Category Archives: Politics & Such

Paris, Friday the 13th and me

Tempus ends to fugit whether one remarks on it or not, so no point really. Time has passed, things happened, blog posts did not.

One of the things that did happen was Paris and yes, I was there, on Friday the 13th, in the 11th arrondissement, on the Right Bank of the Seine, Blvd Voltaire, hash-tag Paris attacks. I found out several days later that one of the attacks had been closer to me than I’d known; I was sipping Cote du Rhone, listening to jazz, oblivious that quite close by there were gunshots at the Comptoire Voltaire (where the only casualty was the somewhat, er, inept gunman who blew himself up without hurting anybody else).

It’s rather bizarre being in the centre of history as a friend puts it.

The trendy area around the Place de la Republique is not my natural habitat;; I was never especially young and trendy even when I suppose I was. But this one time, weirdly, I had made my way to the 11th to the café Aquarium where a friend, Benoit Gil, was playing.

Things were normal until half past nine or so when – perhaps in retrospect – things seemed a bit tense and, uncharacteristically, café staff made it clear they were closing. Seemed a bit early but as they were starting to mop under our feet we left. We heard some murmurs about an “explosion”. A bomb perhaps? We made our way to my friend Minnie’s car; in the street two passers-by told us something was going on at the Bataclan. (This was completely unenlightening to me as I had no idea what Bataclan meant; it was only later that I realized it was a theatre. I am a Left Bank person.)

In the car we did see the Blvd Voltaire cordoned off and a lot of police cars and SAMU (emergency vehicles) but nothing especially alarming. Still, we turned on the radio, talk was of the Stade de France and nobody knew what was happening. President Hollande had just been whisked out. Later, on TV, he seemed a tad rattled which was understandable under the circumstances.

It was, I admit, altogether a bit surreal.

Since then the attackers’ provenance has been traced to Brussels, specifically Molenbeek. A former resident Teun Voeten, cultural anthropologist and photographer, clearly knows more about this area of Brussels than I do (though I think I have wandered through on the odd occasion) and his take is dead on I think. I suspect that many young men (and perhaps a few young women) fall into terrorism for banal reasons: boredom, a desire to belong, the usual preoccupations of the young like heartbreak or being in with the in crowd. And becoming a martyr provides purpose and a higher calling, structure even, that the boring and commonplace does not. (And what one does not realize at that age is that much of life is neither dramatic nor extraordinary or that youth in general – contrary to the cultural myth  –  is an anxious, difficult time for most.)  Alas, at the moment too many conflate that discomfiture into violence or the Caliphate.

“To be willing to die for an idea is to set a rather high price on conjecture.” Anatole France *

At the Place St. Sulpice on the other side of the Seine, just after 10, all was quiet and the man at the hotel desk knew nothing. I told him what I knew, which wasn’t much but turned out to be more than BBC World which told me the sky was falling and the end was nigh. Oh good. It seemed that all of Paris was burning, even though I had just seen it was not. I checked Twitter (unhelpful) then, just in case the news made it to Vancouver, sent a few messages and went to bed to the sound of sirens and helicopters. The next day Paris became the nexus of a terrifying news cycle (for about five days) and I woke up to some 40 concerned texts and mails. I then did something I’d never done in my life, I changed, my “status” on Facebook, which had obligingly provided a phrase along the lines of “safe in Paris” for me to tick.

I had always known but never experienced first hand the parallel universe(s) of reality and news but here it was. The next day Paris was essentially fine, though subdued; quiet for a Saturday. By afternoon reaction had set in and museums closed though metros and buses ran and people milled about in cafes and elsewhere.

Context is best found, I think, in poetry, in art, in history and narrative.  Auden, in the poem Musee des Beaux Arts wrote: “About suffering they were never wrong, The Old Masters.” In the Brueghel painting Icarus: even as the young man falls from the sky with a large splash, the ploughman, head down, keeps working, the sun shines and “dogs go on with their doggy life”. It was “something amazing, a boy falling from the sky” but to most people it was “not an important failure”. Paris, of course, was hard to miss; but that ploughman of Brueghel’s had no smart phone.


