Author Archives: susan

Staying Alive

The absurdity is beyond irony. In a country obsessed with “proactive” health, screenings and tests; a country where celebrity figures urge everyone to “fight” this or that cancer with mammograms or colonoscopies or PSA tests; a country that spends over 16% of GDP on health care and still has the poorest health outcomes of any developed country, one of the biggest threats to health is an amendment to a 300-year-old document professing the right to “bear arms”.

Originating in a different time and frame of mind, the American constitution was a masterpiece of hope and imagination; that “well armed militia” (bearing aforesaid arms) and hope, all that stood between a young country and its colonial past.

Today, in the age of iPads and wifi, environmental change and globalization, it all seems so sad and silly. Particularly in the wake of the tragedy in Tucson a few weeks ago, where a Congresswoman and many others were wounded and six people died.

In terms of health it seems to me that that the United States would do well to stop its preoccupation with political rhetoric (not to mention those colonoscopies) and – for five minutes – consider whether the number of guns in circulation might, just might, have something to do with the incident.

bang bang, you’re dead (the healthiest corpse I’ve ever seen)

As the Economist put it:  (January 15, 2011 print edition, here)

“Opportunists who seek to gain political advantage by blaming the shootings on words would do America better service if they focused on bullets. In no other country could any civilian, let alone a deranged one, legally get his hands on a Glock semi automatic. Even in America, the extended 31-shot magazine that Mr. Loughner used was banned until 2004. As the Brady Centre, established after the Reagan shooting to commemorate one of its victims, has noted, more Americans were killed by guns in the 18 years between 1979 and 1997 than died in all of America’s foreign wars since its independence from. Around 30,000 people a year are killed by one of the almost 300m guns in America – almost one for every citizen. Those deaths are not just murders and suicides: some are accidents, often involving children. The tragedy is that gun control is moving in the wrong direction….”

I couldn’t have said it better myself.

Loathsome Lycra

What do Lycra, Stainmaster carpet, Dixie cups and oil refineries in Alaska and Texas have in common?

They’re all owned by Koch Industries, ranked by Forbes as the second largest private company in the United States. The biggest corporation nobody’s heard of.

Owned by the brothers Koch, the company also has the distinction of being one of the top ten polluters in the U.S. not to mention a staunch (financial) supporter of the Tea Party movement. (The brothers’ father started the company – apparently Koch pere trained Bolshevik and helped Stalin set up some oil refineries in the Soviet Union, well, until Stalin turned on him), Not only for libertarian reasons but solid business ones: after all, less government means less government meddling in pesky details like environmental laws and lower corporate taxes.

So that, girls and boys, is what you’re supporting when you pay good money for stretch material, spandex  – or, as the labels proudly hanging on virtually every piece of clothing one sees these days, “Lycra”.  Jeans, dress pants, cotton shirts, sweaters: you name it, the damn thing has umpteen percent Lycra.

mah-ve-lous stretchy Lycra

I have never understood the attraction of clothes that stick to you, refuse to hold their shape after you’ve worn them once; have that synthetic feel and make Koch Industries richer. So ubiquitous is Lycra that even Levi jeans ostensibly made of “100% organic cotton” contain 3% of the vile stuff. I know this because I fell for the “organic cotton” line (I absolve the saleswoman of all guilt; I doubt she even realized there was Lycra in the jeans) and ended up giving them to the hotel chambermaid in disgust.

Maybe it’s my shape – or my orneriness – but on me, jeans with spandex/Lycra fit too tightly when washed, then start to droop upon second wearing. In a day, not only am I tugging at myself like some demented ferret but my crotch is hanging lower and lower. And trust me, nobody will mistake a woman of a certain age for Fi’ty Cent. Worse, Lycra, being synthetic (and a particularly noxious one at that) doesn’t breathe and if there is any humidity in the air I end up hot and cranky. OK, crankier than usual.

These days I’ve taken to walking into all manner of posh stores I didn’t used to frequent, secure in the knowledge there will be no natural fibres in sight, all our fine talk of “green” products notwithstanding. I saunter jauntily into Hugo Boss, Max Mara, Holt Renfrew … Once the statuesque salesperson has realized that like the universe I really do exist and do expect service, being posh they immediately treat me like royalty.

Whereupon I pleasantly ask if there’s anything in the store – a pant suit maybe – that consists of natural fibres: cotton, silk, hemp, wool, bamboo, whatever. “Of course,” they assure me in somewhat superior tones. Then I see The Look. Perplexed, followed by darting eyes back and forth across the hangers … and then the “Umm … actually …

Actually no. Yes, there’s one wool jacket in a noxious beige my grandmother wouldn’t have worn, lined in polyester and oh, there’s 5% Lycra. Occasionally there is a triumphant leap towards a cashmere sweater or a cotton shirt, neither of which I want (or would wear on a bet).

Does anyone even remember that cotton jersey stretches? That denim jeans are briefly tight after  being washed but then have plenty of give? That good fabrics feel nice – versus petroleum by-products, aka nylon, polyester, spandex that are slimy smooth, don’t breathe, pick up very jot of ambient odour and make one hot and sweaty?

