Beasts In Gray Suits

I haven't been able to post for a very long time, but I cannot remain silent after watching Bill Moyer's Journal last night:

In his first extended television interview since leaving the health insurance industry, Wendell Potter tells Bill Moyers why he left his successful career as the head of Public Relations for CIGNA, one of the nation's largest insurers, and decided to speak out against the industry.

Wendell Potter is doing a good thing, but his story turned my stomach. I listened to him explain that sick and dying people were "just numbers" to him and his colleagues in the insurance industry. I spoke out loud to the TV: "They will burn in Hell."

I don't believe in a literal Hell run by a red guy with horns, but I do not doubt the reality of spiritual consequences. People who have the power and the responsibility to alleviate suffering but choose to dismiss the needy as "just numbers" bring onto their own souls the most serious of consequences.

I'm not alone in my belief. The final straw came for Mr. Potter when he read JFK's Profiles In Courage:

. . . one of the president's . . . favorite quotes was a Dante quote that, "The hottest places in hell are reserved for those who, in times of moral crisis, maintain a neutrality." And when I read that, I said, "Oh, jeez, I--you know--I'm headed for that hottest place in hell, unless I say something."

Amen, Mr. Potter, and good for you for having the courage to face yourself and do the right thing.

People whose lives have been too easy often find it easy to dismiss the suffering of others. I've always believed that, but I never heard one of them say it until I saw this interview with Mr. Potter. It hit me hard to hear him describe just HOW e-a-s-y it is for the powerful and privileged to dehumanize others. I have not been able to get it off my mind.

Bill Moyer's Journal, July 10, 2009, Transcript

Thursday Ramblings

THE HUBBY ET AL
My husband is home today working on an assignment for grad school and doing laundry so he can pack for a business trip. He needed help getting chocolate out of a pair of socks. Wouldn't it would be easier for a middle-aged man to get chocolate out of his socks than to get chocolate on them? How does that happen?

His morning routine involves listening to local radio while getting showered and dressed. That happened later in the day today, at a time when the local station carries (cringe) Rush Limbaugh. Rush was picking apart the President's ESPN appearance in excruciating detail. It takes a lot of hatred to obsess about something like that to such an extreme. Dick Cheney, Rush Limbaugh: who gives a rat's ass? They're not relevant anymore.

CHANGES
I got a job. Can you believe that?

For some of us, life has an interesting way of changing our perspective. Four years ago, I was an Associate Director in charge of technical support for a major administrative unit at a large university. The money was damn good for someone with a BS in Social Science. Then I got sick--too sick to work.

I had good insurance, but the doctors had nothing to offer but drugs and platitudes, both of which were more harmful than helpful. I'm better now, thanks to medical people who refuse to succumb to the AMA and Big Pharma Borg. I still have a big medical bill with the local Borg clinic and monthly expenses for "alternative" care that is not covered by insurance. And we are struggling financially. So, I started looking for work.

Part-time is all I can manage. I found an office job that seems well suited to my needs and abilities. It was such a fluke; there are so few jobs available and most are too physically demanding. I had to negotiate to get the pay up to $10 an hour. I'll bring home one-tenth the take-home pay of my last job. And I feel very fortunate to have it.

Bill Maher Slam Dunk: Illness in America

As usual, my apologies to those of you don't do video--I don't have a transcript. I'm sorry.

Mad Rant About A Mad World

My conservative Christian brother-in-law sent me an email this morning with the subject line "No Stimulus Petition." I didn't open it. I've decided to support this stimulus package, even though the Bushies squandered billions with the last one. The truth is, this stimulus contains a lot of spending that should have been done over many previous years--infrastructure projects, renewable energy, increases for food stamps and other assistance, and so on. Greedy, irresponsible, war mongering politicians spent our fortunes elsewhere. Now it's time to pay the piper.

After lunch, I headed for the dreaded local clinic. For over a month, I've had a strange popping in my right chest when I breathe out. No other symptoms--just that odd thing. In the last few years, I've known two women about my age--nonsmokers--who had almost no symptoms but suddenly discovered they had stage 4 lung cancer. After the cancer was discovered, they lived only a few months longer. So, I figured I should get it checked out.

Jesus, Mary, and Joseph: it was a bad idea. The woman doctor was very nice but couldn't hear anything in my lungs. Good. That's what I hoped for. But docs are freaked out these days about the harmful effects of overuse of radiation, so she didn't want to order a chest x-ray. Instead, she said we need to aggressively treat my very mild asthma and do an x-ray if the asthma is not all cleared up in a few days. Ok, I said (sigh). I went to pick up the drugs. Holy Crap: $100 for antibiotics, steroids, and an inhaler--and that's with insurance. I don't have enough money to pay my bills this month, let alone give a $100 subsidy to the out-of-control drug industry. Why should I put all that crap in my body anyway when I have no fever, no productive cough, my lungs sound clear, and the asthma goes away if I stop eating diary products. Is there something wrong with this picture?

