Reality And Hallucinogens

To be honest I came of age in the late 60s and early 70s and I have smoked a lot of cannabis taken LSD more than once and mescaline even more.  I never had a bad trip and always found it to be an enjoyable experience.  What it did do was make me question "reality" - that is, what is it?
Via Andrew Sullivan we have this interesting post by Miles Klee, Blowing Your Mind.

Aldous Huxley in 1954 wrote as eloquently as one can about taking mescaline, which accomplishes more or less what Psilocybe semilanceata does. He had a more pleasant day than young Edward’s family, however, and in The Doors of Perception quoted Cambridge philosopher Dr. C. D. Broad in describing the mental processes modified:

Each person is at each moment capable of remembering all that has ever happened to him and of perceiving everything that is happening everywhere in the universe. The function of the brain and nervous system is to protect us from being overwhelmed and confused by this mass of largely useless and irrelevant knowledge, by shutting out most of what we should otherwise perceive or remember at any moment, and leaving only that very small and special selection which is likely to be practically useful. 

“According to such a theory,” Huxley continues, “each one of us is potentially a Mind at Large. But in so far as we are animals, our business is at all costs to survive. To make biological survival possible, Mind at Large has to be funneled through the reducing valve of the brain and nervous system.

In other word Hallucinogens don't alter reality they simply give us an overdose of reality.  The drugs disable the filter that determines what we perceive.  This pretty well matches my experiences.  It's been 40 years since I have performed any chemical experiments on my mind but I'm am convinced that it has impacted the way my mind works - the way I see things and in a positive way.  I question what I perceive which I think is a healthy thing.  Are drugs dangerous?  Of course they are but I have not personally known anyone who had a "bad trip."   I have known many who's lives were ruined by alcohol however.     

Tilting At Windmills

George W Bush speech writer Michael Gerson takes to the pages of the Washington Post to make his second attempt to explain to the Republican Party what they have to do to become relevant again.  He thinks the Republican party is stuck in the 1980s:

This stunning reversal of electoral fortunes has taken place for a variety of reasons: changing demographics; the end of a GOP foreign policy advantage during the Cold War; a serious gap in candidate quality; the declining relevance of economic policies that seem better suited to the 1980s; and an occasionally deserved reputation for being judgmental and censorious.

And this:

At the national level, Republicans have a winning message for a nation that no longer exists. 

In his Op Ed at Commentary he and Peter Wehner had this to say:

First, and most important, is focusing on the economic concerns of working-and middle-class Americans, many of whom now regard the Republican Party as beholden to “millionaires and billionaires” and as wholly out of touch with ordinary Americans. This is a durable impression—witness Bill Clinton’s effective deployment of it more than 20 years ago and its continued resonance during the 2012 campaign when Team Obama portrayed Mitt Romney as a plutocrat who delighted in shutting down factories and moving jobs overseas. Sure enough, in November exit polls, 81 percent of voters said that Barack Obama “cared for people like me”; a mere 18 percent said the same of Romney. They also showed that a majority of Americans (53 percent) said Governor Romney’s policies would generally favor the rich, versus only 34 percent who said he would favor the middle class.

Daniel Larison points out that Foreign Policy has also become a problem for the Republicans that is not really addressed in Gerson and Wehner's Commentary piece:

At most, Gerson and Wehner acknowledge that the GOP’s advantage on foreign policy and national security has vanished, but they still rely on the assumption that Republicans should normally have an advantage that the wars in Iraq and Afghanistan have not bolstered. A proper reckoning of the state of the party’s reputation on these issues would admit up front that it has suffered enormous damage, and the party’s new disadvantage on these issues has existed since 2006. Republicans need to recognize that the Iraq war was a debacle, but they also need to understand why it was and then learn to avoid making similar errors in the future.
There would need to be an end to constant threat-hyping and threat inflation, which contributed greatly to the paranoia and fear that warped the debate over Iraq in 2002-03. There should also be a repudiation of preventive war. Ideally, it would be rejected because it is illegal and wrong, but it would be good enough if Republicans rejected it because it is an imprudent, reckless abuse of U.S. power. No less important, Republicans need to learn to be much warier of executive power when one of their own is in power. That is probably the hardest thing to learn, since many partisans tend to tolerate awful behavior from “their” presidents that they would otherwise condemn, but it would be essential to Republicans’ resistance to new wars in the future.

But for the foreseeable future Gerson, Wehner and Larison are simply tipping their hats at windmills. The lunatics have taken over the asylum and thanks to the conservative media machine it's not about to change.   
 

