euphemism for implementing strict community control policies that would mitigate the spread of a pandemic. When do you close schools? Bar church gatherings? Impose curfews? Force people to telecommute from work? Issue food rationing plans? Again, with the input of massive amounts of mathematical modeling and some say from experts and the business community, a fair amount of planning has been done in regards to preparing for such contingencies, with SARS being a good flash in the pan preview of coming events.

 

So, this leads to the question of what sort of pandemic planning has YET to be done? Unfortunately, it’s a doozy: there is little guidance and policy on any level on what is called “altered standards of care.” Altered standards of care refers to situations in which, during a pandemic, hospitals are overflowing, vaccines are rare or non-existent, and 2/3 of health care workers have either perished or have run for the hills. One critical question is: who gets prioritized for medical care in these situations? You’ve got a pregnant woman in labor, a 10 year old kid with significant influenza symptoms, and a cop who just got shot trying to stop rogues from looting a grocery store. Who should get treatment from the only available physician at the hospital first? The flip side of the coin is a healthcare delivery question: If you’re a pregnant woman in labor and there are no physicians available to help you, who should deliver your child? A nurse’s assistant? A 1^st year med student from the local college who just finished his first OB/GYN course? Important questions, with few answers out there. Although many individual hospitals do have plans in place for such disastrous scenarios, many others do not.

 

Well, at this point its clear that there is a lot of media generated hysteria out there (bolstered with a fair amount of xenophobia) about this current epidemic. Lets pray that we get this thing in control fast, and I believe that we will in fact do that and this outbreak will be brought under control soon. These are just my 2 cents and I hope it somehow contributes to a better understanding of the overall context and what plans have been made and what plans have yet to be made. Stay safe everyone. 

Madness and Love

It’s been a long time since I contributed anything to this blog. I don’t even know if anyone reads this anymore.

I’ve decided to write some thoughts here about a close friend of mine. I’ve chosen this blog because its one this particular friend does not know about, and hence he will not know I have written this.

Some of you may know that after obtaining my bachelor’s degree, I lived and worked in Thailand for close to 5 years. I may dwell a bit about my experiences in general there at a later point, but for the time being I mention it because that is where I first met Charles (not his real name), and we became close friends.

At that time, Charles – a fellow American expat – was working as an ESL consultant. He later obtained a position as an editor and writer for one of Thailand’s major English-language newspapers, a dream job for a young expatriate. Charles was quite bright, funny, and had a serious interest in both the politics and cultures of the region. Charles also had a very good relationship with his Thai girlfriend. In many ways, he had a lot to look forward to with his life.

Given that both Charles and I were of the same age range, both Americans, and had somewhat similar interests, we became quite close. The expatriate lifestyle can be lonely at times, so when friends are made, bonds can be deep. Years later, I returned to the United States to go back to school, and Charles elected to continue living in Thailand as an expatriate, a big decision (one I at times wish I had the courage to have done myself), but one supported by the fact that he had an excellent job as a journalist, and his relationship with Noi - his Thai girlfriend - had become very close. They married about 5 years ago.

This past month, I returned to Thailand for a visit, to see friends, old haunts, and just go on a much needed vacation. Although I had been in email contact with Charles for some time, we hadn’t met in years. I was deeply shocked and saddened to learn that he had become afflicted with paranoid schizophrenia.

I do not know much about schizophrenia at all. I have been relatively lucky in life. I have known few people with serious mental health issues, and those I have known were for short durations and usually met within the context of work. For the most part, everything I knew about schizophrenia was derived from watching A Beautiful Mind. Charles himself does not like to talk about his condition – a disposition I understand and respect. Almost all of what I know of the disease’s initial onset with Charles was told to me by Noi.

Charles first experienced a psychotic episode while participating in a Buddhist meditation retreat. He was about 34 years old. Basically, he began hearing voices and commands in his head. The voices often urged him to do very reckless things, like jump into canals. Anyone who has visited Bangkok knows that the city’s canals are possibly among the most polluted waterways in the developing world. Although there may be some waste water treatment, it is certain that many canals flow with raw sewage and human waste. To contemplate that he was jumping in and swimming in them is horrifying.

Other times, the voices were urging him to do things that were more innocuous, but no less removed from reality. He would try and enter buildings to search for non-existent people the voices were telling him to talk to. He was urged to get on trains and buses to go places that didn’t exist. Noi was absolutely terrified. I cannot imaging how bewildering and frightening it must have been for her in those first few weeks as this behavior was unraveling.