I left the clinic and got in the car, feeling a little stunned, turned on the radio to hear about some crazed rich dude leading police on a high-speed chase in his Bentley because his business failed. He killed himself in his car during the resulting stand off with a SWAT team on an LA street. That car could easily have been worth over $200,000. Why didn't he just sell the damn Bentley? What's up with filthy rich people killing themselves because they aren't quite as filthy rich as they used to be? Have they never had to deal with the real world before?????

Then, when I got home, I discovered I'd lost a button from my favorite sweater, a covered button that I can't buy at the fabric store. Well, if I have to, I'll replace every damn button on that sweater. Yes, I can fix something in this mad world.

CDC, FDA Are F'ed Up

Don't even get me started on the FDA . . . . I'm going to have to control myself or this post will get completely out of control. I turned on CSPAN this morning and discovered the Peanut Butter Recall hearing before the Senate Agriculture Committee. The testimony about FDA and CDC failures in this case was so shocking that I wasn't sure I could stand to listen.

According to William Hubbard, Former Associate Commissioner of the FDA, "The FDA has a food safety system that is a relic of the 19th century." One hundred and fifty thousand food companies are registered with the FDA; 6,000 of them are considered high risk companies. The FDA inspects only 7,000 of the 150,000 firms annually. Furthermore, there is an abysmal lack of communication and cooperation between the FDA, the CDC, the respective state agencies, and the medical community.

By far, the best, most moving testimony was that of Gabrielle Meunier, the mother of a formerly healthy seven-year-old boy who contracted two forms of salmonella from peanut butter crackers. Her son was violently ill, hospitalized for a week, and has lingering problems--including arthritis flares--resulting from the devastation to his body. In her testimony, Ms. Meunier recounts the horrible ordeal of trying to find out what was wrong with her son and, then, trying to get information from the CDC and FDA. Initially, someone (CDC? doctors?) told her she "didn't need to know" about the strains of salmonella her son contracted, even though this is important information in locating the source of the tainted food in her own home.

Diagnosis of the Meunier boy's illness took days, despite the fact that the CDC already had ample data about this peanut-butter-borne salmonella outbreak. Ms. Meunier's passion and anger were obvious as she recounted the insanity of stonewalling and demeaning behavior on the part of the CDC. Most compelling, however, is her determination to advocate on behalf of patients and consumers. As she so rightly pointed out, informed patients and consumers who are able to share information are powerful forces for consumer protection and patient self-help. She suggested--almost demanded--accessible government databases and online communities that would empower people to help themselves.

Empowered consumers and patients, hmmm . . . . How would the FDA, the CDC, and the medical community receive that? Listen: we have to empower ourselves, by whatever means we can. We are far, far too passive about these things. We must apply pressure and demand change and accountability, but we cannot wait for the government and the medical community to empower us. That's not likely happen.

Victimizing Obese Teens: Today's Oprah

I rarely watch Oprah, but I took a chance on it today. The topic was teenage obesity. I hoped the show would offer something other than the same old tired anti-obesity tripe that we hear day in and day out: eat fewer calories, exercise, and control emotional eating. And if that doesn't work, maybe surgery is the way to go.

Everyone with any interest in obesity should understand the following facts:

• Obesity is not a mental illness. Therapy and "learning to love yourself" can't hurt, but they are no more curative for obesity than they are for any other physical disorder.
  
  
• Appetite and cravings are hormone driven. Simply repressing them eventually throws the body into crisis mode. The hormones will win, if you can't get them under control.
  
  
• Stress can increase appetite and cravings. That's why most people eat when they are emotional.
  
  
• All calories are not equal. If you saw the show, you know the nutritionist said a glazed doughnut is a better choice than a bagel with low-fat cream cheese because it has fewer calories. Nonsense. Eat the doughnut and you'll be hungry again very soon. The bagel with cream cheese will have a less dramatic impact on your blood sugar, give you a little protein, and leave you satisfied longer. But the truth is, neither of these is a good choice.
  
  
• Gastric bypass surgery has dangerous long-term consequences. It's the typical simple-minded pseudo-science of conventional medicine that says if you lose weight with gastric bypass, you'll have a greater life expectancy. Where's the longitudinal data? What about the hormonal changes, the dangerous vitamin deficiencies, and the gastrointestinal disorders that result from bypass? How do they impact life expectancy?
  

As usual, the obese teens on today's Oprah faced a hearty dose of shaming. That's guaranteed to drive up the stress hormones and make matters worse. Dr. Oz presented some good nutritional information but, on the whole, the nutritional advice was very confusing.