China: 'leading bad actor in cyberspace,' experts say

China: 'leading bad actor in cyberspace,' experts say (via AFP)

China's full-throated denials of hacking and counter-accusations of its own do nothing to allay growing concern over large-scale cyberspying alleged in a bombshell report this week, Western analysts said. Chinese officials and state-run media have lashed out after a report by a US firm laid out in…

Hackers hit Apple in wake of Facebook attack

Hackers hit Apple in wake of Facebook attack (via AFP)

Apple on Tuesday said it suffered a cyber attack similar to the one recently carried out against Facebook, but that it repelled the invaders before its data was plundered. The maker of iPhones, iPads, iPods, and Macintosh computers said it is working with law enforcement officials to hunt down the…

Post Hospice One Month

It's hard to believe but it's been a month today since Mom passed away.  I have been confused by my emotions but I think I finally figured it out.  As an engineer in the world of hi-tech for 35 years I have been downsized or layed off more than once.  There is a void after that - you have to reinvent yourself.  I was my Mothers caregiver for 10 years and the last couple of years it has been a 24/7 job.  Suddenly I am unemployed.  Unlike previous unemployment I don't have to worry about the finances as I have investments and collecting Social Security but the void still exists and I still have to reinvent myself.  Yes, I have kept busy - shredding years of documents and getting rid of junk but it's not the same.  When you watch someone die slowly for for months or years most of the grieving is finished when it finally happens - in fact as cold as it might seem it's almost a relief.

I write this in part to clear my mind but I also hope it may help others. 

Boehner and McConnell Head to White House for Sequester Chat

Boehner and McConnell head to White House for sequester chat: youtube.com/watch?v=eeOmXJ…
— TheObamaDiary.com (@TheObamaDiary) February 18, 2013

Rethinking Medical Education -- Long Read

I'm not the only one digging around in old blog posts. I received notification of a comment left yesterday to a post published in 2011 at The Health Care Blog. The subject is a policy-level question not likely to receive popular attention, but like most policy-level discussions may be more important than lay people want to admit.
Victor Fuchs is the Henry J. Kaiser, Jr., Professor of Economics and of Health Research and Policy, emeritus, an FSI senior fellow and a core faculty member at Center for Health Policy/ Center for Primary Care and Outcomes Research at Stanford University. He has written extensively on the cost of medical care and on determinants of health, with an emphasis on the role of socioeconomic factors.

Dr. Fuchs' principal focus is the structural reforms undertaken by ACA, but in this article he reflects on the need for change in how medical professionals are trained and educated.

In the face of such revolutionary changes, how has the structure of medical education adapted? It seems that the answer is hardly at all. Fifty years ago, the basic structure was four years of college, four years of medical school, and three years of post-graduate training. Only after 11 years of post-high school graduation was the physician deemed ready to practice medicine. The same is true today, although a much larger percentage than formerly go beyond 11 years to obtain additional specialized training. And in one medical school I know of fewer than 40 percent graduate in 4 years.

He compares how engineers are trained with how doctors are trained and comes up with some provocative suggestions.
A somewhat long but generally polite and intelligent string of comments follows.
Reader advisory: This is heavy lifting. Don't go to the link unless you have an open mind and time to reflect on the material. A cup of coffee might also be a good idea. 

'Stench cruise' fallout: Will it create a stink for Carnival and the industry? (via The Christian Science Monitor)

'Stench cruise' fallout: Will it create a stink for Carnival and the industry? (via The Christian Science Monitor)

Five days adrift in the Gulf of Mexico without flushable toilets did little to please some 4,200 people aboard the Carnival Triumph. It’s also a blow to the cruise industry and especially to a major player in it, Carnival, even though the passengers are now back on land. At least in the short run…

AQIM Long Read

When operatives sponsored by Al Qaeda in the Islamic Maghreb provoked the recent French intervention in Mali they had overplayed their hand. (h/t Mark Doyle via Blake Hounshell)
 A fascinating document left behind, now public, provides a glimpse behind the curtain.

The document is an unprecedented window into the terrorist operation, indicating that al-Qaida predicted the military intervention that would dislodge it in January and recognized its own vulnerability.
The letter also shows a sharp division within al-Qaida's Africa chapter over how quickly and how strictly to apply Islamic law, with its senior commander expressing dismay over the whipping of women and the destruction of Timbuktu's ancient monuments. It moreover leaves no doubt that despite a temporary withdrawal into the desert, al-Qaida plans to operate in the region over the long haul, and is willing to make short-term concessions on ideology to gain the allies it acknowledges it needs.

The letter apparently had six chapters of which three were found. It reveals a sophisticated awareness of public relations not usually attributed to this group. Clearly they are learning from experience and observation.

Droukdel's letter also urges his followers to make concessions to win over other groups in the area, and in one case criticizes their failure to do so. For several months, the Islamic extremists controlling northern Mali coexisted with the secular National Movement for the Liberation of the Azawad, or NMLA, the name given to Mali by Tuareg rebels who want their own state. The black flag of the extremists fluttered alongside the multi-colored one of the secular rebels, each occupying different areas of the towns.
In late May, the two sides attempted to sign a deal, agreeing to create an independent Islamic state called Azawad. The agreement between the bon vivant Tuareg rebels and the Taliban-inspired extremists seemed doomed from the start. It fell apart days later. By June, the Islamic extremists had chased the secular rebels out of northern Mali's main cities.
"The decision to go to war against the Azawad Liberation Movement, after becoming close and almost completing a deal with them, which we thought would be positive, is a major mistake in our assessment," Droukdel admonishes. "This fighting will have a negative impact on our project. So we ask you to solve the issue and correct it by working toward a peace deal."
In an aside in brackets, Droukdel betrays the frustration of a manager who has not been informed of important decisions taken by his employees: "(We have not until now received any clarification from you, despite how perilous the operation was!!)"