Speculation (and heavy police presence) continues and no doubt will continue for a long time. A few days later it was Mali. What a world, what a world, as that great philosopher, the evil witch in The Wizard of Oz, said. On a side note, I have to say I have wondered about those small cafes, especially le Petit Cambodge. I’ve seen small Asian cafes like that all over Paris and it seemed like an odd target. Call me crazy but that one felt personal to me. Being fired or a former girlfriend working there? Too often the political is personal even if we don’t realize it at the time.

However. The City of Light recovers, the news cycle has moved on – and next week there will be jazz again at the café on the Blvd Voltaire. Tout passe. That is the nature of it all.


*etre pret a mourir pour une idee est de fixer un priz assez eleve sur des conjectures


Republicans prepare for Brave New World (of 1835)

“I read somewhere that Mitt and I have a storybook marriage. Well, in the storybooks I read, there were never long, long rainy winter afternoons in a house with five boys screaming at once. And those storybooks never seemed to have chapters called [multiple sclerosis] or breast cancer,” offered Ms. Romney, who has battled both diseases. “A storybook marriage? No, not at all. What Mitt Romney and I have is a real marriage.”

That was a quote from Ann Romney speaking at the Republican Convention; apparently she is meant to humanize her husband who is perceived as wooden and clinical.

I did like the photo of her in the Globe – however much my evil twin wonders if that smooth forehead of hers has something to do with Botox some other cosmetic filler. (hey, we should all look this good at 63)

It is ironic, though, that she brings up having been ill, when her husband’s party so demonizes government spending, in particular anything that might benefit the less fortunate, namely programs like Medicare, Medicaid and Social Security.

But, I suppose when you have a gold-plated health insurance plan it doesn’t occur to you that not everyone has the means or the employment (private insurance being so tied in with work in the U.S.) to afford breast cancer treatment or long-term therapy for MS. Or can get any care outside of an ER.

I am of course sorry that she has been so afflicted; one would not wish those diseases on anyone. But they happen and it certainly helps if you can get reasonable care. As a friend of mine used to say, money may not buy happiness but it’s a easier to cry yourself to sleep on satin sheets.

Meanwhile, a rather good piece in a recent Archives of Internal Medicine plaintively asks why nobody is questioning the “multiple examples of overdiagnosis that arise when technology, rather than clinical findings, are the catalyst for finding disease”. The authors, Jerome Hoffman and Richelle Cooper, both MD’s, point out that incidental findings of “disease” that will never lead to anything are both a waste of time and money. Not to mention turning people into patients. Their italics. (Arch Intern Med/Vol 172 (No. 15), Aug 13/27, 2012, pp 1123-4)

I thought of this article because of what Ann Romney said about having had breast cancer. Mea culpa but whenever I hear the word “cancer survivor” my first thought is: was that a real cancer (the kind that would actually kill you) rather than one that you would die with. An  incidental finding when you went to have that mammogram everyone assures you is part of good, pro-active care? Simply having a handful of cancerous cells in your body (or “pre” cancer) is no indication of anything. As you age, some cells mutate. Doesn’t mean anything. My grandmother had colon cancer for the last 25 years of her life; she died at 92. Wasn’t the colon cancer what did it, just old age.

But Americans are staunch believers in the power of technology, in the predictive power of science and the ascendancy of good old American know-how in controlling disease just as they have tried – with such success – in controlling various countries in the Middle East.

One of the signatories of the Declaration of Independence, Benjamin Rush, was a physician. He, like many of his ilk at the time, genuinely believed that American diseases were meaner and tougher than their effete European cousins. Rush’s claim to fame was treating the yellow fever (which was said to have killed more enemy soldiers in Panama a century later than the enemy did) by using humungous doses of mercury which, presumably, if it didn’t kill the patient effected a “cure”. Historians later questioned Rush’s prowess, suggesting that the individuals he was said to have cured actually weren’t that sick (hence were able to withstand his toxic treatment). Rush and his contemporaries, nevertheless, were convinced that massive purging, bloodletting and strong dosing were key to good medicine.