Shame, confusion, and a sense of desperation turn eating into a source of anxiety--and the stress hormones rise even more. It's a damn dirty shame that we turn a biological necessity into a source of such torment. And that torment is heaped on top of all the other difficulties the truly obese must live with every day.

Exercise is the one positive in this infernal debate; it's the one thing the so-called experts seem to be getting right. Exercise can help tame and balance the hormones that drive appetite. Unfortunately, exercise alone is usually not sufficient.

When are we going to cut the crap and get to some serious answers? When it comes to obesity, traditional medicine is still way off the mark, often doing far more damage than good.

Hard Times: Emergency Aid for Vet Care

Things are tough and getting tougher. Many people are living on the edge with no funds for unexpected expenses. Money for the necessary expenses--food, gas, utilities--doesn't go far enough, despite constant efforts to cut back and cut down. Decisions to seek medical care are weighed carefully, and all too often care is postponed or dismissed altogether as completely unaffordable. Each and every expenditure involves a hard choice.

All of this belt tightening is having an impact on our ability to care for pets. People are adopting fewer pets, and those with pets are cutting back on pet care. I've cut back on optional medical expenses for myself and for my dogs. Fortunately, my girls have been healthy and safe. But what happens when your dog or cat has a medical emergency and you have no money to pay for care? Thankfully, Dr. Lucy Pinkston Schroth, a small animal veterinarian, has established the Veterinary Emergency Funding Mission (VEFM) to help pet owners locate funding for medical emergencies.

The VEFM is still in development with a target starting date of January 2009. Dr. Schroth's VEFM blog provides all the details on its current status and how you can help in this wonderful and much-needed endeavor.

Two spoiled hounds: Katie and Samantha

Note: Since most of my posts are political in nature, I feel the need to separate my endorsement for VEFM from all things political. When it comes to helping hurting animals, animal lovers put politics aside. Fortunately, most animal lovers are good, compassionate people, and that is the tie that binds us. I have no idea about Dr. Schroth's politics; I only know that what she is doing merits our support.

Obesity: Isn't It Time For Some Facts?

Journals published by Nature hold a vast wealth of information on the latest research in the physical sciences, particularly biology and medicine. The online site for Nature also has free informative videos. Today, I discovered yet another interesting tidbit on the topic of obesity. I already know that appetite is governed by hormones. I've just begun to learn about the central role of gut ecology in entire bodily systems, from nutrient absorption to neurotransmitters and beyond. A new video from Nature discusses the role of intestinal bacteria in obesity:

Video: Human Gut Microbes
Hear scientists explain how our gut flora are involved in how we regulate body weight and may even be a factor in the obesity epidemic. . . .
-From Nature online at http://www.nature.com/nature/videoarchive/index.html.

The video highlights individual differences in gut flora and the capacity for the body to create fat tissue. We are not all alike; as individuals, we are not living, breathing manifestations of clinical averages. To think we are all replicates from a standardized template--and that what is true for you must also be true for me--is sadly and profoundly ignorant.

On a related note, I can't resist pointing out once again that John McCain's plan for dealing with the childhood obesity epidemic is to send athletes to schools to give presentations. Dear John: If you don't have a freaking clue about the problem, don't try to devise a plan to fix it. You're simply confusing the issue and compounding the problem.

The Healthcare Debate: Greater Access to a Failing System? -or- Why Are We Always Stuck on Stupid?

Earlier today, I came across a heated online discussion about healthcare. The conversation revolved around the usual hot topics in the health care debate: (1) access to care and (2) the costs/benefits of "socialized" v. private medicine. While the public and the media are arguing and obsessing over these important questions, a third and critical issue is ignored entirely. So, I had to jump into the fray:

Consumers of healthcare in the US need to understand that our healthcare problems are far more serious than costs and access alone. While access to the existing system is important, all the money and insurance coverage in the world won't fix a system that has unacceptable outcomes.

Traditional clinical medicine in the US is unable to help many people with chronic illness and, in fact, often makes things far worse. Medical mistakes and just plain bad medicine kill and sicken thousands needlessly every year. The system needs a major overhaul from a near-medieval reductionist approach to an approach that recognizes and respects the human body as a system. It must stop focusing on treatment of disease and begin to care for whole human beings--body, mind, and soul.

The Human Genome Project, for example, had to consult engineers and computer scientists to make real progress because biology and medicine utterly failed to consider genes in the context of the body as a whole. Computer scientists had to educate HGP scientists on the idea that the human body is a s-y-s-t-e-m. If computer science approached computer problems the way medical science has approached medical problems, Bill Gates would be "Bill who??", and we'd all be communicating with paper and pencil. It's insane! But from this experience emerged the long-overdue field of systems biology. For more information, google "systems biology" and "reductionism in medicine."

