1. Featured Article: Shutting Down Alzheimer's
Shutting Down Alzheimer's, New research reveals strategies for
blocking the molecular processes that lead to this memory-destroying disease, By Michael S.
Wolfe in Scientific American
The human brain
is a remarkably complex organic computer, taking in a wide variety of sensory
experiences, processing and storing this information, and recalling and
integrating selected bits at the right moments. The destruction caused by
Alzheimer's disease has been likened to the erasure of a hard drive, beginning
with the most recent files and working backward. An initial sign of the disease
is often the failure to recall events of the past few days--a phone
conversation with a friend, a repairman's visit to the house--while
recollections from long ago remain intact. As the illness progresses, however,
the old as well as the new memories gradually disappear until even loved ones
are no longer recognized. The fear of Alzheimer's stems not so much from
anticipated physical pain and suffering but rather from the inexorable loss of
a lifetime of memories that make up a person's very identity.
Unfortunately,
the computer analogy breaks down: one cannot simply reboot the human brain and
reload the files and programs. The problem is that Alzheimer's does not only
erase information; it destroys the very hardware of the brain, which is
composed of more than 100 billion nerve cells (neurons), with 100 trillion
connections among them. Most current medications for Alzheimer's take advantage
of the fact that many of the neurons lost to the disease release a type of
chemical communicator (or neurotransmitter) called acetylcholine. Because these medicines block an enzyme responsible for the normal
decomposition of acetylcholine, they increase the levels of this otherwise
depleted neurotransmitter. The result is stimulation of neurons and
clearer thinking, but these drugs typically become ineffective within six
months to a year because they cannot stop the relentless devastation of
neurons. Another medication, called memantine, appears to slow the cognitive
decline in patients with moderate to severe Alzheimer's by blocking excessive
activity of a different neurotransmitter (glutamate), but investigators have
not yet determined whether the drug's effects last more than a year.
More than a
decade ago few people were optimistic about the prospects for defeating
Alzheimer's. Scientists knew so little about the biology of the disease, and
its origins and course were thought to be hopelessly complex. Recently,
however, researchers have made tremendous progress toward understanding the
molecular events that appear to trigger the illness, and they are now exploring
a variety of strategies for slowing or halting these destructive processes.
Perhaps one of these treatments, or a combination of them, could impede the
degeneration of neurons enough to stop Alzheimer's disease in its tracks.
Several candidate therapies are undergoing clinical trials and have yielded
some promising preliminary results. More and more researchers are feeling
hope--a word not usually associated with Alzheimer's.
The Amyloid
Hypothesis
The two key features of the disease, first noted by German neurologist Alois
Alzheimer 100 years ago, are plaques and tangles of proteins in the cerebral
cortex and limbic system, which are responsible for higher brain functions. The
plaques are deposits found outside the neurons and are composed primarily of a
small protein called amyloid-beta, or A-beta. The tangles are located inside
neurons and their branching projections (axons and dendrites) and are made of
filaments of a protein called tau. The observation of these anomalies started a
debate that lasted throughout most of the 20th century: Are the plaques and
tangles responsible for the degeneration of brain neurons, or are they merely
markers of where neuronal death has already occurred? In the past decade, the
weight of evidence has shifted toward the amyloid-cascade hypothesis, which
posits that both A-beta and tau are intimately involved in causing Alzheimer's
disease, with A-beta providing the initial insult.
A-beta is a short peptide, or protein fragment, first isolated and
characterized in 1984 by George G. Glenner and Cai'ne W. Wong, then at the
A portion of the
A-beta region of APP is inside the membrane itself, between its outer and inner
layers. Because membranes are composed of water-repelling lipids, the regions
of proteins that pass through membranes typically contain water-repelling amino
acids. When A-beta is cut out of APP by beta- and gamma-secretase and released
into the aqueous environment outside the membrane, the water-repelling regions
of different A-beta molecules cling to one another, forming small soluble
assemblies. In the early 1990s Peter T. Lansbury, Jr., now at
To read pages 2-5, (subscription required) go to
* * * * *
2. In the News: Are Business CEO's Overpaid? Just Check
What Non-Profit CEOs Make
Watchdog report: Good works, great pay; Compensation on rise for top execs at nonprofits, By Phillip Reese and Todd Milbourn -- Bee Staff Writers, Published, Sunday, May 14, 2006
Charity jobs often come with
meager salaries, but a review of nonprofit agencies around the region shows
that, increasingly, is not always the case for the top bosses.
