Tuesday, December 29, 2009

Saturday, December 19, 2009

No Stone Left Unturned



No Stone Left Unturned
One of the biggest indicators of how much we need health care reform is the extent and costs of the battle that the special interests of the medical-pharmaceutical-industrial complex are waging to kill it.
Theirs’ is a well financed, coordinated, no-holds-barred war, leaving no stone un-turned in their efforts to influence the minds, opinions and votes of politicians and the public.
The extent to which they will go, and the strategies which they employ, know no bounds and exceed the imagination of a trusting, misinformed and distracted public.
Case in point:

Health Insurers Caught Paying Facebook Gamers Virtual Currency To Oppose Reform Bill

(click the above link and then their link to gethealthreformright.org)

As the article says: in a process called ‘astro-turfing,’ or in this instance more appropriately called ‘virtual astro-turfing’, corporations like the insurance industry, or organizations like ‘think-tanks,’ etc., create FAKE (virtual) grassroots movements by paying people to act like political supporters. In this case, it isn’t even real money. It is ‘virtual currency!’
Could it get any more insidious or cynical? If this doesn’t exemplify the extent and depths to which they will go…and doesn’t frighten you…I don’t know what will. What else are they doing below the radar of the public at large?
And, could the public knee-jerk response to virtual crumbs (for an inane computer game, of all things) in exchange for their vote (contrary to their own best interests) be any more pathetic?
If you are not ACTIVELY working to enact health care reform (or reform in other major areas: financial, environmental, etc), you should be.
Once again, it reminds me of Hillel’s aphorism: (on personal responsibility)
IF NOT ME, THEN WHO?
IF NOT NOW, THEN WHEN?
Sow the seeds of civil disobedience now!


Tuesday, December 15, 2009

That Was Then & This Is Now


That Was Then…And This Is Now



That Was Then:
Republican President Nixon told a press conference in July of 1969: “We face a massive crisis in health care. Unless action is taken within the next two or three years….we will have a breakdown in our medical system.” An article in Fortune magazine at the time, titled “$60 billion crisis” warned that the American health care system stood “on the brink of crisis.” That was when the national health bill was a mere $60 billion. Even so, skyrocketing medical costs were pricing health care out of reach to most Americans, and medical bankruptcies were on the rise.

At the same time (1970’s) articles were revealing that for all the investment in technology, hospitals, medical specialties and sub-specialties, medical-related expenses, etc. health care in America was not as good as health care in most other industrialized countries; i.e.: America had higher rates of infant mortality and lower life expectancy.

And This Is Now:
A Democratic President, Barack Obama, called “health care reform the single most important thing we can do for America's long-term fiscal health. That is a fact.”

What was $60 billion ($1900/second) in health care costs in 1970 ballooned into $230 billion by 1980, $2.6 trillion by 2006 and is anticipated to reach $ 4.3 trillion ($139,000/second) by 2017. The consequences are already catastrophic.

In addition, things have only gotten worse:

More than 50% of all personal bankruptcies are related to medical bills. Every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem



America ranks 180th of 224 nations in infant mortality

The only solution:

For decades, Congress has consistently failed to take any effective actions to restrain the uncontrolled and runaway costs of medical care.

The ONLY solution is for Congress to break the virtual monopoly that the insurance-pharmaceutical-medical industrial complex has on health care delivery and re-imbursement.
The only effective way to do this is for Congress to enact health care reform, creating a public option to compete with Big Insurance, erasing Big Insurance’s longstanding and privileged exemption from anti-trust laws.

With each passing day, the economic and political power of the special interests only grows. Any plan that does not include a public option is a failed plan from the inception. And, we cannot afford to fail.

Sunday, December 6, 2009

Health Care Is A Sick Business





Health care is a sick business
Imagine an entity that is both amoral and soulless; its guiding precept is profit and growth. This is the foundation of the modern American conglomerate; including those of the health care, pharmaceutical and insurance industries.
Witness:
Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.
In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010…Aetna actually made a profit in 2009 but not at levels that it anticipated.
This is consistent with other insurers as well. In May of 2008, “Wellpoint (one of the nation’s largest private pay health plans) reported less-than-expected profits from the first three months of the year” Angela Braly, President and CEO reported, “We will not sacrifice profitability for membership."