I am actually beginning to wonder if spandex/Lycra isn’t one of the reasons we’re all so fat. After all, if your clothes never feel tight, you never know if your clothes are getting tight and perhaps you should cut back on calories for a week or two and get back to your normal weight. All normal cues disappear in the absence of clothes that fit.

Wasn’t this supposed to be the age of the whatsit graph, that long tail; the age of the choice? When even people with wants outside the norm should be able to tap into an existing market? The internet and globalization were going to make it all possible.

Instead, it’s all made in China and contains Lycra.A friend who’s a seamstress and tailour tells me that spandex “eats” cotton and other fabrics so clothes don’t last as long. Maybe that’s the real point.

If it’s not finding uses for all those leftovers from some nice oil refinery. Like the Koch brothers, who, according to a long article in The New Yorker, “have given millions of dollars to nonprofit groups that criticize government environmental regulation and support lower taxes for industry”. Who says industrialists don’t know how to spend wisely.

Too bad the rest of us don’t.

“Information is power” (not)

As I raced through Waterfront Station last week, late for something or t’other, I overheard a well-dressed young man intone, “Information is power.” The pretty young woman he was with enthusiastically agreed.I moved on, dodging slower pedestrians and trying to figure out why and how such a cockamamie truism had taken such a stranglehold on us all. Information is power? Says who?

Information, aka data, is not even knowledge, never mind power. Without context, without a hypothesis, without a narrative of some kind, simply having access to Google and disparate bits of information means nil.

Anyway, isn’t the usual phrase knowledge is power? And even knowledge, moreover, rarely translates into power- unless you’re a blackmailer.

Unfortunately, the cliché has taken off and far too many people actually believe that having access to information, be it minute by minute stock/business data, medical information or Google (“facts”) actually means something.

Let’s take one example of basic information: observational studies. We observe one thing, see that it seems to happen whenever something else does and presto, we have a correlation on our hands that we conveniently forget are simply disembodied bits of information that probably mean nothing – but which we assume reflect cause.

Epidemiology had one major success with that: cigarette smoking and lung cancer. And they’ve never let us forget it. The problem is that almost no observational studies epidemiology threw at us ever turned out to be accurate when properly scrutinized.

Take the estrogen debacle. For years observational studies and epidemiology insisted that women who took estrogen, particularly at midlife, were healthier, lived longer, had fewer heart attacks and even suffered less from dementia. The problem was that this link came from well-off women who had the time to fill out those surveys and questionnaires, which meant they were better educated and of a higher socio-economic background. This meant that they were also healthier – in fact there’s even a name for it: the healthy user bias. People who are from a higher socio-economic status are healthier. Period. Why? We don’t know.

Perhaps they eat better or have less stress; perhaps they have better genes and it’s that which has led them to be better off in the first place. Maybe they breathe cleaner air and live in nicer areas where they don’t breathe or step in toxic gunk. After all, it’s not the CEO of a company, whether in India or the United States, whose house abuts the factory runoff, it’s the hapless janitor and his family who can’t afford anything better.

The media loves reporting on observational studies, where the inevitable term used in the headline is “linked”. Vitamin D is “linked” to better health. In healthy societies women’s choice of mate is “linked” to more masculine features, which naturally means that evolution has had something to do with the preponderance of older men marrying women young enough to be their daughters.

We forget that correlation has nothing do with cause. The Women’s Health Initiative clinical trial was stopped early because it was the women who took estrogen who were dying in droves from breast cancer and heart disease. All those years researcher upon researcher had insisted that their hypothesis, namely that estrogen was the female hormone, was right and had absolutely nothing to do with the binary nature of our socio-cultural classifications. But gosh, they were wrong.

Failure of imagination follows in the tracks of information – simply knowing that something happens tells us absolutely nothing about why it happens or whether manipulating one factor will have an effect on the other. It could be incidental, an artifact, or just plain wrong.

Still, we walk around, secure in the knowledge that our platitudes, like information, give us an edge.  But it’s not power, just swagger.

A Grinchy perspective on WikiLeaks

T’is the season to be jolly, shop till you drop and generally try to live life through the lens of a Hallmark card or a TV movie. Too bad the movie is usually one of those rapid-fire, vapid latter-day concoctions where they pour on the saccharine and bang home the message with a sledgehammer.

I watched The Bishop’s Wife tonight. A lovely old movie with Cary Grant, Loretta Lynn and David Niven, the movie is neither sentimental nor overtly Christian, title notwithstanding. It’s just a simple story (granted, a simple story with the original McDreamy, Cary Grant) that reminds us not to forget that there are people less fortunate than ourselves during this holiday season when it’s all too easy to lose oneself in grandiose schemes and commercial concerns.

Sometimes not seeing the whole is what makes a good picture

Meanwhile, the cultural leitmotif of the day remains WikiLeaks and the wraith-like Julian Assange whose tens of thousands of cyberspaced emails and cables appear to have thrown everyone into a bit of a tizzy.

