A Story of Medical Greed: Thoughts About Dallas Buyers Club

Had bad dreams last night. Maybe it was because I watched Dallas Buyer’s Club.

Some factual inaccuracies….

Most Americans probably have no idea who Marc Bolan was. He fronted T. Rex. Hugely popular in England. Essentially unknown in America except for the song Bang a Gong (Get it On). He died in 1977. In 1985 Power Station re-released a version of Bang a Gong with Robert Palmer singing….

Another misrepresentation… that the main character was diagnosed with HIV and told he had one month to live in July 1985….

The HIV virus wasn’t definitively discovered until at least a year later. Two separate groups were fighting over the honor. And the Western Blot didn’t become routinely available for a while. And even then… the results took about two weeks…. And there was a HUGE amount of red tape required to test someone. No one could be tested without their permission. Because insurance would be immediately cancelled. And jobs would be lost. And the person would be ostracized from society….

The disease was known as AIDS… or GRID…. Acquired Immune Deficiency Syndrome or Gay Related Immune Deficiency. And the diagnosis was by symptoms. And… by risk group…. The 4 H’s…. Homosexual, Heroin users, Hemophiliacs and Haitians…. Turned out the Haitians were driven to male prostitution through destitution….

The first case in America was from Saint Louis. A black man… who may have been a male prostitute….

Anyway…. The disease was a death sentence…. And no one was sure how it was transmitted….

Now for some medical stuff that wasn’t covered in the movie….

AIDS victims had weird diseases. And the AIDS dementia… wasn’t cured by the magic serum depicted in the movie…. Neither is Alzheimer’s Disease.

AIDS patients frequently had brain lesions on CT or MRI (MRI was a very new technology at the time that wasn’t widely disseminated: we had more MRI machines on the campus at Barnes/Jewish Hospital in Saint Louis than all of Canada, and New York University Hospital didn’t perform MRI on nights or weekends. Most hospitals that took care of the patients depicted in the movie didn’t have MRI or a budget that would allow random Western Blot screening….) We all knew that either the lesions were lymphoma, for which there was no effective treatment, or some strange infection picked up from a cat (Toxaplasma gondii) which would respond to drugs typically used for urinary tract infections (Trimethoprim-Sulfamethoxadole) or was a virus that had no treatment…. And… brain biopsies… put the surgeon at risk for acquiring a disease that would kill him… and potentially his family…. Realistically… there was no reason to do the biopsy…. Treat the patient with Bactrim… and if they didn’t respond… then Bx’em…. But the Neurologists… and the Infectious Disease docs… who were not exposing themselves to risks… demanded tissue…. So… the low man on the totem pole got to do the biopsies…. Which were just being developed and were crude systems…. Same with everything else…. Anal fistulas…. Perirectal abscesses…. Genital warts…. Biopsies of Kaposi’s Sarcoma lesions on the legs…. Lymph node biopsies…. Suddenly… they ALL got passed down….

Saint Louis City Hospital shut down. Saint Louis County Hospital shut down. Saint Luke’s East became Regional Hospital. Saint Luke’s pulled their staff out… to the more profitable West County location…. The Federal Government got involved with Medicine… and reigned in medical costs… and the hospital system that used to treat the indigent… collapsed…. Right at the time that AIDS was beginning to be recognized…. Ronald Reagan got blamed by the Gay Rights advocates…. But… Ronald Reagan didn’t spend America into a financial crisis…. Ronald Reagan didn’t start stagflation…. That was the Keynesians….

And… is it really right to take the majority of the money available for medical research… be moved to ONE disease…? A preventable disease…?

Let everyone with cancer die…. Let all of the children with inborn errors of metabolism die…. Let everyone else in the world die…. Because I have AIDS…. So I can live….

THAT is greed….

The drug companies were greedy, too…. But… despite the way AZT or Zidovudine was portrayed in Dallas Buyers Club… it’s still part of the cocktail that works today…. And back in 1987… no one knew how to use it…. Which was precisely what the medical establishment was trying to determine by not letting everyone do it the way they wanted….

Let me give you a bit of a personal example. Crazy Glue (cyanoacrylate) was used for treating brain arteriovenous malformations. But it wasn’t FDA approved. A trial was performed… just like the FDA demanded… but the administration changed… and the Democrats wanted to decrease the expenditures on health… so… the FDA decided to move the goalposts… for political reasons…. So… the facility in North Carolina that manufactured the material… stopped…. So… medical grade nBCA was only manufactured in Germany… and was smuggled into America from Canada…. But… the FDA wanted another trial… so they clamped down…. But… getting the glue to treat the Senator’s relative wasn’t so terribly difficult….