More
than 200 employees of nonprofits in the
And,
in what appears to be a first for the region, the chief executive officer of
one nonprofit made more than $1 million in 2004 - and another reached that
level through a one-time bonus - according to a Bee analysis of the latest
federal tax records for the charity organizations.
Compensation
for executives at the four-county region's 500 largest nonprofits is rising
fast, too - even quicker than pay at for-profit companies. In the five years
from 1999 to 2004, median salaries, benefits and expenses for the 100 best-paid
rose about 42 percent. Adjusted for inflation, that was a 25 percent increase.
Those
figures would have been even larger had they included nonprofit hospitals,
CAL-ISO - which manages the power grid for most of the state - or Vision
Service Plan - a massive health benefits organization based here with offices
in 23 states - whose high salaries overshadow those of more traditional
nonprofits.
Each
nonprofit organization is unique, but some trends emerged in The Bee's analysis
of individual cases:
*
. . . Some spent more than 10 cents of every dollar raised to compensate one
person - about twice the median compensation for the area's largest nonprofits.
In an extreme example, about one of every four dollars raised in recent years
by Community Dental Care, a dental service for low-income patients, went to its
top executive, Gene Gowdey - more than $115,000 in 2004 - even during a period
when revenue declined.
The public's role
The
With
all that in mind, several experts said, it's in the public's interest to ask
whether publicly supported organizations need to pay someone six figures or
more to run things efficiently . . .
To
read the entire report, please go to
www.sacbee.com/content/business/finance/v-print/story/14255272p-15070633c.html.
About the
writers: The Bee's Phillip Reese can be reached at preese@sacbee.com; Todd
Milbourn can be reached at tmilbourn@sacbee.com.
* * * * *
3. International Medicine: How to Cut the
One way to cut waiting lists: don't treat people with the wrong views,
IT IS BAD enough that you
can be refused medical treatment on the NHS for eating, drinking or smoking too
much. Now it seems that you can be denied an operation for protesting too much
in support of your religious or political beliefs.
Edward
Atkinson, a 75-year-old anti-abortion activist, was jailed recently for 28 days
for sending photographs of aborted foetuses [sic] to
the
Mr
Atkinson sounds like an unpleasant crank, and I am as much in favour [sic] of
legalised [sic] abortion as he is against it. But his treatment (or the lack of
it) is a scandal. This is about admitting a man to hospital, not electing him
to Parliament. Even unhip old bigots need replacement hips.
Ruth
May, the hospital's chief executive, claims that the ban is justified because
the "offensive" publications he mailed caused "great
distress" to her and her staff and thus contravened the NHS policy of
"zero tolerance". Some may already feel that such policies make it
seem as if a hospital's priority is to protect its staff against the patients,
rather than protecting patients from illness. This case goes farther, equating
the posting of offensive photos with punching a nurse on the nose.
Why
on earth should hospitals be distressed by pictures of the sort of operations
that they carry out? An aborted late-term foetus can certainly make a grisly
spectacle, and there is no point trying to sanitise abortion. But neither need
anybody be intimidated by the handful of zealots who like to wave around such bloody
abortion porn.
In
any case, that debate about abortion should have nothing to do with decisions
about who gets hip replacements. Have hospital authorities been granted the
power to turn away anybody who upsets them? It may come as a shock to delicate
souls in the upper echelons of the NHS, but some elderly people can be
cantankerous, obnoxious and express unfashionable opinions in an uninhibited
way. So what? Should the NHS introduce a policy of euthanasia for offensive old
gits?