Although I’ve read bits and pieces on the subject (not to mention interminable commentaries), I have no idea if the information in these leaks is a genuine, eureka, Pentagon-Papers, moment that will save democracy (as Assange in his best delusions-of-grandeur tone asserts) or just a lot of nonsense.

But as a person who spent many years writing for old media (not to mention a curmudgeon), I tend towards the latter.

Journalism, like life, is largely humdrum. What people know and say – well, most of what they say consists of details that are neither here nor there – and have little relevance to anyone outside of those directly involved. Hey, just because people have titles and embossed business cards doesn’t mean they’re smart, witty or fun at parties.

As a journalist, it wasn’t the ideas (i.e., problems) that were difficult to find; it was the execution of it as a viable story.: Finding the right people to interview, the apt quote, the pattern that would turn a jumble of information into a coherent whole.

Let’s face it, good journalism is a lot of work. Hours on “ignore” as you wait to talk to the right person (or to find the right person) who might know a thing or three about your topic. Yet more hours talking to them (bearing in mind that the bulk of most interviews consists of babbling incoherencies) then umpteen more hours transcribing said interview. Finally, the denouement: pacing and rearranging the top drawer of your desk, rereading your notes, trying to find a way to make all this gobbledygook make sense.

Assange and his cohorts cleverly did away with all those boring bits. They were given the cables and mails, downloaded them onto their site and now they’re firmly clamped onto the moral high ground.

Er, OK.

Except as nearly as I can make out all we’ve found out some minor gossip and some tragic bits we all already knew, namely, that “friendly fire” has killed a lot of innocent people – and that those young men and women in uniform, all the hype notwithstanding, are young men and women. Emphasis on the young. Who don’t know who the enemy is half the time and when they do, usually can’t shoot straight.

I once read that in the second world war easily half or more of the casualties were killed by their own “side”. In the heat of battle the vast majority of soldiers panic and shoot at anything that moves. Including their own feet. Is there any reason things are any different now? Don’t think so.

Other shocking revelations from the WikiLeaks crew consist of the earth shattering information that politicians and diplomats say indiscreet things behind the scenes that they’d rather not say in public. Who knew. Unless you’re from a galaxy far far away, you I suspect. Hell, half the time the stuff they say on the record is drivel.

As children we believe in Santa Claus and it is the mystery, the not knowing that gives Christmas Eve its magic. Diplomacy, relationships – well, they also need a touch of that. If everything is thrown out in the open it’s difficult to figure out what’s trash and what’s real.

While there may be some nobility in preventing shady backroom deals, with all the information technology out there today even “elites” have trouble hiding. In general there is far more information than we needed to know.

Tonight, as small children breathlessly await the arrival of Santa Claus, it is perhaps a good time to contemplate that magic and mystery are sometimes more relevant than knowing the minutae. There’s actually a kind of beauty in not knowing – but believing. Believing that overall most people are decent; that most people will respond in kind if we treat them well and that the ultimate transparency is trust. And like Cary Grant in that old movie, angels might just be our better selves.

Merry Christmas.

MS “liberation” therapy – not in Canada (eh)

The story so far:  An unpredictable disease in both course and symptoms, multiple sclerosis (MS) is a terrible diagnosis (and is more common in Canada than anywhere else – perhaps because we’re so far north and lack sun and Vitamin D half the year).  Some people can live for decades with only minor symptoms; others deteriorate with alarming speed. And nobody really knows why; our best hypothesis is that MS is an inflammatory autoimmune disease, one where the immune system turns on itself and destroys the myelin “sheaths” surrounding the various nerves in the body.

Although it was identified in the mid 19th century by the French physician and thinker Charcot, MS is a recent disease, probably because it is devilishly difficult to identify – essentially the diagnosis is made by ruling out everything else.  An MRI, that shows up the lesions that the myelin loss causes, is the ostensible gold standard of MS diagnosis but even that’s tricky because several other conditions cause similar lesions, e.g., Lyme Disease.

Unusually, for an autoimmune disease (which rarely get the same kind of air play as cancer and heart disease even though they’re terribly common), MS has been much in the news lately.

Apparently, a certain Dr. Zamboni, an Italian physician whose wife had MS, has hypothesized that a lack of blood flow to the brain could cause many MS symptoms (known by the unwieldy moniker ‘chronic cerebro-spinal venous insufficiency’ or CCSVI) and that clearing aforesaid blood via angioplasty (a common procedure in cardiac disease) could relieve many of the onerous symptoms. MS could even be said to be “cured” according to some proponents.

Well! The experts and researchers are miffed. This so-called “liberation” procedure has been roundly criticized and a panel of Canadian experts has refused to countenance a clinical trial, insisting something so untried is probably untrue.

Maybe it is. But a great many MS patients have not paid attention to the experts and are flying to various places like Costa Rica to have the procedure done, paying out-of-pocket because they so desperately want to feel better.