Meteor strike in Russia hurts almost 1,000

Meteor strike in Russia hurts almost 1,000 (via AFP)

A plunging meteor exploded with a blinding flash above central Russia on Friday, setting off a shockwave that shattered windows and hurt almost 1,000 people in an event unprecedented in modern times. The extraordinary event brought morning traffic to a sudden halt in the Urals city of Chelyabinsk as…

Gun Death Stats Don't Include Suicide

This is a helluva way to start the day... getting hit in the face by an unexpected fact.

No need to belabor the point. With arguments and discussions about gun violence swirling around, sooner or later this reality will get into the conversation.

I hope...
I was made aware a few minutes ago by a Twitter message, and a quick search tuned up an excellent recent article from the Boston Globe which prints out to about five pages.

This time the gun debate is finally getting the attention it deserves as it relates to mental health issues. When the number of suicides by guns exceeds the number of homicides the conversation is more about gun safety than gun violence. This is especially true when the number of mass killings and gang-related violence, regardless of how tragic they are, are mathematically small by comparison. 

In the public-health community, researchers have widely come to regard it as a basic truth that access to a gun makes it more likely that someone who wants to commit suicide actually manages to do so. A big part of the reason is simply the lethality of guns: Studies show that between 85 and 90 percent of people who shoot themselves die as a result, while the percentage of people who die using other means is vastly lower. Alan Berman, executive director of the American Association of Suicidology, points out that guns, unlike other methods, leave people no time to change their minds. They also require less preparation and planning, provided they’re accessible.
“To some people, it’s just totally counterintuitive, because it’s so obvious that if you want to kill yourself, you can always find something else to kill yourself with,” said Barber. “What they assume is that once you’re suicidal, you remain suicidal.” But a preponderance of evidence, including interviews with suicide survivors, indicates that most suicidal acts come during a surprisingly short period during which the person is suffering an acute crisis.
“When you ask people who’ve made attempts and survived,” Miller said, “even attempts that are life threatening and would have proved lethal [without emergency medical care], what they say is, ‘It was an impulsive act, and I’m glad that I’m alive.’”

Headline-grabbing events are more exciting, but the discussion of guns is a more boring discussion about public health and lowering the risk of suicide.
If the reader doesn't already know, be aware that the number of suicides in the military when veterans are included exceeds the number of combat casualties. This is not news.   Again this year more active duty personnel have killed them selves than were killed in action in Afghanistan.
Mark Shields did some interesting homework and found out that more Americans have died by non-combat gunfire than in all the wars in the nation's history.

...since Robert Kennedy died in the Ambassador Hotel on June 4, 1968, more Americans have died from gunfire than died in … all the wars of this country's history, from the Revolutionary through the Civil War, World War I, World War II...

His figures do include suicides so it is important to keep the numbers straight whenever the discussion leads to statistics. The time has come to connect a few dots and quit the paranoid discussions of politics and the Second Amendment.
America, we have a bigger problem than that.

Bring On The Sequester

Over at TPM Brian Beutler thinks the House Republicans won't pass any legislation to stop the sequester because they can't.  The libertarians and conservative "foreign policy realists" don't see this as a bad thing.
Last week in the post Real Conservative Foreign Policy I quoted Andrew Bacevich:

When it comes to foreign policy, the conservative position should promote modesty, realism, and self-sufficiency. To the maximum extent possible, Americans should “live within,” abandoning the conceit that the United States is called upon to exercise “global leadership,” which has become a euphemism for making mischief and for demanding prerogatives allowed to no other nation. Here the potential exists for conservatives to make common cause with members of the impassioned antiwar left.

Over at CATO Christopher A. Preble thinks Sequestration Is Still Better than the Alternatives:

Late last year, then-Republican Study Committee Chairman Rep. Jim Jordan (R-OH) said of the impending sequester, “The only thing that’s worse than cutting national defense is not having any scheduled cuts at all.”
It turns out, there is something worse: no cuts, or only modest ones, far less than was called for under sequestration, and additional taxes to cover the difference. That is what we are likely to see if President Obama gets his way. In a last-minute bid to avert the spending cuts mandated under the 2011 Budget Control Act, the president on Tuesday offered a package of short-term spending cuts and tax reforms in lieu of automatic cuts. Then, on Wednesday, the White House continued its full-court stop-the-sequester press by meeting with a group of defense contractor CEOs.
But while many Republicans seem anxious to accept such a deal, the GOP should stand fast. U.S. taxpayers already spend too much on the military, in part because we expect our military to do too much. We could achieve substantial savings, at least as much as is foreseen under sequestration, if we revisit the military’s missions, and adapt our capabilities to meet new threats.