We
should take the principle of universal health care seriously, and insist that
medical staff make decisions about treatment on clinical grounds alone. After
all, so far as science can deduce, a member of the British National Party or an
Islamic fundamentalist is the same as you or I under the surgeon's knife. Even
loons who oppose animal experiments should be given the benefits of medical
research that they would deny to others.
Many
who normally shout about patients' rights have fallen silent over the case of
Mr Atkinson. But you need not be anti-abortion to protest against the notion
that only obedient individuals with healthy lifestyles deserve NHS treatment.
Perhaps those who would put their own feelings ahead of others' needs should be
advised that if you can't stand the patients, get out of the hospital.
THIS NEWSPAPER reports that
local authorities are to be given powers to bar ice-cream vans from school
gates. Many councils have already imposed strict
controls on the ice-cream trade. These measures are justified in the name of
the holy crusade against child obesity. Along with police threats to fine kids
for playing football in the street, however, they look more like part of a war
on childhood fun.
This is not just nostalgia
talking. Children today are supposed to be world-weary cynics. Yet nothing
excites my young daughters and their stampeding friends like the ice-cream
van's traditional tuneless jingle. Educational experts pontificate about
teaching "happiness" lessons in class, yet seem to want to stamp out
the more sensual pleasures of being a kid. When selling ice-cream is treated as
pushing an illicit substance, and Mr Whippy risks an ASBO, the warning bells
should surely be jangling.
To read other timelines,
please go to www.timesonline.co.uk/article/0,,8122-2176383,00.html.
Canadian Medicare does not
give timely access to healthcare but only gives access to a waiting list.
* * * * *
4. Medicare: The Medical Bureaucracy in Government Versus
Compounding Pharmacies
Andrew Schlafly,
Esq, Legal Counsel for the American Association of Physician and Surgeons
reports:
"We just won another
big victory against the FDA. AAPS probably holds the record for helping
win the most victories in the medical field against the often-invincible
federal government!
"As
recently described at our Board meeting in
"The
result of our work came in yesterday [May 25] at the hearing in
The Editor-in-Chief of the
JAAPS responds: "This is a really impressive win . . . In a way, an amicus brief is really an expression of free
speech. The fact that the government would so strongly oppose the filing
of our amicus brief speaks volumes.
"If I were a judge, I
would wonder what it was the government didn't want me to hear in deciding the
case. Fortunately, this judge deferred to free speech, which allowed him
to better assess both sides of the issue and render a fair decision."
--
Government
is not the solution to our problems, government is the problem.
- Ronald Reagan
* * * * *
5. Medical Gluttony: Gluttonous Behavior Is Still Prized
Joey Chestnut hopes to be
the new face of speed eating -- first, he has some cramming to do by Justin Berton, Chronicle
Staff Writer,
Hot
dogs one and two disappear into Joey Chestnut's mouth like a pair of flies
going down a well. A flour-dusted bun gets tossed in afterward.
Hot
dogs number three, four, five, six, seven, eight, nine
... 10, 11, 12 ... 13, 14, 15, 16, 17 ... 18, 19, 20 -- all of them. Gone.
Joey
Chestnut is only halfway through his meal, and he's been at it for about four
minutes.
It's
Thursday night, and Chestnut's roommate, Nate Yates, 25, is hovering over Joey
in their
"C'mon
baby," Yates shouts at his roomie, whose cheeks
are bursting with hot dog and sopping wet buns. "Put it down, put it down
-- chew, chew, chew, chew."
At
23, Joey Chestnut is a rising, if humble, star in the world of competitive
eating. Just last month, the "sport" earned a glut of attention after
two books on the subject were released, along with a documentary and countless
magazine articles. Most of the attention was lavished on the sport's more
enigmatic personalities, namely Takeru Kobayashi, the
skinny 32-year-old Japanese man who has won the Nathan's competition for the
past five years.