What I find fascinating is that the argument seems fixated on the notion of “cause”.If MS is caused by the destruction of the myelin, or so the narrative runs, then this venous insufficiency notion is incidental and getting rid of it, useless.

But what if these blocked veins are simply a side effect, as it were, of the inflammatory condition (if indeed that is what it is) we call MS? What if clearing such blockages relieves symptoms for patients for six months or a year or longer? Why shouldn’t it be offered as an option, at least for those MS patients whose veins are blocked?

We give dying cancer patients ridiculously expensive medications in the hope that they will live a few months more. We transplant multiple organs into small children knowing full well that the vast majority of them will not live very long. We provide heroic measures for people whose life expectancy is pretty damn short. So why can’t we at least consider providing a procedure for those MS patients who might benefit – closer to home and without bankrupting them, which was, after all, how Medicare was originally envisioned: a program to prevent Canadians from losing their all in the case of catastrophic illness.

It’s true that for now there’s only anecdotal evidence to support this procedure. But, umpteen clinical trials have shown the connection between high cholesterol and dying of heart disease is tenuous at best if not invisible, but we still insist people lower their lipids. Doubly so if they’ve already had a heart attack. There is little evidence that in people over 60 most cardiac surgeries have any benefit (pharmacotherapy works just as well), but we do them anyway.

But no, now with this treatment we’re gone all cautious and conservative and gosh-we-couldn’t. Venous insufficiency isn’t the cause of MS, trumpeted the expert panel, so the bottom line is that we shouldn’t do it. Heck, we shouldn’t even undertake a test of it.

So why get so fixated on cause – when the myelin hypothesis is still only that, a hypothesis. One that most people agree on, true, but simply because a lot of people think something is true doesn’t make it so.

Many patients insist the procedure has helped. So, are they all nuts? Deluded? Is it placebo? (Bearing in mind that ‘placebo’ means ‘to please’.) The placebo effect is, after all, a wondrous thing and people who have just spent a whole bunch of money flying to Costa Rica for surgery are predisposed to believing they haven’t wasted their time and money. Maybe they just needed a few weeks of rest in a nice hospital in an even nicer tropical paradise.

But the only way to know with a modicum of accuracy is to do a clinical trial: find about 100 MS patients who do have this blocked vein thing, give half of them the real surgery, the other half a sham surgery and see what happens.

In the interim, why not offer it as an option for symptom relief. That’s all most drugs are.

What’s the point of turning it into a battle of wills, an argument about who’s right about the cause of MS? Dr. Zamboni, as nearly as I can make out, is not claiming that his treatment is magic or truth, merely that it seems to help some people.

More later on classification systems and their essential role in medicine in a later post – for now, perhaps medicine and the medical establishment needs to remember that its role is not just about cure but care. Which is what MS MS patients need right now.

Plus ca change …

Art maybe longa and vita brevis (to coin a phrase) – but it seems our memories are even shorter.

There’s a promotion for an upcoming movie I kept seeing on the Space channel – something called Airline or Skyline or some damn fool line (http://www.iamrogue.com/skyline/home.html#/video/). I gather some giant flying machine runs amok, destroying everything in its path, all, no doubt, to stunning and deafening effect (at least for those of us with intact hearing). Unfortunately, all I can see are the fake-looking computer-generated effects that make me want to giggle, dramatic voiceover notwithstanding.

Can anyone take these things seriously? That last Indiana Jones movie, for instance. I watched it on an airplane and could not take the interminable chase scenes even semi seriously: lovely two-dimensional jungles as the three-dimensional Jeep carried away Cate Blanchett and the two guys.

More than anything it reminds me of those corny old movies with the painted backdrops of the Rocky Mountains – Nelson Eddy and Jeannette MacDonald singing “When I’m calling you-hoo-hoo-hoo-hoo-hoo-hooooo …”. Horses bobbing up and down. Or those ‘40’s and ‘50’s movies with cars speeding down some hillside where it’s obvious the car is stationary and there’s a film rolling in the background.  It did not remind me of Gene Kelly dancing with the cartoon characters because that was actually rather cool.

Don’t look at the backdrop .

I suspect most people don’t care because unlike me they enjoyed the Indiana Jones movie and will enjoy the Skyline one – especially if they watch it on their iPhone screen. But c’mon, who are we kidding?

Fake is fake, whether it’s generated by a cool, high tech gizmo or painted onto a piece of fabric by a guy who went to art school and can’t believe he ended up in Hollywood and not some Montmartre atelier. In the end, it’s goofy and tiresome and repetitious. Personally, I’m more impressed with that Bridgestone tire ad where they come to a crashing halt at the end of the pier because naturally their tires are so terrific. (I gather the director was so nervous that the car wouldn’t stop in time that he suspended a net in the water to catch the car – and the actors – in case it went flying into the bay.)

My curmudgeonly gripe today is that we just don’t realize it’s been done before. Except we forgot or don’t know. So this wide-eyed aren’t-we-all-so-clever-today thing is just so the day before yesterday.