More dollars don't equal a safer United States:

Spending is not the best measure of military effectiveness, and conservatives, especially, should know this. Some still do. A letter signed by eight different organizations, including Americans for Tax Reform, the National Taxpayers Union, and Taxpayers for Common Sense, calls for “eliminating outdated, Cold War-era weapons, cutting programs the military doesn’t even want, reforming military health care programs, and closing unneeded bases.” Such reforms, the letter concludes, “will not only save taxpayers billions, they will also make our nation stronger by helping safeguard our financial security.”

I would add that while more dollars don't equal a safer United States they do equal more potential mischief so in fact make us less safe.
But would sequestration result in economic armegeddon?  According to William Hartung of the Center For International Policy the answer is no.

The Pope

Anyone else sick and tired of hearing about the Pope?
— Ron Beasley (@ronbeas) February 11, 2013

Those People You've Never Heard Of That Changed Your Life

We have all heard of Thomas Edison and Alexander Graham Bell but there are many people who changed our lives that we have never heard of.  A few years ago I wrote about Hiro Moriyasu who developed the digital oscilloscope and the first desktop computer, the Tektronix 4051.  He certainly changed our lives but few have heard of him.  

Today where hear about another such individual, John Karlin of Bell Labs.

A generation ago, when the poetry of PEnnsylvania and BUtterfield was about to give way to telephone numbers in unpoetic strings, a critical question arose: Would people be able to remember all seven digits long enough to dial them?
And when, not long afterward, the dial gave way to push buttons, new questions arose: round buttons, or square? How big should they be? Most crucially, how should they be arrayed? In a circle? A rectangle? An arc?
For decades after World War II, these questions were studied by a group of social scientists and engineers in New Jersey led by one man, a Bell Labs industrial psychologist named John E. Karlin.
By all accounts a modest man despite his variegated accomplishments (he had a doctorate in mathematical psychology, was trained in electrical engineering and had been a professional violinist), Mr. Karlin, who died on Jan. 28, at 94, was virtually unknown to the general public.
But his research, along with that of his subordinates, quietly yet emphatically defined the experience of using the telephone in the mid-20th century and afterward, from ushering in all-digit dialing to casting the shape of the keypad on touch-tone phones. And that keypad, in turn, would inform the design of a spate of other everyday objects.

I am old enough to remember dial phones and party lines where you shared a wire with one or more other numbers.  I also remember  when our home phone number went from CApitol-XXXX to 227-XXXX and the first touch tone phone.  But I'd never really thought about this:

In 2013, the 50th anniversary of the introduction of the touch-tone phone, the answers to those questions remain palpable at the press of a button. The rectangular design of the keypad, the shape of its buttons and the position of the numbers — with “1-2-3″ on the top row instead of the bottom, as on a calculator — all sprang from empirical research conducted or overseen by Mr. Karlin.
The legacy of that research now extends far beyond the telephone: the keypad design Mr. Karlin shepherded into being has become the international standard on objects as diverse as A.T.M.’s, gas pumps, door locks, vending machines and medical equipment.

Touch Tone Key Pad

Tektronix 4051

Health Care Links

It's not a stretch to call Gary Schwitzer the Walter Cronkite of health care journalism. His Health News Review was fact-checking since before fact-checking was cool.  I followed it for a long time with Google Reader but dropped it when I got overwhelmed by the volume. It's like the Guinness Book of Records or an unabridged dictionary -- more than most laymen can handle. But this week I re-subscribed and will give it another run. Anybody serious about health care news and reform should have this guy on their radar.  Here are some recent links for starters.

►  7 Words (and more) You Shouldn't Use in Medical News
This is a thirteen-year-old classic.

Over a 25-year career in medical journalism and health care communications, I have developed my own list of taboo terms – all of which appear in print and on the public airwaves too frequently. I offer my own list of the seven words you shouldn’t use in medical news and health care communications. I urge colleagues – both health care providers and professional communicators – to abandon their use for the sake of health consumers everywhere. I urge consumers of all health care information to be wary of these words because they mean different things to different audiences.

• Cure

• Miracle

• Breakthrough

• Promising

• Dramatic

• Hope

• Victim

How many times do we see these words in headlines, TV reports and most notably in commercial messages?  I once had a teacher who had a firm rule: Never use the word "thing." Ever. There is always a better word. If you can't think of it, then you shouldn't be writing about it. 
Over the years I have slipped a few times, but not often. Go to the link for a fuller explanation of each, for example...

Dramatic discoveries seem to occur in the medical media more often than even in our television soap operas. The ancient Greeks would remind us that drama could be both comic and tragic, as can the use of the word “dramatic” to inject hype into an otherwise important piece of research news.
Veteran science writer Victor Cohn once chided medicine and the media by saying, “It seems like there’s only two types of medical news stories: new hope and no hope.” A woman struggling with cancer once told me she wished medical reporters would leave the word hope out of their reports and allow consumers to decide how much “hope” to assign to each story.