A handful of physicians like Oliver Wendell Holmes, who had studied in France (the French were much admired at the time for their diagnostic prowess), disagreed with Rush and his ilk. Holmes felt the American penchant for aggressive cures had more to do with cultural constructs than science. But it was Rush’s perspective that prevailed; it fit better with how Americans saw themselves.

Women were particular victims of this “heroic” ideology of strong medicine – starting from pregnancy and childbirth, where the use of forceps, episiotomies (cutting the perineum in childbirth) and later Caesarians became increasingly common to midlife and menopause when  hysterectomies and oophorectomies (removal of the uterus and ovaries, respectively) became the norm, as these organs were no longer considered “useful” once the woman could no longer bear children. Ah yes, now we know what women’s utility consists of …

Oh, and thank you sociobiology so much for keeping that swell idea alive.

Hubris, children, hubris. How the hell do you know what’s useful and what’s not? Tonsils were routinely yanked out until we realized that they were actually part and parcel of natural immunity. We have an unfortunate tendency to dismiss any organ or part we can’t figure out – a case in point being the large junk of genetic material we call “junk” DNA.

“An aggressive approach, of course, implies that the doctor can do something for the patients, and this ‘can do’ attitude is as much a characteristic of American medicine as it is of the American character in general,” writes Lynn Payer in Medicine and Culture.

You’d think by the 21st century we’d have evolved somewhat but no. Romney, Ryan and the Republicans hang on to these nonsensical notions. Zero clue  that today’s globalized, cyber-connected, micro-blogging world is hardly the same as the one Rush knew in the 1800’s. (He died in 1845.)

I shan’t delve too deeply into the right-wing perspectives on women’s reproductive rights, abortion, rape and so on lest I self combust. I will simply quote an old line from a Whoopi Goldberg one-woman-show that I always loved. Her character, a wise-cracking, foul-mouthed former drug addict, walks past a group of marchers – men – holding anti-abortion signs. She (playing a he) pauses, thinks for a minute and says: Hey, you want to stop abortion? Shoot your d—k.

9/11 revisited, again and again

Many years ago when I was young, idealistic and – not to put too fine a point on it – an idiot, I truly believed that ideas, beliefs (like democracy) could drive action, states, life. I thought that if you had the right attitude then, by golly, the right institutions and governments would follow. As I said, I was an idiot. Most 17-year-olds are.

I now know that it is lives and who we are, how we are, how we live that drives the systems we adhere to. What does that mean? Well, it means that the Bush Doctrine of heading into Iraq post 9-11 to bring democracy into the region – democracy deprived as those poor Iraqis were – then all would fall into place, like a jigsaw puzzle opening up into its full splendour of a sunset over the Rockies.

But it’s not like that.

People’s lives, whether they have enough to eat, a place to live; whether their children can go to school, safely, and come home after without being blown up; it is having decent work under reasonable conditions, living in a place where you can make a life for yourself: it is these that then give rise to political and moral beliefs.

Years ago a psychologist by the name of Kohler (I think that was his name, my lamentable memory) spoke of the slow process through which true moral understanding develops. Another psychologist, Maslowe, spoke of the hierarchy of needs and how it is only after the fundamentals are satisfied is one able to concern oneself with abstract concepts like ethical societies or an ecological metaphor for life. One can only become a person with genuine global, ecological concerns required living in a world where one’s other more basic needs like food and shelter are met.

But we don’t talk much of development or developmental processes these days. Early education is under attack (no matter how much the school day is extended) and our reverence is focused on the gene and its so-called blueprint. Well, if you believe that it’s all there, ready to go, in your genes then why the hell would you even think about development, learning, the ways in which an individual evolves into that wonderful Jewish notion of a mensch?

To care about things larger than oneself one needs to have the basics and the knowledge that more is out there if one applies oneself. This is what the Arab Spring is about and this is what the guardians of terror and nitpickers at airports do not get. As long as entire regions of the globe only see the good life in movies downloaded from the internet or from satellite television – never in their own lives – there will be terrorism and people willing to die because they have nothing to lose.