Cutting their rolls, increasing premiums and lowering physician re-imbursement to enhance profit margins…could it be any more obvious that the only insurance business they are in is ensuring profit?

Cutting their rolls and raising premiums will increase the numbers of uninsured, typically the sick and elderly, who in turn, will be added to government-run Medicare and Medicaid programs. If that isn’t socialized medicine, what is?

Witness:
Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.
In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.”
Wow, what a concession: raising prices by more than $10 billion, conceding $8 billion, on their way to $300 billion annually, and growing!
In addition, David Brennan, head of pharma giant AstraZeneca, when asked if he would oppose reform said: "We said there were principles we didn't want to see violated. And if those principles -- price controls, Medicare rebates, moving dual eligibles back from Medicare and back into the Medicaid discount program -- if those things happen, I can't see how we could be supportive of the program."
In short, if health care reform does not guarantee increasing profit margins and growth, BigPharma will oppose it.
By 2017, health care costs are projected to reach $4.3 trillion dollars; an astounding $138,890 per second!! Don’t forget; what you and I call health care costs, the medical-pharmaceutical-insurance industrial complex call profit, projected growth and earnings.
It is precisely this profit oriented approach to health care that has created and drives both, the disease crisis and its subsequent disease-care financial crisis in America.
At the current rate of increase, the cost of family insurance will reach twenty-seven thousand dollars or more in a decade, taking more than a fifth of every dollar that people earn. Businesses will see their health-coverage expenses rise from ten per cent of total labor costs to seventeen per cent. Health-care spending will essentially devour all our future wage increases and economic growth. State budget costs for health care will more than double, and Medicare will run out of money in just eight years. The cost problem, people have come to realize, threatens not just our prosperity but our solvency.”

Without reform the only thing that will alter this course is its obvious and anticipated collapse, as happened on Wall Street.
Does anyone really still believe we don’t need reform? If so, what have you got to offer that can save us?

Sunday, November 22, 2009

This is a Test?


This is a Test?

Wow! What a week of reversals in medical testing guidelines for mammography screening and Pap smears.
Let’s sideline the emotional issues for women, who for decades have been inculcated in the necessity and life-saving benefits of annual Pap smears and mammograms. Some women may now feel betrayed for having been put at increased risk by medical science. Other women may feel betrayed, believing the new guidelines represent rationing, thus denying them essential care. They (and their doctors) will hold onto their ingrained beliefs in the old mistaken guidelines.
But, this isn't about feelings or beliefs. This is about science. And sadly, as happens all too often, the science was flawed from the start.
Let’s look at the facts.
The singular and most important reason behind the guideline reversals is the astonishing admission that for decades, and for hundreds of millions of women across the globe, both of these screens done routinely, on an otherwise healthy population of women, does more harm than good.
That is, the new guidelines for Pap smears and mammography are designed to decrease the multitude of subsequent unnecessary diagnostic tests, invasive medical procedures and the psychological damage, physical pain, disfigurement, disability, and deaths associated with them. All, for routine screening that in the best of circumstances, did/does very little to improve a women’s odds of survival, preventing only a small fraction of breast or cervical cancer deaths (an absolute risk reduction of .05%, for breast cancer).
This is not to say that Pap smears and mammograms are of no use. Rather, it is saying that their use as routine screens, for the population at large, damages or destroys far more lives than it saves. This is the inherent danger of ALL broad-based population disease screens.
How can that be, you ask?
Logically, it just makes so much sense that screening will lead to early detection that can lead to early treatment and save lives. And, in some cases it does. Over-screening, to a much larger degree, puts the population at risk of greater harm due to subsequent potentially and outright harmful invasive unnecessary tests and medical procedures.
In performing population screening we have lost sight of context. The “value and meaning of the test is entirely dependent on who we test.” All tests are wrong some of the time. Therefore, testing everyone raises the number of false positives, decreasing the value and meaning of the test. At the same time, it puts that large population of false positives only at increased risk, with no potential benefit.
Not to mention the mindlessness of routine testing and the money such testing and subsequent procedures generate as exemplified in the following: “In addition, Dr. Saslow said, doctors in this country have been performing 15 million Pap tests a year to look for cervical cancer in women who have no cervix, because they have had hysterectomies.
1. “roughly 25% or more of cancers are missed…at least one in four cases of breast cancer is found after a normal mammogram.’”
2. “the cumulative risk of having a false positive mammogram in ten years is 50%...at least half of all women having mammograms for ten years will receive a positive result that is incorrect…20% of these lead to biopsies.”
3. “the consistency and accuracy in reading mammograms is a serious problem.”
4. “97% of positive mammograms are false rather than true.”
5. “we can estimate that (x-ray exposure from) mammograms cause about seven thousand cases of breast cancer for every ten years of screening.”
6. the psychological toll (ranging from anxiety to depression to suicide) of false positive reporting, while hard to calculate, is huge.
7. In 2001 “the Cochrane Collaboration, a multi-disciplinary group of scientists that produces what are widely believed to be the most respected and objective reviews in medicine, exhaustively examined the data on mammograms. They concluded that mammograms were associated with no improvement in breast cancer death rate, i.e.; that having mammograms was of no benefit at all.” (an absolute risk reduction of .05% when compared to physical breast exam)
As for Pap Smears:
"the argument for changing Pap screening was more compelling than that for cutting back on mammography because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean."
As the incidence of most cancer is on the rise, the cry for cure intensifies. However, for decades, focusing only on screening for early detection, treatment and the possibility of cure has not stemmed the growing tide of cancer or cancer deaths. More importantly, it fails to address the causative factors in our environment and our lifestyles that are creating the cancer thus minimizing the environmental and lifestyle changes we can make to dramatically reduce cancer incidence and death rates.
(To read an interesting, opposing viewpoint and my comments on it (pm).)