►  Prozac and SSRIs: Twenty-fifth Anniversary by David Healy 
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that affect serotonin levels in the brain. Serotonin is a chemical neurotransmitter. For many people, SSRIs are the first choice of depression treatment selected by health care providers. And by now, everyone has heard of Prozac.
Schwitzer links this reflection which reminded me of the a sad retrospective of trans-orbital lobotomies, a treatment of choice for extreme cases of mental problems prior to the introduction of Thorazine in 1954.
The NPR story of Howard Dully is a haunting story of how much worse mental problems were managed in the past.  It's only 23 minutes long.  Highly recommended.
But Dr. Healy reminds us that the journey still has a long way to go.

Prozac was approved in 1987 in the US, and launched in early 1988, followed by a clutch of other SSRIs. Twenty-five years later, we now have one prescription for an antidepressant for every single person in the West per year.
Twenty-five years before Prozac, 1 in 10,000 of us per year was admitted for severe depressive disorder – melancholia. Today at any one point in time 1 in 10 of us are supposedly depressed and between 1 in 2 and 1 in 5 of us will be depressed over a lifetime. Around 1 in 10 pregnant women are on an antidepressant.
No one knows how many new cases of depression there are per year partly because modern depression is a creation of the marketing of Prozac. Until recently what is now called depression was called anxiety, nerves or a nervous breakdown. SSRIs can help some cases of nerves but they are of no use for depression proper – melancholia. But the money for companies lies in treating nerves not melancholia – and as a result any of us with severe depression is likely to get worse treatment now than we once did. We’ve gone backwards.
[...]
Many see or saw psychiatry as a medical backwater with grim, overcrowded hospitals, and a dim understanding of the disorders it treats. In fact it was the first branch of medicine to have specialist hospitals and journals, the first to discover the bases for and eliminate several serious disorders, the first to adopt rating scales and controlled trials. And with Freud’s son-in-law, Edward Bernays, it was the first to step into public relations.
Twenty-five years ago, no one could have imagined that the bulk of the treatment literature would be ghostwritten, that negative trials could be portrayed as glowingly positive studies of a drug, that controlled trials could have been transformed into a gold-standard method to hide adverse events, or that dead bodies could have been hidden from medical academics so easily. Twenty-five years ago no one would have believed that a drug less effective for nerves or melancholia than heroin, alcohol or older and cheaper antidepressants could have been brought on the market and that almost as a matter of national policy people would be encouraged to take it for life.

►   An update on how we die in the U.S.

Okay, this is another pitch for all readers to take action on advance directives for medical care, for themselves and anyone in their life who needs encouragement.  

Schwitzer points to yet another article about end-of-life care, this time in the LA Times. 

But the latest research suggests that patients' wishes may not be getting through to the family members and physicians who help guide patients' end-of-life journeys. As a result, their final days are far from what most would consider ideal.
There's almost always, in every medical circumstance, one more thing we can try," said Dr. Julie Bynum, a gerontologist at Dartmouth's Geisel School of Medicine and coauthor of the study. "It's hard for a doctor to say, 'I have one more thing I can do, but it's not a good thing.'"
The time to begin the conversation with family members and doctors about end-of-life care is well before the final crisis begins, she said. If a patient's wish to avoid aggressive treatment is clear, "you need to prevent him from getting into that cycle of acute care," she added, "because once they get into the hospital, it's really hard to get them out."

Grim humor here....
Q.  Why do coffins have nails.
A.   To keep out the oncologists.

Real Conservative Foreign Policy

As you have probably noticed Republican/conservative foreign policy has been taken over by the neoconservatives.  What you may not know is that until about 1972 the neoconservatives were part of the Democratic Party - the Scoop Jackson wing.  The "real" conservatives over at The American Conservative magazine would like to bring back the old conservative foreign policy.
The cover story of the magazine this month is by Andrew Bacevich,  Counterculture Conservatism where he writes as one of his bullet points:

Exposing the excesses of American militarism and the futility of the neo-imperialist impulses to which Washington has succumbed since the end of the Cold War. When it comes to foreign policy, the conservative position should promote modesty, realism, and self-sufficiency. To the maximum extent possible, Americans should “live within,” abandoning the conceit that the United States is called upon to exercise “global leadership,” which has become a euphemism for making mischief and for demanding prerogatives allowed to no other nation. Here the potential exists for conservatives to make common cause with members of the impassioned antiwar left.

Now Charles Krauthammer and Bill Kristol aren't going to like this very much but Daniel Larison, a blogger at the same magazine, does.