So to speak.

It’s not just movies, it’s science and everything else. The so-called new neuroscience where we’ve realized the neuropolasticity of the brain. Genetics. All presented in the tones of a child who’s just learned to tie his or her own shoelaces for the first time and figures there’s an award in it. A Nobel prize even. (The parents would concur.)

One of my students practically spluttered a few weeks ago when I told her that actually epigenetics and the concept that the developmental process mitochondrial DNA undergoes is more important than the actual nature of the DNA itself isn’t new at all. In the thirties and forties it was called embryonic or, quite appropriately, developmental genetics.

In his 1926 book, The Theory of the Gene, T.H. Morgan pointed out that it’s important to keep apart the “phenomenon of heredity, that deals with the transmission of the hereditary units” and the issue of “embryonic development that takes place almost exclusively by changes in the cytoplasm”. (quoted in Evelyn Fox Keller: Refiguring Life; Columbia Univ. Press, NY, 1995)

Epigenetics in other words.

Whoever it was who said that we stand on the shoulders of giants knew whereof he spoke. Too bad we seem to have forgotten.

The brand’s the thing (for a’ that)

Reading the paper today– including business pages and parts of those “special supplements” that appear now and then on technology, entrepreneurship and whatnot (whatever sells the most ads I suspect) – I am struck by this notion of branding and how anyone who’s anyone needs a brand: an easily understood meme for who they are, where they stand, in the grand scheme of things.

Like Kleenex or Xerox (which I should, by rights be adding that squiggly trademark symbol to) where the name contains what linguists call a script and normal people simply use as shorthand.

We all need a brand, at least according to this Canadian woman with some 30,000 Twitter followers whose 140-character pearls of wisdom are all about this.

The piece, alas, made zero sense to me. I read it carefully, finding out in the process that this woman has several employees so clearly makes money. Yet, she does not recommend individual brands. Um .. so who pays her? (This, incidentally, is my ongoing question with so many tech companies – where’s the damn money? If even information on the internet wants to be free, how do these companies get valued at x billion dollars? Who is buying into this, and why? And if nobody clicks on that sponsored Google site, will it continue to exist?)

Which gets me thinking. If I were to “brand” myself, what would I be? Writer? Teacher? Critic? Eccentric? Curmudgeon? Zontar, Thing from Venus?

Could I be any more last century? Writer? Surely it’s content provider. Critic? Curmudgeon? Does anyone even know what these mean, at a time when we compute in the clouds and watch movies on our phones, at least while the battery lasts.

In any event, a proper brand needs to sound important – so even more important people will notice and be impressed. Certainly all manner of people (and not just tiresome 24-year-olds like the Zuck, founder of Facebook) seem to have managed this. So surely anyone with an ounce of nous should be able to as well, non?

A brand simply reduces things down to a noun – or a phrase, max. So Starbucks is shorthand for coffee; Kleenex: tossable hankie. Xerox: photocopy. It’s a great thing, being the corporation that makes the whatsit that stands in for all the other whatsits in the world.

But you and me?  Surely we’re not that easily reduceable. Our social roles alone should take up a bit more space.

Maybe that’s why everyone’s always nattering on about how the digirati are all under 25. (The Zuck needs to watch out, he’s nearly obsolete.) That’s the time in your life when you honestly believe that what you know and feel matters more than what’s been said and done. It takes a mind that’s only recently left high school to conceive of a program that considers superficial social ties more important than, well, life. You have to have that swagger of youthful self-absorption – and, frankly, also be a bit stupid (which we all are at that age).

More important, it’s a time in your life when there’s not a lot of baggage – mortgage payments, credit rating, ageing parents, a bum knee and roots that need touching up every five weeks. Even though you don’t know it, you look and feel great even after pulling an all-nighter and pulling on some wrinkled jeans (you don’t know this of course, which is why you complain incessantly). If you screw up, well, who cares, you have your whole life ahead of you.

Then, things accumulate. Not just stuff – that needs ever larger space to enclose it as George Carlin pointed out – but life. In all its marvelous, tiresome added-on-ness. Which makes it all rich and chaotic and wonderful but it also makes it all complicated. You can’t just pick up and leave for six months to backpack through Europe and Africa. Aside from the obvious physical issues (you want me to carry that thing on my back?! you do realize I have a compressed disk in my spine, yes?) and the fact that walking down the hall to a washroom in the middle of the night is No Longer An Option, one simply has too many responsibilities and things to do to simply pick up and leave for that long. That’s why old people call it the best time of your life even as you’re wondering where they get off saying anything that daft. It’s simply harder with time, particularly if you want to pick up more or less where you left off.

As always I digress. So back to this branding thing. Are we really going to take it seriously or is that woman simply boasting about all her Twitter followers? Because really, easily half of them probably don’t even read her tweets. Here’s the thing. The people who follow my tweets number in the double digits not in the tens of thousands, but why most of them have opted to follow me defies logic. I suspect they neither read nor care about my tweets, it’s that number – following and followers – that’s the end game. The numbers game.