Tuesday, November 10, 2009

First, Do No Harm


First, Do No Harm

Imagine running a scam that earned you $3 billion dollars a year!

Imagine having legal counsel calculating and telling you, ahead of time, that it might take the Feds 3 or 4 years to catch on, and another 2-5 years of court battles to reach the guilty verdict you anticipate. Imagine, knowing that when all was said and done, you were found guilty of a felony, fined $2 billion dollars and no one goes to jail.

Re-cap: on the low end, you earned $11 billion dollars, and you were fined $2 billion dollars; leaving you with a net profit of $9 billion dollars and no accountability.

Question: Would you do it again? Duh!

This pattern of willful criminal behavior has been the norm in the pharmaceutical industry for many years, with one major addition: they are knowingly killing hundreds of thousands of unsuspecting people on the way to those windfall profits.

In January of 2009, Lilly pleaded guilty and paid $4.2 billion in fines and penalties to settle charges that it had for at least four years illegally marketed (for off-label use) Zyprexa…Lilly already had a criminal conviction for misbranding a drug when it broke the law again in promoting Zyprexa for off-label use starting in 1999. The medication provided Lilly with $36 billion in revenue from 2000-2008. That’s more than 25 times as much as the total penalties Lilly paid in January.

Companies regard the risk of multi-million dollar penalties as just another cost of doing business.”

Ultimately, BigPharma has an absolute total disregard for patient welfare, or even life, as death is factored into the costs of doing business: First, Make Obscene Profits.

Death is built-in to the price you pay for drugs!

Sunday, November 1, 2009

A Green Thumb

The Green Thumb
Here is a little thinking exercise I like to work through with my patients. I call it the green thumb analogy.
What does it mean when we refer to someone as having a green thumb?
Everyone knows that it refers to someone who has a natural skill for gardening, or growing plants.
So, let’s dissect that a little more.
What does it take to grow plants? Is it rocket science?
What do plants need?
Again, everyone knows that plants need:
Sufficient sunlight:
Not too much, that could burn the plant and make it wilt
Not too little or the plant won’t grow, and may die.
Sufficient water:
Not too much, that could drown the plant
Not too little, or the plant will wilt, and may die.
Good soil:
Nutrient rich soil
Free of toxins that may harm or kill the plant
Oxygen:
Sufficient and clean air
Well, what happens to any plant if you give it sufficient sunlight, clean and sufficient water and oxygen, and nutrient rich, toxic free soil?
It not only grows, it thrives! (Hence, the green thumb.)
But why, if given those ingredients, does the plant
thrive?
Because it is genetically (DNA) hardwired to thrive under the right conditions.
What makes you think you are any different?
Answer: you are no different!
Your body is genetically programmed for health. More precisely, it is genetically programmed for survival by maintaining homeostasis (balance), and adapting to chemical, physical and emotional stressors that challenge that balance.