That was the real lesson of 9/11. Or ought to have been.

Riotous Living

Coming at things a bit late – no surprise there, particularly in the summer when I teach and run around like a crazy person – so it’s taken me a bit of time to get to that Stanley Cup riot thing.

Fahrenheit 451?

Like a lot of people I watched it evolve with fascinated horror on CBC television; struck by the  destruction and sheer, wanton glee in those fires and general mayhem.  The restraint shown by the VPD also impressed me – and since I have been critical of heavy police presence in the past this did strike me as … civilized.  A camera crew caught one particular young man in mid rant as he poked and yelled at a couple of cops who calmly ignored him. Poke the bear with a sharp stick why don’t you, I thought. Later, quite a bit later actually, I saw him being arrested. Frankly, I’d not have displayed such forbearance with a drunk kid having a tantrum if I was holding a baton.

Restraint aside, one did have to wonder why nobody seemed to even consider that this was a a problem in the making, A Situation, what with the number of people downtown, the amount of alcohol consumed and the sheer intensity with which this city greeted that Stanley Cup final. Feelings ran so high that last week you could cut the air with a knife, even in stores just going about your business, as I was. And it didn’t occur to anyone that trapping a whole bunch of people in a five block radius might be a bad idea? Just asking.

Then the immediate analysis that of course it was really a vile bunch of outsiders, no doubt lurking in the wings waiting for their chance to wreak havoc. Like movie extras, just waiting for their five minutes of fame (and a chance to wear those balaclavas).

Ah yes, the outsider theory. Which, as anyone who’s ever read an Agatha Christie knows, is never the case. For in the immortal words of whatshisname, we have met the enemy, sir, and he is us.

But we are fond of that notion of the outsider and hate to give it up, be it in terms of disease or terrorism or anything else. We don’t like thinking that our friends, neighbours, colleagues and those nice people living around the corner have it in them to behave so badly. Most importantly, we don’t like to believe that we have it in ourselves.

Yet that’s why we have police and judges and juries and international courts. Individuals, once tossed into a group, lose all decorum and – for the most part – are reduced to their lowest common denominator. And that all too often is all that is loutish, cruel, and bloody inelegant..

As with disease we prefer to think of the problem as somehow external to us, not our own cells turning rogue, with cancer, or our own immune system becoming destructive as in rheumatoid arthritis or lupus. Far better to believe in the metaphorical infectious disease, the tuberculosis bacterium, the smallpox virus, the malaria parasite transmitted by mosquito. Even swine or bird flu. Identifiable and on the outside, attacking and therefore something we can attack, mobilize forces against, fight – be it through an analysis of its genome or killing it with chemotherapy.

Comforting thought that – that we can somehow protect ourselves if we just put our minds to it. The problem is that it’s not the way even a microbial disease behaves, given that a virus or bacterium or parasite is always, in epidemiological terms, necessary but not sufficient. The immuno-competence of the host, his or her life, diet, life circumstances and a host of other factors go into determining whether or not we get ill.

Think on that the next time you try to “fight off “ a cold or hear someone say they won’t let the cancer win. There are no winners or losers in physiology, any more than there were any winners in that Vancouver riot. We all pay for the broken windows and stolen property and we all have to deal with the moral, aesthetic and social consequences.

Maybe if we recognized that to begin with we’d be better equipped to face it in the first place. And wouldn’t have to run around setting fires and losing our heads.

Yet another election – is it still 2008?

No self-respecting curmudgeon would consider the current (federal) election a worthy topic of conversation (the superficial nonsense on health care alone is enough to put one to sleep), nevertheless given the ridiculous fact that it is even happening seems to require some kind of reaction.