But… of course… it’s more complex than that…. The doctors who used Crazy Glue were World Famous… and drew patients from all over the world…. And made a lot of money doing so…. The vast majority of those doctors were foreign-born and educated physicians…. And they didn’t really want to give up their monopoly…. So… they sought to get around the FDA…. And… it was a game of cat and mouse….

One other thing that Dallas Buyers Club alludes to… but doesn’t address…. While the movie promotes vitamin regimens and off-label and unregulated uses of medications… it never explores the dangers…. Or the possibility that unscrupulous people were just ripping off the desperate…. That the “doctors” or shaman were shills… selling smoke enemas…. Nothing more than Hope Merchants….

I will specifically mention Steve McQueen… who went to a clinic in Mexico for treatment of his mesothelioma… and received laetrile, coffee enemas, injections of live sheep and cow cells… an all “natural” remedy… and died in that clinic about twelve hours after surgery to remove metastatic tumors from his neck…. Laetrile is obtained from peach pits…. An all-natural source of Prussic Acid… also known as Cyanide…. Not exactly safe, but certainly effective….

I took care of a young man who refused chemotherapy so that he could receive “Cancell Therapy”… which was touted as a “safe alternative” to traditional chemotherapy…. The good news… it is safe…. The bad news… it ain’t effective…. Putting Sulfuric Acid into your body does nothing… good…. But… the people who sell the stuff… claim that the government is trying to keep them from selling the stuff because the bureaucrats’ souls were bought out by Pharma….

That would be difficult… because only elected officials can take money from Pharma… or anyone else….

(So then… a paradox… how can bigger government be perceived as better…?)

One of my friends patented Crixivan… a protease inhibitor used for HIV treatment…. College buddy…. Chemistry and French major…. Honors College at USM…. From Laurel…. The city…. Not a hick like me…. She and I spent a lot of time together… studying…. She did a good thing…. She deserved to be rewarded…. So did the company she works for…. That is how free enterprise works…. Her mother and her were responsible for her education…. She worked hard…. People invested in the company she worked for…. They ALL should be rewarded for their hard work, success… and their investments…. But… only if their hard work can be proved to work….

That’s really the problem…. People profiting from hawking products that don’t work….

When you look on the internet… and you see someone hawking a product such as Hemp Oil for cancer…. And the add shows a beautiful woman… who had brain cancer… and refused surgery… and used Hemp Oil… and is feeling great…. But… they never state what the actual diagnosis IS…. Well… be suspicious…. Or… if they talk about a child with brain cancer…. Certainly anyone who takes marijuana products is going to feel better. And eat better. But… they are not responding to treatment… if their tumor was never diagnosed… and they have no follow-up…. And… you have an n of 1 or 2… undiagnosed patients…. That in no way suggests that the products are effective…. Because the patients probably didn’t have “brain cancer” to begin with…. They probably had benign brain tumors…. Or something else completely…. But the people profiting from selling the products are probably just going to suggest they are the victims of conspiracy…. Of government corruption….

So… let’s talk about… corruption… shall we….

If a medical device or pharma company paid for a glass of wine for my wife… while I discussed ideas that may be worth millions of dollars to them… I  could be put in jail for corruption…. If they paid for my dinner… or bought baseball tickets… or even a cup of coffee…. Same if I were in the Defense Industry…. Or worked for the government… in any capacity… other than as an elected official….

So… what would happen… if someone paid for my wife… and kids… and mother-in-law… went on an all-expense paid vacation… to China… to stay in a suite that cost $9,000 per night…? Or… I took money… ala Senate Majority Leader Harry Reid…? Or… used the Senate Lunchroom to close Real Estate deals… ala Senator Claire McCaskill…? Or… used my position as a Democratic Leader in the House to aid my spouse… ala House Minority Leader Pelosi and former Representative Barney Frank…?

I do not mean to suggest that the ethic of the Grand Old Party are any better….

I do not mean to suggest that the ethics of physicians are better than those of drug companies… or elected officials….

I am saying that we all should be treated equally….

I am saying that President Obama… his family… and Senator Reid… and his family… and Representative Pelosi… and her family… should not be aided and abetted in stealing from the American taxpayer for personal gain…. The no free lunch rule should apply there as well….

And… Hollywood… and the Mainstream Media… should strive to present a clear… and impartial view… of important stories….

Hollywood… and the Mainstream Media… should strive to be honest… and not simply skew and politicize one side of a debate….