Until clinical medicine approaches the human body as a system, until it shifts from attacking disease to healing human beings, and until doctors stop relying on drug companies for information and treatment protocols, all the access in the world won't result in the good health care we sorely need.

Check out these excellent articles at PLoS Med:
The Clinical Application of a Systems Approach
The Limits of Reductionism in Medicine

Clinical medicine must change!

Kindness and Love: It's a VERY Big Deal

This post is for everyone--but especially for the devoted daughter of the woman who shares my mother's nursing home room. Your disapproval has been duly noted. Your mother is a lovely person. I bet she was a lovely mother. You have been blessed--more than you know. Thank your mother. Thank her every day you wake up with a normal, healthy brain.

Never abuse a child.
Be careful how you judge.
You may have no idea . . . .

Wounds That Time Won't Heal

Oh, Oprah....

Bless her heart, she means well; but sometimes she speaks about things she doesn't understand. Once I saw her interview a famous actress who went through a terrible depression and battled thoughts of taking her life. Oprah said she can't imagine having such thoughts.

The other day, I saw a video clip of Oprah with Eckert Tolle as they responded to a question on depression. Oprah said, "If you're depressed, it's because depression works for you." Oh, Oprah....

You know, some human beings are prone to adopting lovely, simplistic philosophies (that 'work' for them) and then measuring everybody and everything else through that belief system. I tend to think their lives have been too easy or their experiences too narrow.

No, Oprah, depression does not work for depressed people.

A Bit About Me & PTSD

I currently spend most week days with my beads, my dogs, and my computer. If I'm not home, I'm probably visiting with friends, showing my beadwork, going to medical appointments, or just drinking tea at Panera (well..., ok, maybe eating a bagel, too). To some of you, that may sound idyllic (except for the medical appointments). Two years ago, I would have said I'd give "anything" for that life, but I had no idea what lie ahead or what it would cost.

Not so long ago, I had a job with a title and a good salary. It was chaotic, stressful, and full of challenges. My entire life had been full of challenges, and I'd always been able to 'go deep' and rise to the situation. But the days were becoming harder and harder. I began to see signs that I was in trouble: losing my temper, inability to remember things, difficulty following conversations, not being able to focus on tasks, and becoming hopelessly disorganized--all things that were the opposite of my normal personality and performance. The harder things were, the harder I pushed and the longer I worked. Despite all the strength I could muster, things kept getting worse. I began to feel that I was hanging over a precipice by a small thread.

Something had to give. I talked to my husband, my boss, my doctors, my colleagues, asking for support, assistance, or relief of one kind or another. Nearly everyone responded with anger or denial ("take a day off, you'll be fine" and "you have obligations and responsibilities, so just get over it"). One high-level administrator became so angry that she hit me with a full-blown personal attack in a meeting with my boss. So, I tried one more time to regroup and push on; but this time, the thread snapped. I collapsed and was hospitalized with complete mental and physical exhaustion. I no longer had the strength or the will to keep fighting.

Over the course of the following weeks and months, a very surprising picture emerged. For starters, I found out that my thyroid had become under active. That alone can be debilitating. It was another three months before my thyroid problems were addressed, but the debilitating symptoms persisted. In fact, I wasn't any better. So, I pressed on looking for answers. Several months and many expensive tests later, I learned that I have a neurological problem involving the prefrontal cortex of the brain (governs higher cognitive function) and the HPA axis (controls hormone levels that underpin health and vitality). The shocker: it can be caused by life-long stress and/or a history of trauma in the critical developmental years of infancy and childhood.

Since then, I've learned a lot about the brain and the long-term impact of childhood abuse and neglect, as well as the effects of adult stress on brain function. PTSD is not just about memories and feelings--it's about serious alterations in the brain's structure and function. Complex PTSD is even more devastating; problems can multiply exponentially with repeated or prolonged trauma and stress.

For more information, see:
Does Stress Damage the Brain? by J. Douglas Bremner, M.D.
Trauma Spectrum by Robert Scaer, M.D.
Observations on Traumatic Stress, online article by Robert Scaer
Waking the Tiger by Peter Levine
Reading list by Dr. Bryan Post
Any books or articles by Bruce McEwen

POSTSCRIPT:
More than a year after I made this post, I was able to have my adrenal glad tested and learned that it was (and is) not functioning normally. Major improvements came upon beginning supplementation with an adrenal hormone and a mix of bio-identical hormones. It's by no means a cure, but it has made an enormous difference.

All Things Are Not Equal

A recently released study reports that abuse in early life permanently lowers serotonin levels in mice. Implications are that the same is true for humans. So much for the "Happiness Is a Choice" crowd.