In practical terms, it should go without saying that this rules out preventive war. Few things better reflect the belief that the U.S. should enjoy “prerogatives allowed to no other nation” than the idea that the U.S. has the right to attack other countries for what they might do in the future. The U.S. should also be less involved in supporting other states’ internal political opposition, which is often the very definition of “making mischief” and meddling where we aren’t wanted by most of the people in these countries. The U.S. should be reducing how much it spends to subsidize the defense of countries that can readily provide for their own defense, and it should be cutting back on the overseas commitments it already has instead of adding to them. Specifically, that would mean no more NATO expansion, no new security guarantees to other states elsewhere in the world, and a review of the existing guarantees that the U.S. has made to determine whether or not they are outdated and irrelevant to American security today. Conservatives in the U.S. should be interested in trying as much as possible to get the United States back to the position of being at least a normal major power that has no special obligations and assumes no special authority or rights.

I think this is right, our interventions since WWII have brought us nothing but blow back and pain.  When talking about why we are so hated in the Middle East Pat Buchanan, said it best:

They don't hate us because of who we are they hate because of where we are.

Now I don't agree with Buchanan on much of anything but he called that right.  bin-Laden himself said the reason for 911 was American troops stationed in Saudi Arabia.  Most of our foreign policy difficulties today are the result of meddling to protect the interests of multi-national corporations since the end of WWII.  Case in point is Iran where the CIA overthrew a Democratically elected prime minister because he was going to nationalize the country's oil resources.  They put the much hated Mohammad Reza Shah Pahlavi in charge and helped him create his secret police to hold onto his power.
Being the world's bad cop is not something that benefits the citizens of the United States and in addition we can't afford it anymore.

Perhaps It's Time To Move

I live in the Portland, OR area and I have been aware of the Cascadia suduction -zone and the associated earthquakes since I took geology in 1964.  The Japanese earth quake was a subduction-zone earthquake.  Never the less this was a bit disconcerting:
Cascadia earthquake, tsunami could cost Oregon economy $32 billion

The next great Cascadia subduction-zone earthquake will kill thousands in Oregon and cause at least $32 billion in economic losses unless preparations are radically overhauled, a state panel says.
When, not if, the magnitude-9.0 quake strikes -- let alone an accompanying tsunami -- Oregon will face the greatest challenge in its history, the state earthquake commission said in a 290-page draft report released Monday to The Oregonian.
Buildings will be so severely damaged that restoring full utility service will take three months to a year in western valleys and far longer on the coast, the commission found. Businesses tend to move or fail if utilities aren't up in a month.
"So Oregon faces a very real threat of permanent population loss and long-term economic decline," said the report, which recommends 50 years of seismic upgrades and other investments -- price tag incalculable.

It's been 300 years since the last one and they occur on average every 300 to 600 years.  Northern California and Washington State would also be impacted.

What few think about is the economic impact this could have on our technology driven world.  The largest Intel facility in the world is located in Hillsboro Oregon.  Every Intel microprocessor has been designed at the Intel Ronler Acres facility for 20+ years.  In addition it is where the manufacturing process is developed at which time it is duplicated at facilities all over the world.  The Hillsboro facility is a multi billion dollar one and probably accounts for a good share of that 32 billion dollar number.

Now very few of the recomended seismic upgrades will be made-neither the will or the resources are there. 

The Republican Base Problem

Cliff Owen/Associated Press

The Republican Party has a base problem that may have already cost them control of the Senate.  There was Todd Akin and Richard Murdoch in 2012 - Sharron Angle and Christine O'Donnell in 2010 who were able to win primaries but unable to win general elections because they were just well crazy.  Establishment Republicans are trying to stop the bleeding but they have a problem in Iowa.

The Republican Party may be dealt another far-right candidate in a potentially competitive U.S. Senate race if a poll released Tuesday is any indication.
Rep. Steve King (R-IA) is the favorite among Iowa Republicans to run in next year’s contest to replace retiring Sen. Tom Harkin (D-IA), according to the latest survey from Democratic-leaning Public Policy Polling. The poll showed 41 percent of usual GOP primary voters in the state identifying King as their preferred candidate over three other Republicans. Rep. Tom Latham (R-IA) was a distant second with 22 percent support among Hawkeye State Republicans. Neither King nor Latham so far has declared an intention to run.
Some conservatives, including a new group backed by political operative Karl Rove, have warned recently that nominating King would put Republicans in the same bind they found themselves in the previous two cycles, when the party squandered prime pick-up opportunities in Senate races by fielding candidates who turned out to be too extreme for voters.

Doug Mataconis:

The problem for the GOP is two fold. First, Iowa’s Congressional Primary’s are closed, which means that the electorate will be restricted to a Republican electorate that tends to be more conservative than the state as a whole. Additionally, King’s popularity among Christian and Tea Party groups is likely to be a boon to him in a primary race where voter turnout is likely to be low. Second, of all the potential GOP Senate candidates in 2014, King is clearly the furthest to the right and the one most likely to commit an unforced error like the ones committed by Todd Akin and Richard.

 This is a problem created by the Republican Party but to a greater extent  the conservative media machine - think FOX news and talkers like Limbaugh.  They encouraged the paranoia of the already paranoid and suddenly the lunatics had taken over the asylum.