How many people died because they bought unregulated pharmaceuticals…?

How many poor people spend money they don’t have to waste on unproved vitamins and supplements… and unregulated injectables like  industrial silicone…? How much money has been made by unscrupulous dealers…? How many lives have been ruined by drugs…?

I’ve been there…. I’ve seen the carnage…. Whole families infected with Hepatitis C… because they all share the same works to shoot up their Methamphetamine…. America’s Burn Units are clogged with uninsured manufacturers of Single Bottle Methamphetamine… who put themselves… and their families… and unsuspecting others… at risk to manufacture their fix…. And the necessary components are being smuggled across our open border from Mexico….

Maybe after the Liberal Progressives find a way to tax it… they will be interested in controlling the illicit drug trade… and prostitution… and human trafficking….

But… ordinary American Citizens… especially minorities… will need to grow considerably wiser… and embrace education… so they will become less susceptible to exploitation… for political expediency… and corrupt profit….

And… Unions… are probably the single greatest source of political corruption in America… because their corruption is the easiest to hide…. All other corruption is solely due to the greed of corrupt people involved…. Union corruption is extended to EVERYONE in the Union… because no one can withhold their contribution… even if they disagree whole-heartedly with what the contributions go to support….

Looking Good… and Smelling Good: Advice for Spring….

Spring is such a magical time….

Always has been….

And… I have some fond remembrances….

Looking good. And… smelling good….

I remember sitting on those cement benches by the Coke machines at West Jones High School…. Between classes, of course….

Watching the yellow jackets swarm the trash cans….
Wondering….

Watching the yellow jackets buzz the beautiful women strutting around on those brilliant Spring days….
Wondering….

Ever wonder why yellow jackets are always crawling into people’s coke cans…?

Ever wonder why yellow jackets have such great tastes…? Why they always seem to buzz the beautiful girls…? The ones who are so carefully made up…? Strutting their stuff…?
Leaving the boys… and the girls of lower social stature… who expend less time and effort looking good… alone…?

I also remember synthesizing isoamyl acetate in Organic Chemistry my sophomore year at the University of Southern Mississippi… back in the day… and thinking… this stuff REALLY smells like bananas! Or… Juicy Fruit…. But… that’s another story…. And it brings me back…. To….

Science….

Hornets (and Yellow Jackets are hornets, not wasps) are attracted to sugar for food…. They borrow into over-ripe fruit… where the bruises are…. And Coke cans….

And… isoamyl acetate…. Essence of Banana… is their attack pheromone….

And… it’s in a ton of cosmetics and eau de cologne and everything else….

And… swatting at hornets… makes them spray it on warm targets….

So… I guess my mother was right about that one….

Anyway… a word of advice… and a word of caution… from the Rock Man in Harry Nillson’s “The Point”…. “Don’t go messin’ with the bees….” Or the hornets…. Or the yellow jackets….

If you don’t want to attract bees and hornets… don’t try to smell like a flower….

Especially if you plan to go hiking in the mountains of China or Japan in the Late Spring or Summer…. About a hundred people die in each place a year from giant hornet attacks…. Many of which could probably be prevented…. By not wearing isoamyl acetate in cosmetics….

Recent Reads: The Celebrated Cases of Judge Dee

I really haven’t trashed anything I’ve read recently… and I’m not about to start now….

Quite frankly… this is one of the most interesting and entertaining books that I’ve read in a while…. And I’ve read some good ones and re-read some of my faves….

Many it was the mood or the stage of life… or something else… but this book just struck me a thoroughly entertaining….

One aspect is the historicity…. van Gulik points out the good, the bad, and the ugly…. He put appropriate points from the actual Chinese Penal Code in the notes at the end. He points out critical details that are necessary to understand some of the workings of the milieu… such as the interesting observation that Magistrates… or Detectives… or Judges… were the highest… and essentially the only officer within their district…. They were overworked…. And… they required the assistance of “Men of the Greenwood”…. Wayfaring officers of the peace who had in the not-too-distant past walked on the other side of the law…. Similar to Robin Hood…. Or Wyatt Earp… Bat Masterson… and the Father of the Fast Draw himself… Wild Bill Hickok….

Some of the conclusions… require suspension of disbelief… if you have a medical… or forensic mind…. But even the most outlandish of those… were pilfered by none other than Sherlock Holmes… whose author was knighted physician….

Some of the aspects of “Justice” are outlandish to the Western Mind….