Expressing messy qualitative information in neat quantitative terms: popularity and importance expressed in terms easily compared and neatly understandable. Reductionism personified.

Literally.

The Message in the Metaphor

We may have forgotten Marshall McLuhan’s famous phrase – the medium is the message – but its aptness hasn’t faded; if anything I find my mind wandering towards McLuhan’s prescience quite a lot these days. (No matter that the Americans have co-opted him – apparently, according to The New Yorker, McLuhan was American.)

Whatever his … provenance, McLuhan’s basic point is still genius: how the message is delivered matters as much as the message itself.  And I would add that as important as the medium, moreover, is the metaphor inside.

Take the ostensibly weighty piece in last weekend’s Globe where this mega important person, vice-chair of BMO Financial Group no less (I gather the stodgy name, “Bank of Montreal”, had become too twee for this grand, globalized institution) describes the imminent dangers from the “new world order” we are so fortunate to inhabit.

Rife with boardroom logic and market metaphors, the piece explains how “broad structural trends are reshaping our world”. In fact, we face great “challenges” (in quotes because I loathe the word and were I to sink so low as to use it in a sentence, please, just shoot me) and need “fiscal-policy exit strategies” (um, pardon? why would fiscal policy require an exit strategy, particularly since it seems to depend entirely on the whims and paranoid delusions of the prime minister?) . Most important, the Canadian “productivity level” is (brace yourselves) is “only 75 per cent of that of the U.S.A”.

All together now: Produce!

I initially read the piece thinking it would contain some sort of insight. Alas, mega important or no, your man is as hollow as a bamboo shoot and not nearly as ecologically friendly. Worse, the piece makes no sense. Once you strip away the gobbledygook and the stirring pamphlet rhetoric (“tip of the proverbial iceberg”, “sapped public trust” and “gaping fissures in the body politic”) the sum total of the argument appears to be that, well, there’s been this process, globalization (which is how the banking crisis went global), and, er, we are getting get older so demographics are changing (no?! really), and, oh, then all this stuff happened like Y2K (Y2K?), 9-11, the war in Iraq and so forth – so, Canada needs to sit up and pay attention. By which I assume he means Canadian banks and financial institutions (even though the only reason they did well was that Chretien put the brakes on their megalomania back in the last century).

Buried in the market metaphors and glib nonsense, however, is a frightening implication; namely, that business – money, productivity, doing well in the “global economy” – is all that counts.

Apparently it was written somewhere – on some stone or burning bush or book of ages (don’t feel bad, I missed it too) – that the key to life, the universe and everything is really business. And New world Orders being what they are, to succeed within it one must produce. Apparently, the only value human endeavour has is in the goods it produces. And productivity, an obsolete measure of input/output if ever there was one (seeing as how it originates with factories like the one that made the Model T) – person hours expended for goods manufactured is our sole measure of worth.

One doesn’t know whether to laugh or cry.  Art, music, laughter, eduction, family, the environment, friendship, silly walks – zero. Business and money: important.

What”s worse is that far too many people take this kind of bunkum seriously. To the point where such nonsense phrases as “global drivers of change” have entered the lexicon and get invited to all the best parties.

So we forget, or just don’t know, the extent to which this type of language, this level of discourse, these metaphors, affect us and our thinking. The extent to which such language and thinking diminishes us. No longer does every man’s death diminish me, as Donne wrote; today, it is the market and its metaphors that make up our moral centre.

Take just one of those phrases, “production”. Raising productivity is simplicity itself. Just dump factory waste into the river as is done in China (poisoning nearby villages with the black muck the runoff makes) or pay your workers as close to minimum wage as makes no difference. Output is easy to keep high when workers’ hours are kept just below the level at which you are legally obliged to pay benefits (as WalMart does in the U.S.) and productivity should be a breeze if your work place about as safe as an Iraqi road side and you don’t provide workers with protective gear as they use dangerous machinery or chemicals. By all means, have young workers use dangerous machinery wearing flip flops, as they do in all kinds of places.

The real “challenge” is to make production a viable part of a social world in which people can at least hope to thrive.

I am so tired of reading and hearing this nonsense perpetuated. While I do concede that a reasonable standard of living is essential and poverty sucks, how did we get to a place, here, in Canada, where we turn to bankers for advice on how to approach life? How did studies done in second rate economics departments, with college freshmen, become the bloody Oracle? (Oh, you know what I mean. Those snippets where they have people engage in the Prisoner’s Dilemma and discover we’re all as selfish and petty and unpleasant as economics has always told us we are.) Anyone stop to think that the conclusions are based on what an eighteen-year-old thinks? We were all there once. And frankly, I’d hate to think anyone was basing anything on what I thought at that age.

My point with all this curmudgeonly ranting is that these market metaphors have taken on too much power and it’s time to say ‘enough’. We saw what the result of that market belief was: financial annihilation. Unemployment. Environmental degradation. Surely life is a little more complicated than these barren business narratives would have us believe.