The simple truth is: your body has certain specific genetic requirements to BE healthy. If those requirements are met, in pure and sufficient quantity and, if you stop poisoning yourself with toxic foods and chemicals, improved health is inevitable
When you understand and act on this simple truth, your health and your life will change.
Health is mostly a matter of choice; how you choose to live your life; how you choose to think, what you choose to eat and how much exercise you choose to get; as strongly influenced, for better or worse, by the habits of the people you hang out with most, your family and friends.
It is all about making a solid lifetime, lifestyle commitment, to create good health by developing and consistently maintaining healthy habits.
It’s not rocket science.
It’s as simple as having a green thumb!

Sunday, October 25, 2009

The Fountain of Youth



The Fountain of Youth
Almost every cell in your body is being continually regenerated, some at faster rates than others. The cells lining the stomach are replaced about every five days. The epidermis, or surface layer of skin cells, recycles about every two weeks. Red blood cells last about four months while liver cells are replaced every 300-500 days. Even the human skeleton renews itself about every ten years.
So, if the body is in a constant state of renewal, replacing old cells with new ones, that begs the questions; how and why do we age?
Theories of aging fall into two basic categories.
  1. Programmed-based: which says that aging is a genetically regulated predetermined process, occurring on a fixed schedule.
  2. Damage-based: which says that aging is the result continuous damage accumulation as a result of interaction with the environment, exposure.
In my opinion, these theories are not mutually exclusive, and both are at play in the aging process.
In essence, all living organisms are genetically programmed for three things: survival-growth and reproduction. After reproduction, and a period of nurturing of the progeny, nature has very little use for the aging. As humans, we are done physically growing and developing by the age of 25. Then, consistent with the programmed-based theory, we begin aging, the decline towards death.
The rate of aging is strongly influenced by our exposures, consistent with the damage-based theory. Consider the reproduction and replacement of cells analogous to photocopying. However, instead of making all copies from the original, we make each subsequent copy from the preceding copy. Along the way we lose some quality, resolution, create imperfections, and progressively degrade content from the original, with time and the number of copies made. Therefore, in our analogy, the rate of aging is directly related to the rate at which copies are made.
Again, in my opinion, programmed and damage-based aspects of aging also influence each other. Detrimental exposures (poor diet, smoking, sedentary lifestyle, environmental toxins, etc) may cause programmed aging to begin earlier, and accelerate the effects of damage-based aging. On the other hand, damage-based aging can, to a greater extent, be delayed and slowed by fewer detrimental exposures, especially when combined with more positive exposures (healthful diet, regular exercise, positive mental attitude, a life’s purpose, community, decreased stress, etc).
The link is allostatic load, the amount of work/effort your body has to expend to maintain homeostasis, your set-point, and to keep you alive.
Allostatic load is a product of your genes and their response to environmental exposures. These exposures may have their roots in your grandmother’s and your mother’s health, at the time of pregnancy (epigenetics), and includes all of your lifetime, lifestyle habits.
The healthier you are, the less your body has to work to maintain homeostasis, the less the allostatic load, the slower the rate of photocopying, the slower the rate of aging. And, obviously, vice-versa with poor health

In addition, if disease creating lifestyle behaviors start in childhood, resulting in obesity and diabetes, for instance, than programmed-based aging may be triggered earlier and damaged-based aging will likely be more pronounced at younger ages.
Ultimately, your genes (25-30%) + your exposure (70-75%) = your state of health and your biologic age.
Therefore, THE FOUNTAIN OF YOUTH IS HEALTH!

Sunday, October 11, 2009

Bus 31

Bus 31
On my way home, stopped at a light in North Adams, I spotted BRTA (Berkshire Regional Transit Authority) Bus 31 stopped, facing me in the oncoming lane. Its digital display was flashing its route: WalMart-Hospital, WalMart-Hospital...with the return route, presumably, Hospital-WalMart, Hospital-WalMart.
Irony becomes reality: a literal mass-transit loop between mass-consumerism and mass-sickness. If it only stopped at MacDonalds!
A sad and poignant observation. Millions of years of evolution have led to this!
(click for larger view)

Wednesday, September 30, 2009

Got Health Care Reform?