A suspect is not innocent until proven guilty…. But… no suspect can be punished without a signed confession…. Torture… even extreme torture… may be used to obtain a confession…. But the Judge… and his accomplishes… may receive the same punishment they mete out if they are proved to be wrong…. Some of the punishments… and interrogation procedures… are gruesome…. And some of the quaint superstitions… and the beliefs of the time… lead to quite entertaining results….

A historical note…. Judge Dee lived during the T’ang Dynasty… during the rule of Emperor Wu…. The only female emperor in the long history of China…. Apparently… the original story went into a very roundabout… essentially pornographic interlude about the sexual prowess of Emperor Wu… involving the Chief Priest… after her second Imperial Husband died… and she ascended the Throne… rather than simply serving as Regent for her underage son…. In the end, she allowed the Dynasty she sought to establish to return to the T’ang…. She was ruthless…. And efficient…. And by all accounts… effective as a ruler….

The Judge Dee in this work is much more human… and much less of a superhero… than portrayed on the big screen…. All of the martial arts prowess belong to his deputies…. Again… like Wyatt Earp… he never killed anyone with his own hands….

Recent Reads: Monkey

Finished reading Monkey: Folk Novel of China by Wu Ch’êng-Ên, translated by Arthur Waley a few days ago.

This book is an abridgement and translation of the Classic Chinese Novel: A Journey to the West….

I think it’s a rather older translation. And… it was abridged for Western tastes….

Thus… Waley did an amazing job! Excellent story. Moves along at a rollicking pace. Not too difficult to pick up some nuance…. A very entertaining Picaresque… that evolves into a fast-paced tale of redemption….

Clearly… the purpose is to display the redemptive Everyman theme that is inherent in Pure Land Buddhism…. Salvation is not hard….

This story mocks other religions… especially Taoism… which is esoteric by its nature….

And… the heroes are presented flaws and all…. In fact, much of the humor is due to the impetuous “sins” of the Pilgrims who accompany the Bodhisattva on the Journey to the West to retrieve Buddhist Scripture in order to save China….

In this story… the Bodhisattva is a whiny wimp… who constantly requires intervention from his four traveling companions… all of whom have sinned and fallen short… and thus need redemption….

In Pure Land Buddhism… the West… which is the area of India in the foothills of the Himalaya Mountains where Siddhārtha or Gautama Buddha was born… represents Heaven…. The Four Pilgrims or Disciples are all monsters… who have fallen from grace….

I think a lot of details were left out of story… and many of the names, which to Western minds would likely seem redundant and confusing… were omitted or replaced by the profession of the character…. Many of the allusions have no Western equivalent… so the more you know about Ancient China and Buddhism and Asian Culture, the more meaningful many of the details will be to you…. Many of the characters come straight out of Chinese and Buddhist Mythology… though many of the references have various alternative tellings….

All-in-all… I found Monkey to be an amazingly entertaining and informative tale…. And a brisk read….

One other comment…. Novels were considered beneath the dignity of the Literati in the Ancient Orient…. The author of novels typically typically wrote those works under pen names…. This work is EXTREMELY well written…. In a later period in Japan… indigenous Japanese literature… and prose in particular… were the purview of women…. That was because fiction was considered beneath educated men, who wrote in Chinese… in a derivative Chinoisesque style…. Women were discouraged from studying Chinese… and women were accorded the freedom to create works of fiction without ridicule…. Women also wrote in a style that suited them…. Meaning that the stories were catty… and romantic… and even sexy…. So… needless to say… the works of the women writers of the Heian Period in Japan were… interesting….

Renga (Response to Bashō’s Famous Frog Haiku)

In quiet contemplation

Pondering green pond

Ancient frog… still… knows nothing….

Renga were an ancient form of linked verse, in which the most proficient poet would start with a poem expressing the seasonal (ephemeral) nature of the human world (which was considered to be merely an illusion), and other lesser poets would contribute poems based on the original idea that explore different aspects of the ideas.

Another concept in Japanese poetry involves multiple possible interpretations…. Multiple… subtle… suggestions from single words…. Developing depth….

A Spring Hokku

Spring sunrise surprised me.

Burst through my window.

Sudden Illumination!

 

A hokku or haiku is a seventeen syllable poem that typically involves a 7-5-7 syllabic structure. The essence of the form involves kireji or “cutting”. An appropriate kireji is a word that suggests a sharp turn in the poem, thus defining the skill of the poet. Proper hokku present images drawn from a very specific seasonal vocabulary: kigo (seasonal references) defined within saijiki (collections of appropriate imagery). Appropriate words emanated from Chinese treatises and obliquely present religious references drawn from Taoist and Buddhist traditions.