Remember, it’s our belief – our tacit agreement – that keeps these metaphors alive.  And we all know that aging does not mean we are are liabilities, that life is not just about the market, that sure, we face challenges but the solution isn’t with the bankers who got us into this mess.

Good grief. If this is order, give me chaos. At least it has the potential to be amusing.

Summertime Blues

Summer. It’s been hot; I’ve been teaching and dealing with undergrads and trying not get too cranky. There’s been no time to post – plus my office gets too darn hot. (Whoever said ‘summertime and the livin’ is easy clearly had air conditioning). So, some thoughts on summer, written years ago and published in Chatelaine, revised, shortened and slightly updated.

The temperature also rises ..

I realize everybody’s supposed to love summer but I do not. I do not enjoy being hot and uncomfortable – plus, there are the obvious sartorial disadvantages, like shorts with elastic waistbands and flip-flops. (Incidentally, I don’t care how cunningly a bathing suit is cut – the only way anyone’s oeil will be tromped into believing I have thin thighs is through a funhouse mirror.)  Not to mention far too many people running around looking inelegantly, er, glowy.

Summer, moreover, is a breeding ground for mosquitoes, children running around screaming (their natural habitat, school, being temporarily closed to give teachers a break) and total strangers, by definition people we do not know, telling us to cheer up and smile, the sun is shining.  Yes, I noticed.

I’m the person you see  skulking around like some  Creature of the Night: hat pulled over my face, dark reflective Maui Jim sunglasses clamped on my nose, long sleeves and collar protecting my befreckled self – hovering as close to the miniscule shade buildings have in the midday sun – trying to avoid the inevitable migraine that the sharp, bright light and heat brings. on.  (And no, I don’t vant to suck your blood, what a disgusting thought. Though I could use the salt.)

I just do not see what the fuss is about, particularly when autumn is so much nicer. Take Shakespeare, going on about comparing thee to a summer’s day. (Did you ever proof what you wrote, Will? Or actually go outside?) A summer’s day is bloody endless. Most of us end up looking like one of those cartoon characters with corkscrew spirals for eyes. That’s because it’s so hard to sleep, given that there’s about two hours of darkness before the sun rises again, day after day after interminable day. That is if one even can sleep, given the heat.

You can’t even drown your sorrows with a stiff drink in the summer unless you’re willing to sacrifice all dignity and drink some Day-Glo concoction that looks like it escaped from Sesame Street. As for that stupid little umbrella they stick in most of those drinks, who are they kidding? That thing wouldn’t keep a gnat dry.

Then there’s sunscreen. Sunscreen is a slimy substance one must slather all over oneself lest one’s freckles mutate into monstrous melanomas.  First, of course, one has to spend hours poring over Nature, Science and every piece on nanotechnology one can to determine whether those zinc-nano-lie-on-top-of-your-skin things are better than the chemical variety that seep heaven-know-what synthetics into your system. (I opt for the nano kind, my friend and nano expert Frogheart assures me the EU has determined they’re safe and I trust her and them.)

Sunscreen means that the harder you try to be cool the more you look like a dork. Or some  Kabuki creature from a Japanese B-movie. The Green Slime is the one I’m thinking of but feel free to go with Alien if it makes you happy. Doorknobs slide out of one’s slippery fingers and opening a bottle is nigh-on impossible. One’s greasy fingerprints are everywhere. This is not the time to embark on a life of crime; they’d catch you faster than that bank robber who wrote his demands on the back of his personal cheque.

And don’t get me started on summer sandals. Sure, they’re cute and come in pretty colours. But summer = hot and hot = blisters. Which means one is constantly hobbling about, carrying extra shoes (or frying one’s feet wearing closed walking shoes with socks). I have become close personal friends with Dr. Scholl.

And at the end of the day, what’s left? Reruns, that’s what. (And how do programmers know exactly which two episodes of Arctic Air I’ve seen and just keep rerunning those same two over and over again? It’s fiendish plot, I swear.)

Now it turns out that all indicators point to the warming of the planet – and one long endless summer. The summer of my discontent. No, I’m sorry, but that Simply Will Not Do.

So it’s settled. One, two, three – we will all sit up straight, figure out what we can each do to ward off this nightmare and get on with it. Agitate for more and better transit. Stop our over-reliance on fossil fuels and stop with this nonsense that everything has to cost $2 and be steamered over from some village in China where they pay their workers next to nothing so we can have yet more cheap junk to toss into even more landfills. This economic downturn is the perfect opportunity to scale back, recycle, reuse and realize that one, long, endless sunburn will make curmudgeons out of all of us, not just diehards like me.

Medical myths, cholesterol and more

“If only I’d known … ”  I’ve heard it a lot, that phrase, when people talk to me about their various medical misadventures. ” If only” someone had realized the potential consequences of that surgery or those drugs or that ostensibly innocuous test – before they’d done it. Maybe they’d have asked for a second opinion or talked to a few people who had done the same thing. Waited. Not assumed that it was safe and easy, like the brochures promise. Except of course most of us don’t know – so we go ahead. It’s only later that we realize that everything carries a risk; all drugs have side effects; all medical interventions are ambiguous.