I'm Back

Pauline Beasley

This is kind of a follow up to John's excellent post below.  About 2 weeks ago my my 90 year old mother died.  She had been in home hospice for over 2 months.  I had a caregiver come in 5 hours a day but for the rest of the time I was her caregiver.  Those caregivers were not covered by medicare and it cost my sister and I about $12,000 for those two months.  Medicare did cover the Home Hospice service which was truly a blessing.  They supplied the hospital bed, wheel chair and Oxygen in addition to all medications.  In addition a bath aid came in twice a week and a nurse came in twice a week.  It was a sacrifice for me but worth it as mother died peacefully in her own home.
My mother was in good health until she was about 88.  She was still walking nearly a mile a day.  But about two years ago she had the first event that resulted in an ambulance ride.  No hospital stay but several hours in the emergency room.  After that she was slowed but not out.  She was still going for walks at our favorite park - just not as far.  There was another event about a year ago that also resulted in an ambulance ride.  That marked the end of the walks but she was still getting around the house.
Then end of October 2012 is when the real downward spiral began.  She could no longer sleep in her bed and spent all of her time in a powered recliner in the living room.  I slept on the couch next to her so I could help her to the restroom.  I called my sister and she came up from Houston.  We decided I needed some help so we called an in home care agency.  We made arrangements for a caregiver to come in and give me a break 5 hours a day.  They also suggested that we make arrangements for Home Hospice which started about two weeks later.
Over the next two months she ate less and less and systems would shut down and then start again.  She slept more and more.  On the Monday before she passed away she went to sleep in the evening and never really woke up until she died on Friday.  To be honest there was very little grieving.  I was told that my grieving process had probably started 2 months before and was almost finished.  I do miss the caregivers who had become part of the family-I had the same 3 for most of the 2+ months.
I can't say enough about the caregivers and the Home Hospice team.  My sister said it well "until I met these people I didn't know there was that much empathy in the world."
So I should be back posting soon.

Immortality Is Not An Option

This is a repeat of a post I put together three and a half  years ago following the death of Senator Kennedy. It  mentions a dental appointment "yesterday" but that's not 