Mine is mostly boredom. Well, I do confess a that those appalling conservative attack ads do vex me – ah, Ignatieff didn’t come back for me? Why would he have to? Was I lost? (Perhaps there is some subliminal religious theme here that I’m missing: “I once was lost and now I’m found, etc.” )

Four old white men, desperately trying to seem relevant – tweeting, eating hot dogs, hanging out at Tim’s drinking some weird concoction called a double-double (and you call yourselves coffee drinkers, pah) – wandering around the country in a repeat of 2008. Women my age apoplectic at the sexism and waste of money; young people completely disengaged and why shouldn’t they be when the one time a bunch of them try to get into a Harper rally they are turned away, and older people the only ones paying attention lest anyone go anywhere near their various entitlements. Touch my senior discount sonny and I’ll bean you with my walker.

Sorry. That was uncalled for. Particularly from a person of my advancing years. As, incidentally, we all are.

So, in keeping with the spirit of this corner of the cybersphere, I will focus on one small aspect of the discussion, one that I know a thing or three about, health care. Notably that dastardly phrase in the Canada Health Act, namely that all “medically necessary” services will be provided, ad infinitum and ad nauseum.  For aye, there’s the rub.

What, in this age of in vitro fertilization and knee replacements, full body MRI’s to “rule out” any serious hidden condition and various and sundry (highly expensive) drugs that will prolong life for a few weeks, is actually medically necessary? According to whom? CNN? The magazine you’re reading? The specialist? Your Aunt Sadie?

Things were a lot easier 50-odd years ago. Your grandmother knew when she was sick and needed to go to hospital (well, most of the time, if she didn’t decide she was too busy and couldn’t afford the time). Nobody was breathing down her neck insisting she had all kinds of risk factors that needed treating or pointing out that type 2 diabetes was the “silent killer” and surely someone her age needed to be on a biphosphonate for her bones. Oh, after a bone scan of course. Ah, the good old days.

Today, on average, women live past 80 and men about 78. In all likelihood anyone that age has a few things “wrong”, the question really is whether or not all of these need intervention and whether these treatments and drugs and so on end up often doing more harm than good.

What we need is a genuine, difficult discussion on what “medically necessary” means. For everyone, not just my Uncle Joe or me down the road (which of course must only be the best). Hell, why don’t we go all out and have a discussion about science policy as well. Rather than just the blather – science good, health care, good, oog oog. (For a more nuanced and informed discussion on science policy in Canada, visit my friend frogheart’s blog here.  ( Or you can listen to her being interviewed on Peer Review radio.)

In terms of health care, which everybody wants in on (versus science policy which makes most people run shrieking – forgetting that without policy we remain the commodities market we always were and that, boys and girls, is finite – those forests and minerals eventually will give out – the basics are as follows: Any national health care program has to navigate carefully between being all things to all people (and going bankrupt) and being most things to (almost) all people (there will always be people who end up getting better care than others, that’s life) but then we have to de-list somethings. We can’t do everything all the time. So that means we all have to give up a few things, like getting that MRI right this instant.  In any event, most of the time later on is good enough.

Take a painful knee.  Whether you’re a weekend warrior or a professional athlete, the reality is that joints take time. With or without that MRI your knee needs rest, ice, elevation, an anti-inflammatory and tincture of time. You may never need the MRI, the knee will probably get better. If it doesn’t, well, eventually you’ll need surgery. Again, MRI optional. But our belief in technology is so extreme that we transpose screening technologies with treatments. Simply knowing what something looks like isn’t a solution. But we always want “more”, like that Dickens kid.  And if we don’t get surgery next week? We end up complaining to the media that our health care stinks and all is lost. Like that woman, a gazillion pounds overweight, who whinged to the Globe and Mail a few years because she didn’t make it to the top of the surgical list. Or the alcoholic who’s peeved that his new liver can’t be had on demand.

My prejudices and curmudgeonly asides aside, this is a discussion Canadians need to care about and engage in. What constitutes medically necessary care? It’s not enough to think health care is just the greatest thing since sliced bread. We have to define what it is, what it means – and we all have to be prepared to give up a few things for the good of the all. That’s what ‘public” means.

But that’s the conversation nobody wants to have, which is why this election is really about individual (male) ego. And that’s boring.

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.

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.

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.