Eventually, they went to see doctors, who confirmed that he was indeed afflicted with paranoid schizophrenia. The doctors prescribed medication. But Charles did not adhere to his medication regimen, largely because of denial. Further psychotic episodes occurred, and at the advice of a doctor, Noi began slipping the medication into his drinks. He now takes his medication voluntarily.

Although the medication successfully prevents Charles from experiencing psychosis, the side effects of the drugs are sadly, very powerful. Charles sleeps at least 10 hours a day, every day, which is really too much. When he is awake, he is sluggish and has a sub-normal level of energy. Additionally, his physical reaction time has become very slow. It seems to me that the drugs basically seem to have a strong sedating effect. Consequently, Charles really cannot engage in any sort of robust physical activity for any extended period of time. Playing sports is out of the question. Because of this, Charles has now become quite overweight, which of course leads to a host of other physical health issues. Because his physical reaction speed and overall physical coordination is now stunted, he is also much more prone to trips and falls (which can be potentially very dangerous and even deadly).

I’ve also learned that another side effect of the drugs is what is called “parkinsonism” – a derivative from Parkinson’s disease. “Parkinsonism” basically means that the facial muscles will relax into a state where they do not contract, similar to the symptom experienced by those with Parkinson’s disease. Unfortunately this means that at times Charles also has that dreadful, deadened look that afflicts Muhammad Ali and other sufferers of Parkinson’s disease.

On a more general level, Charles simply lacks the vitality and energy of his former self. I’m not sure if it’s the condition, or the medication, but he seems emotionally and mentally stunted. At times he seems to waver in and out of consciousness. It sounds horrible to say, but most of the time he is just flat out slow. To make matters worse, he enjoys drinking beer quite a bit (to the protest of his wife). I’ve got nothing against consenting adults drinking alcohol, but I can’t imagine how drinking alcohol can be good for someone with his condition and taking his medication. I can only wonder what kind of harm the mix of beer and drugs is doing to him. When he is drunk, he is so drunk he is barely lucid. It can’t be good.

His condition has also threatened Charles’ financial and professional life. About a year ago, Charles was laid off from his job as an editor and writer for the newspaper he had been with for so long. Noi told me that a significant factor was the decline in his work performance due to his condition. I can’t help but wonder if stigma and discrimination also had something to do with his dismissal as well. I have no idea if Thailand has employment anti-discrimination laws, but if they do I doubt they are as strong as those in the United States. Luckily, he recently obtained another job, although it is unclear if his condition will affect his responsibilities there as well.

In addition, the medication Charles takes is costly. A single pill costs $6, and he needs to take several a day, every day. Six dollars is not too much, but considering that his current employer does not – that I know of – offer any form of health insurance, and that the salary he makes is not comparable to a professional-level salary in the states, those costs can add up over time.

In short, paranoid schizophrenia has – at the very least – seriously affected Charles’ quality of life for the worse. One could even say it has ruined his life. Upon meeting him, I was immediately shocked at how poor his overall health and appearance have deteriorated. It is really quite sad.

One very positive note is this: His wife Noi – who has also become a close friend of mine – has stuck with Charles now since they first met many years ago. Rarely have I met a woman or known of a relationship in which the wife has sacrificed and endured so much to care for a disabled husband. I imagine some people (of any nationality) might have bailed out on a spouse who was stricken with such a horrible disease. I wonder if even I would. Luckily, Noi continues to care for her husband with genuine love and compassion. She is truly a remarkable woman and possibly one of THE most remarkable women I have ever known.

I’m not sure what will happen to Charles and Noi in the future. Although the schizophrenia has certainly taken a major toll, Charles is still a somewhat active, functioning person. He has a loving wife and friends, and both his family and his wife’s family are loving and supportive as well. He remains a close friend of mine, and we keep in regular contact. I do not know much at all about the medical aspects of schizophrenia. I don’t know if it is possible to get better. I do know that medication and treatment will continue to progress however, so I hope that in the future his medication won’t have such strong effects on him.

I wasn’t sure why I started writing this. I don’t even know if anyone will read this. It is really quite depressing, and I would say that on one level I simply wanted to write these thoughts as a way to express my sadness and shock at the fate of my friend. When a close friend or family member is stricken by such a horrible disease – or for that matter any major disease or condition with grave consequences – it gives one pause to re-examine the state of one’s own health and well-being, and those of your loved ones.

So I guess I’ll end in what will sound like one of those silly, maudlin, sickly-sweet Hallmark Card moments. Take care of yourself, your health, and the health of your loved ones. Be grateful for what you have. Love and protect those you cherish. I don’t know what else to say.