Republican vs. Democratic Health Reform Plans

US Representative Alan Grayson, from the great state of Florida, sums up, simply and precisely, the Republican Health Reform Plan vs. the Democratic Health Reform plan, the public option.




What don't people get?

Tuesday, September 22, 2009

The Public Option vs Insurance Industry Profit Protection and Enhancment Act

The Public Option vs The Insurance Industry Profit Protection and Enhancement Act

Recently, Wendell Potter, current whistle-blower and former Communications Vice-President of Cigna Health Insurance, of one of the nation's largest health insurance companies, testified before congress declaring the Public Option the only real option to reign in the insurance industry, control costs and provide affordable insurance to all Americans.


"If Congress goes along with the so called solutions the insurance industry says it is bringing to the table, and acquiesces to the demands it is making of lawmakers and if it fails to create a public insurance option to compete with private insurers, the bill it sends to the President might as well be called "The Insurance Industry Profit Protection and Enhancement Act."

(Bill Moyers interview with Wendell Potter, while a bit long for some, is both fascinating and revealing.)

The recent 9-12 Tea PartyProtest in Washington attracted thousands of Americans vehemently opposed to health care reform and the public option. Obviously, they support insurance industry profits and self-regulation over the health and welfare of their fellow citizens.

When all of them openly renounce their own social security, public welfare, heating assistance, WICS (women-infants and children), medicare, veterans benefits, and for that matter, the US military, all government-run programs, I will be more open to hearing their point of view.

Sunday, September 20, 2009

The Dark Side of Science


The Dark Side of $cience
Science: knowledge, as of facts or principles, gained by systematic study.
In the past century the miracles and wonders of science have helped us understand our world and tap into, channel and use its natural forces and resources. In every field, from physics to chemistry to medicine, etc., scientific discovery has contributed to benefit and advance humankind. It is no wonder that we look at science with awe and respect bordering on reverence.
However, as the saying goes, ‘power corrupts’ and, science is not exempt.
As I wrote in my last entry, Science Fiction, in today's world $cience is abused to manipulate the masses for corporate profits. Just referencing ‘science' enhances our beliefs and primes our acceptance. Combine that with knee-jerk responses to fear triggers (ie: high cholesterol, osteoporosis, swine flu,etc.), and a general respect and desire for an authoritative voice, and you have a marketing bonanza creating obscene profits.
The corruption of science comes in two basic forms: either the science itself (e.g.; the construct and bias of studies) has been corrupted, or the use of the science (e.g.; the intentional misuse of information) is corrupt. Both abound in medicine. The rigging of medical studies and misrepresentation of research results have become routine and the accepted norm.
Due to the conflict of interests that exist in the prevailing medical-pharmaceutical industrial complex, science and medical knowledge have been appropriated and are being ‘sold’ to an unsuspecting, trusting and increasingly unhealthy public.
But, to what extent?
In September of 2001 the editors of 12 of the world’s most prestigious medical journals issued an unprecedented and chilling alarm. In an article titled: Sponsorship, Authorship and Accountability, they wrote:
“We are concerned that the current intellectual environment in which clinical research is conceived, study subjects are recruited and the data analyzed and reported (or, not reported) may threaten (scientific) objectivity….In light of that truth, the use of clinical trials primarily for marketing makes a mockery of clinical investigation and is a misuse of a powerful tool.”
In no uncertain terms they are saying that the science has been corrupted to the extent that it is no longer reliable. And, even worse, it undermines all they do while putting all of us at tremendous risk: i.e: if the doctors cannot trust the science, the basis for all they do, then how can they (or we, as patients) trust the treatments based on that science?
This begs the question:
How come the editors continue to print commercially sponsored studies?
Answer:
The pharmaceutical companies that sponsor the research also sponsor the journals. They are their largest advertisers. But, more insidiously, to the tune of millions of dollars, they ‘buy back’ reprints of the published studies and use them as scientific evidence of efficacy to market their drugs to doctors and the public.
How are we to know the truth?
The truth, most often, is quite simple, and as such is often too difficult for people to believe.
The truth is: your body is genetically programmed for health. Health is your set-point, your body's most basic survival mechanism. If that was not true, we would have died out, as a species, long ago.
The truth is: we need to reform our health. We need to change our focus away from the failed scientific, never-ending, profit-generating fight against disease to a model of personal responsibility that nurtures our own natural health.
It is often wiser to trust the wisdom of the body and let good sense prevail over corporate science.