The popular narrative is self-assured, authoritative and leads us to believe that medicine Knows. Knows why we get sick, how we get sick. The problem is, most of the time it does not. Particularly when it comes to prevention.

Acute illness – well, as a rule it does OK but the model is different. Let’s face it, if you’ve just fallen off a ladder and heard an ugly “crunch”; you have a temperature of 42C and a stiff neck and are delirious; if you are doubled over in agony with abdominal pain – the risk of what could happen without medical intervention is probably far worse than the alternative. So you rightfully race to the ER and get help – do whatever it takes.  Hey, I’m with you; when  I’m deathly ill I’m not stopping to look at statistics or evidence or googling “abdominal pain”, I want Dr. House.

The problem is when we extend this model to prevention. That’s when we’re walking along, singing a merry song – having a good day thank you very much – when our glance idly falls on some seemingly innocuous headline or pamphlet or poster warning that You Are At Risk. A ticking bomb, in fact, unless you do something immediately. You need that blood pressure checked, those glucose levels looked (diabetes on the rise you know), your cholesterol measured. You need to head over to that mammography clinic post haste. Or if you’re a guy, you need to have that PSA looked at. Or a bone density test. In other words, you need to engage in “pro-active” health care. Most people naively believe that this is good advice – and that’s when they can get into trouble (and many realize medicine is nowhere near as blindingly accurate in this as most of us think).

On television, on web sites, on the radio – whatever it is, whether it’s drama or news, it’s all presented with authority. Implication: we know what causes heart disease, we know how breast tumours evolve into cancer, we know how normal physiology morphs into pathology.

The trouble is we don’t.

And unlike those doctors on House or Mercy or whatever the medical show du jour happens to be, the outcome in real life is rarely neat and often not pretty. Contrary to what the news items tell us, it’s not all overwhelmingly positive and very little is “miraculous” or a true “breakthrough”.

Here’s where the risk/benefit thing kicks in. If you’re in pain, sick and feeling like hell, you don’t care what the risks are. It has to be better than whatever’s going on right now. Plus, that high temperature and stiff neck could be meningitis – which could kill you in less than 48 hours if you don’t get antibiotics. That crunch in your spine could mean paralysis. That abdominal pain could be appendicitis. Whatever the down side of the surgery, the side effects of the drugs, well, they probably aren’t worse than death.

But when we merrily head over to the clinic to have our blood checked for lipids, we are assuming that those panels of experts who’ve decided that anything above or below X is bad and wrong and abnormal know what they’re talking about. We assume that “they” know what ideal blood pressure is for a person of our age and weight and size; a person who eats the way we do and has the family we have; is, in other words, us. When we docilely head over to have mammograms and PSA testing as we’re bid, well, that’s where it gets tricky.

Take cholesterol. True, in a fairly smallish subset of people, hyperlipidemia or the tendency to create more cholesterol than the body needs, will create problems. Often, these are the folks who have had one or more close relatives drop dead of a massive coronary at a young age, say 50. Interestingly, often there is a geographical connection – people from northern countries such as Scotland seem to have this tendency.

What evidence there is (and virtually all of it comes from drug companies) does tell us that after a person has had a heart attack, lowering cholesterol with medication does seem to reduce their risk of a second one. But in people who’ve never had a heart attack, what is called  primary prevention? Not so much.

Not that you’d know it from the television ads for statins and other cholesterol lowering meds on TV that here in Canada we get from across the border. (Direct-to-consumer ads are only allowed in the U.S. and New Zealand – all other countries ban them.) They make it sound as though it’s a moral imperative to take drugs if your numbers aren’t right. In fact, cholesterol is needed for normal physiologic functioning. It protects against infection and not having enough, as Finnish researcher Ravnov has shown, can be dangerous.

(For more see his site: http://www.ravnskov.nu/cholesterol.htm and also the Cholesterol Skeptics site: http://www.thincs.org/ which includes hundreds of names of physicians, researchers and other bit ‘names’.  Also see “Should we lower cholesterol as much as possible?” in the BMJ (3 June 2006; Vol 332, pp 1330-32)

What they don’t tell you is how many of those expert panels the makers of these drugs have funded. Or that the whole idea behind cholesterol as a risk factor came from the Framingham study, a longitudinal study begun in the late 1940’s in Framingham (Massechusetts), in a report where a researcher hesitantly noted that it seemed as though cholesterol might be a factor in heart disease. (That was what the Framingham study initially was looking at, cardiac disease and why its incidence seemed to be on the rise at that time. And, they wanted to test out some cool new technologies that were being developed like the electrocardiogram.)

Science deals in probabilities, in maybe’s; it is a dynamic process. Individuals are not statistics and what works for one may very well not work another. Plus, medicine is just as prone to fads and fashions as anything else. Unfortunately, too often in the culture we have it descends into dogma.

And that isn’t healthy.