important. The realities remain the same. 

~~~§§§~~~

Ted Kennedy's death is a reminder that dying is the only universal fact of life. The country swirls in yet another argument about the role of government as frightened crowds of white-haired people, some close to tears, vent their fears in trembling rage at elected representatives. It is a fitting tribute to Kennedy that his passing has done nothing to calm the political fire lines at which he so vigorously fought. The first order of business is arguing over the argument itself, carping over whether it is fitting to discuss a successor, naming reform legislation in his honor, or speculate about how other political dominoes will fall. I imagine him looking down sadly at chattering over unimportant matters, avoiding the real challenges that threaten the country. And white-haired fears ratchet up another notch as Michael Steele continues to fan the kindling.

Changing the subject for a moment, over at Deron's Blog [now deleted] are these good questions.

• Do we need to live past 85? Is 20+ years of being a senior citizen worth it? 
• Is it better to go out with a bang as opposed to going out while barely being able to walk, jumping from physician to physician, on 15 medications?

These are just some questions that each of us should be asking ourselves. In healthcare, it used to be the family doc and the patient. Now there are 12 other people involved. Did you ever try comparing TV today with TV from 25+ years ago? The editing today is absurd. Has our attention span gotten so short that we lose interest if we're not seeing a new frame every half second?
I'll get back to them later, but first a little anecdote about yesterday's dental appointment.

Last month I broke a tooth and had to be fitted with a crown. (I learned years ago why they call it a crown. It takes a king's ransom to buy one.) Removing the temp and seating my new custom-made tooth took only a few minutes. I was pleasantly surprised but a little anxious that he didn't give me a pain shot. I've been down this road before and cold rinse water followed by air-drying on the stump of an broken tooth is like something from a James Bond film. This time, no problem.

"It didn't hurt at all," I said. "I guess it didn't break off that close to the nerve."
"You would have to bring that up," said the dentist. "How can I say this... as we mature the nerves shrink in our teeth. If you were younger I would have given you a shot, but considering your... maturity... I figured you didn't need it."
"Got it," says I, looking over at the assistant. "What he means is that I'm getting old. And as we get old our teeth die. Right, Doc?"
"Well, yes. I didn't want to bring it up, but you wanted to know."

The cat is out of the bag. I'm aging. It's okay to say so. I don't care and I don't take it personally. Thanks to working in the retirement community for the last six or seven years I have a different attitude. I see aging up close and personal in a way that most people never see. Until a family member gets there the reality of age remains as distant to most people as the details of how the mechanic repaired the car or where trucks go when they pick up this week's garbage. As long as the car goes when they put in the key or they don't forget to put out this week's garbage, that's as much as most people want to know. Sometimes an adult "child" enters the world of aging in a way that understands the reality of what it means but more often than not, even those who are aging remain in personal denial as long as possible.

When I had a colonoscopy last week I realized it was for one purpose only, screening for colorectal cancer. Just before they knocked me out I took advantage of the sixty seconds or so available to ask the doctor what my chances are at actually having colorectal cancer. He didn't know. He said "I should know those numbers but I really don't know at the moment. We do know that the rates have been going down, however, because by screening we catch a lot of them before they become fatal."

Not satisfied with that answer, I looked it up at the CDC website. I learned that as a male my chances of getting colorectal cancer were slightly worse than those of a female. The rate for someone my age, 65, is not provided. But for a man at the age of sixty...

The table shows 1.55% of men who are now 60 years old will get colorectal cancer sometime during the next 10 years.  [Hey, that's good news! That was just three and a half years ago and the number is now down to 1.46. Science and medical progress marches on.]  That is, 1 or 2 out of every 100 men who are 60 years old today will get colorectal cancer by the age of 70.

The numbers increase with age, of course, just as with any other form of cancer. The longer you live the more likely you are to get sick and die. Hello. But another way of looking at it is that I have a ninety-eight percent chance of never getting colorectal cancer by the time I'm seventy or so.

Statistical odds are not the same as individual events. The victim of a lightning strike or brain aneurysm at the age of thirty isn't interested in hearing about the odds. Theirs is a more personal challenge. But for those of us who have survived six or seven decades and still seem to be in fairly good health can have a more sanguine view (excuse the adjective, please) of disease, death and dying. I told my wife afterward that unless symptoms appear sometime in the future (bleeding, blockage, suspicious blood signals, whatever) I have had my last colonoscopy. I see no reason to go through the procedure again just because another five years goes by.

I underwent a less sophisticated version of the same exam about fifteen years ago. I think the doctor called it a sigmoidoscopy because they didn't turn the corner and look all the way around to where the colon begins, way down there where the appendix lives (or in some cases used to live). Science is fifteen years further along now. So instead of chatting with the doctor as he does something intensely personal where no man has ever been, today's procedure is conducted under the darkness of propofal, currently fashionable thanks to the late King of Pop and his physician.

Speaking with my sister and other lay people about the effect of anesthesia on elderly patients we all recollect noting that problems with memory and dementia often accelerate following general anesthesia. Obviously many old people seem never to show any after-effects. (Just as there are young people who regularly smoke grass and never get more than the muchies.) I'm sure there are studies about that phenomenon, but I don't expect to see them advertised in an era when knocking old people out for surgery is as lucrative as it is. Even faced with facts, most people, both old and young, tend to follow fears more than facts as illustrated by the current health care debate.

Back to Deron's questions.

• Do we need to live past 85? 
• Is 20+ years of being a senior citizen worth it?

As long as my mind hold out and my ability to communicate remains tolerably good, I'm all for living as long as the Lord allows. The biblical ration of "three score and ten" is coming up for me in less than five years, but science seems to be returning us to longer lifespans. America may have forty other places ahead of us in life expectancy but we're still ahead of Cuba, China and most of Africa. Don't forget, we have "the world's best medical care." [More good news. In just three years we now only have thirty-nine ahead of us. That's progress, no?]

• Is it better to go out with a bang as opposed to going out while barely being able to walk, jumping from physician to physician, on 15 medications?

Given the option, I choose the longer life, even with multiple medicines and doctors. But between now and then I would like to see all my records in one place, preferable with a software program looking over many shoulders as they prescribe the fifteen drugs, sending the doctors and me a message if any of the drugs cause side effects when combined with others. (As for the walking part, I have already accepted that no matter what other problems come with age, mobility is the issue that crosses all the lines. If the pain can be controlled and I can still pee, dress and get into bed, I'm good to go. Walkers and motorized chairs are becoming part of the landscape.) I'm not wasting time taking care of other seniors. I'm taking notes.

In a perfect world we all have one primary care physician, but they are a vanishing species. The medical homepractice is the ideal replacement of the future but it may disappear along with PCP's if Congress isn't careful.

• Did you ever try comparing TV today with TV from 25+ years ago.  The editing today is absurd. 
• Has our attention span gotten so short that we lose interest if we're not seeing a new frame every half second?

Good points, Deron. I will treat these questions as rhetorical.

In my case I pay so little attention to commercial television that except for C-SPAN and the evening news I rarely sit through a whole program. I watch the news is by using the "back" button on the remote, alternating one of the alphabet channels with a PBS report on another channel during the commercials.

Senator Kennedy's death, like all deaths, is a reminder of everyone's mortality  All political persuasions will end in death. None is exempt. Thanks to science, if you don't want to die or let someone go, a persistent vegetative state may be available for years, but even that eventually ends with death. At some level everyone knows this, which may explain why Ms. Palin's imaginative locution of death panels drew such a visceral response. And seeing how effectively that line worked to frighten old people, opponents of reform grabbed it like a bloody shirt to advance the emotional appeal of their cause.

Hacking incidents ignite fears over China

Hacking incidents ignite fears over China (via AFP)

A string of cyberattacks on major US media outlets like the New York Times has intensified worries over Chinese hackers, who analysts say are probably linked to the secretive Beijing government. The attacks, part of a series of incidents traced to Chinese servers associated with previous intrusions…