Monday, September 7, 2009

Science Fiction







Science Fiction
In the last 50 years or so a new science emerged that now dominates and influences almost all, if not all, fields of research: corporate science. The name itself exposes the obvious conflict of interests between the corporate profit motive and scientific independence and integrity. This bottom-line driven science leaves little, to nothing, to chance, let alone real science.
Perhaps, the only real and accurate corporate sciences are their self-serving studies on population demographics and human motivation/psychology as they affect profit, i.e.; consumerism.
Corporate profit-driven science, as endorsed by the government, and glorified and broadcast by the media has created a through the looking glass reality that has us believing incredible non-science, non-sense; selling us spin as science that is literally making us sicker, and killing millions annually as profits soar.
We have come to rely on their science, disguised as television and media news, informative ads and magazine articles, patient advocacy groups, etc., as our prime source for health and nutrition information. More so than any other source. And then, conveniently, they sell us the cure.
Could the atmosphere be any more conducive to manipulation and corruption? Yes.
Our belief in science has been carefully cultivated and nurtured to elicit a knee-jerk, hypnotic-type, unquestioning and accepting response to key words, phrases, visual and auditory cues that drive our buying habits.
We have been indoctrinated to respond to unsubstantiated words such as: studies show,
scientists say, doctors agree, FDA –AMA-American Heart Association or American Cancer Association approved, low-fat, cholesterol-free, high fiber, vitamin-fortified, omega-3, heart healthy, calcium-enriched, anti-oxidant, osteoporosis, acid-reflux, etc.; visual cues such as actors in white coats, a stethoscope, a clogged artery, an acid-filled stomach, a gurney, an ambulance, an ER, an MRI machine, a ‘Healthy Heart’ logo, and now, a ‘Smart Choice’ logo, etc.; and, auditory cues such as a heartbeat or the electronic sound of an EKG, and the never-ending drone: "ask your doctor if you need."

The mere fact that most people even know these scientific words, phrases, visual and auditory cues is testimony to the extent and effectiveness of the indoctrination. Why else, but for marketing reasons, would your average person even know words like cholesterol, anti-oxidant, osteoporosis, trans-fat, etc.?

How else could you possibly explain the labeling of non-food chemical concoctions such as:

vitamin-fortified, high-fiber, low-cholesterol, fat-free Froot Loops and Popsicle with anti-oxidants, as ‘Smart Choice’ healthy foods?
We are willing, if not unwitting, participants in this science of deception. We continue to allow ourselves to be duped and manipulated by corporate science to the extent that we have lost our most basic understanding of our own health and how to nurture it.
Sadly, as we have listened to corporate science over the past 50 years we have gotten only sicker. All of their scientific non-food products have led to skyrocketing rates of the chronic degenerative diseases: diabetes, heart disease, obesity, osteoporosis and cancer. We then seek salvation from corporate run medical science and pharmaceuticals taking us through the looking glass to a place where drugs, tests, and procedures supposedly equal health, but in reality only equate with profits.

Sunday, August 23, 2009

An Interesting Case Study: Phantom Limb Pain


A few months ago I read an interesting article, Brain Games, in The New Yorker magazine. A few weeks ago, I saw the author, neuroscientist, VS Ramachandran, give a lecture, On Your Mind, on the fabulous website TED.com. In both, a featured topic was phantom limb pain.

Phantom limb pain is the sensation of pain emanating from a missing limb that has been either lost in an accident or surgically amputated.
Specifically, Dr. Ramachandran was elaborating on the case of a man (James) whose amputated right forearm felt as if it was tightly and painfully knotted into a clenched fist.
Dr. Ramachandran had the man place his left arm into a mirror box, “visually resurrecting the phantom limb.” Even though James consciously knew it was his left arm in the mirror box, the image in the brain, seeing it as his right arm/hand, was very compelling and convincing. By unclenching the existing left fist in the mirror box, visually it appeared to the brain as though the right fist was unclenching. Using this “visual feedback to trick the brain,” upon unclenching his right fist, James’ pain immediately went away.
At the same time that I saw this, I had a 70 year old female patient enter my office complaining of low back pain. She also reported a 6 year history of ‘hemi-facial spasms.’ Her left eye appeared as though it was constantly, tightly winking. Over the years she had tried multiple medical approaches, including medications and even Botox injections, with no relief.
I excitedly told her about Dr. Ramachandran, James and the mirror box. I suggested that if the mirror could work for a phantom limb, it seemed very likely that it would work for her eye as well. I suggested that she go home and stand in front of a mirror, with her left eye out of the visual field, her good right eye in front of the mirror. Therefore, her brain would see the normal relaxed left eye looking back at her; again, using visual feedback to trick the brain.
She came in a few days later and reported: “as soon as I stood in front of the mirror, I felt my left eye relax.”
While she is by no means ‘cured,’ she now has a useful tool to use to relax her left eye. Now it is a matter of practice, like learning how to ride a bike or play violin, retraining neural networks to a normal relaxed left eye, to overcome 6 years of winking.
This is all small piece of a larger picture: reality, even the reality of your body, your body image, is constructed in your mind.
Note: Dr Ramachandran has a wonderful series on YouTube, Phantoms in the Brain. 3 min/ 13 seconds into Episode 1, Part 2 you can see James and the mirror box.

Sunday, August 9, 2009

Follow the Money



Things are getting seriously ugly as the health care reform debate moves forward. That’s because we have a President who is determined to actually DO something. What it is that he actually CAN do, remains to be seen.

Conservative and GOP-backed think-tanks along with the medical-pharmaceutical-insurance industrial complex’s media, advertising arms and hired guns/lobbyists have ratcheted up their spare-no-expense, no-holds barred, all-out-to-win, fear-mongering campaigns of misinformation and outright lies. Not to mention their wholesale buying of votes, as campaign contributions, from senators and congressmen.

In short, they have nothing positive to offer because they don’t see any problem. According to them, there is no health care crisis. Our health care and insurance systems are fine as they are. Any attempt at reform is a slippery slope to socialism (which, of course, leads to communism), that will lead to the rationing of care (as if we don’t already have it), the end of medical innovation, euthanasia of our elderly (I couldn’t make this up) and, God forbid (or, GOP forbid), higher taxes!



None of this is surprising or new. But sadly, these tactics work.

Fear is a great motivator. Throughout history, governments have used it and, more recently, multi-conglomerate global corporations use fear and lies to motivate the masses to act contrary to their own best interests. We just don’t want to believe that United States’ politicians or agencies (FDA, EPA, etc), or American corporations would knowingly do anything to hurt us.

They wouldn’t, right?

This is a betrayal of the public trust of the highest order, for profit over the public good. And, for that matter, profit over the viability of life on the planet.

We, the People, have the power to direct the national health care debate to achieve the outcome that benefits us most. First, we must learn and understand the facts of the issues and then get involved and take action.

We will be the victims of whatever level of ignorance, apathy and inaction we accept.

As the Nobel Laureate, Economist Paul Krugman, writes:

It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved (Medicare, Medicaid and the VA/Veteran's Administration), even in private insurance.

And that government involvement is the only reason our system works at all… the bottom line: if you currently have decent health insurance, thank the government

Indeed, surveys consistently show more patient satisfaction in the government run, single payer, systems of Medicare and the VA than with private sector or employer provided insurance.

And, don’t you find it more than ironic and cynical that the most outspoken critics against the public option for health care are Senators and Congressmen with government sponsored health care? Follow the money!


The role of government is to protect the basic rights of its' citizens from the government itself, and from businesses, corporate and other special interests.

In the case of the health care debate the case for the citizens is clear: access to affordable, ethical health care. Secretly negotiating and brokering deals with the medical, insurance and industrial special interests is clearly more about protecting their incomes than it is about protecting the welfare of Americans.

The 'single payer' sytems of Medicare and the VA, in particular, are excellent examples of government's success in protecting and providing for the basic right of health care to the elderly, the disabled and our veterans.

Perhaps, the area in which the government has proven the most incompetent and dysfunctional is in the Congress itself. That is where reform is needed most; campaign finance reform must happen to reclaim our political system and restore the government to the people.