Yet
Chestnut, whose rise to prominence occurred in the past 15 months, has been
largely ignored. He was an unknown until April 2005 when he beat 37-year-old
American Sonya Thomas, the world's No. 2 ranked eater, at a fried asparagus
contest in
In
the past year Chestnut devoured world records for waffles (18.5 in 10 minutes),
pork ribs (5.5 pounds in 12 minutes), grilled cheese sandwiches (32.5 in 10
minutes) and chicken wings -- 173 in 30 minutes, wiping out the previous record
by 29 wings.
And
on May 18, at a Nathan's qualifier in
"Joey
Chestnut," marvels George Shea, president of the International Federation
of Competitive Eating, "is clearly going to change the face of American
competitive eating. He may become the greatest eater in
To
read the entire article about this unhealthy gluttonous behavior, please go to www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/05/27/DDGCHJ2JM21.DTL&type=printable.
Can't
we leave speeding performances to track, auto and horse racing events?
* * * * *
6. Medical Myths: Doctors Always Know What's Best for the
Patients
Buchwald can wait for heaven
By DARLENE SUPERVILLE, Associated
Press Writer
A funny thing happened to humorist Art Buchwald on
the way to his grave.
Nearly
four months after refusing potentially life-extending treatment for his failing
kidneys, Buchwald is alive against all expectations. He's planning to spend the
summer at his house on Martha's Vineyard, Mass., writing his twice-weekly
newspaper column, finishing a book about his experience and waiting for Carly
Simon - once tapped to sing at his funeral - to serenade him while alive.
"I'm
in a very good mood," Buchwald told The Associated Press in an interview
Wednesday.
"I
was happy when I made the decision not to have dialysis and now I'm happy that
I made a decision to go to the Vineyard. I would say, on the basis of that, I'm
a happy person."
Buchwald,
80, made plans to leave his hospice for the island July 1 after his doctor said
he was unlikely to die right away. Experts say he's lived an improbably long
time without properly functioning kidneys or dialysis.
And
so heaven can wait, however much longer. So can his wished-for meetings in the
hereafter with
The
man who thought he was done suddenly has a to-do list again. Among the items
checked off: scrapping plans for his own funeral.
A
week ago, Buchwald received a prosthesis to replace
his right leg, which doctors amputated below the knee in January because of
circulation problems.
"Everybody
cheers when I use it and I cry," he said . . .
To
read the entire article, please go to www.sacbee.com/24hour/entertainment/books/news/v-print/story/3295265p-12143125c.html.
Sometimes Patients Know What's Best for Them.
* * * * *
7. Overheard in the Medical Staff Lounge: Is the Violent
Death Rate in
Dr Dave: Quoted
the Best of the Web Today -
How
Does Iraq Rate?
In her
According
to Mr. King, the violent death rate in
Dr Sam was even more upset today
than last month as he was continuing his battle with Medicare or perhaps with
his billing clerk. Since there were no Medicare payments for eight weeks, his
billing clerk stated she had sent out paper claims for the last eight weeks
while she tried to research the Medicare lack of response. She then reminded Dr
Sam that Medicare would not process these claims for four weeks. Medicare had
arbitrarily inserted the four-week delay for paper claims as an effort to
encourage electronic claims and discourage paper claims.
Dr Sam had tried to
intercept this mailing of claims but the clerk had already deposited them into
the mailbox the previous day. He almost fired her on the spot, but then
realized it might take an extra month or two to replace her and then a month or
two for the learning curve in a new job. This could make a pending desperate
event even worse. Oh, for the joys of a government largess and then being a
slave to the government. Dr Sam made the decision to leave Medicare. He felt
that it would take a year or possibly two to make the transition since so many
of his friends had experienced retaliatory legal action when they left
Medicare. It was critical that all the "I's" were dotted and all the
"T's" were crossed.
Dr Rosen was surveying an
article in the SF Chronicle about the crises in Government Education, formerly
known as Public Education. Nanette
Asimov and Heather Knight, www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/05/28/MNG4GJ3R251.DTL&type=printable, reported:
"This
should be a good time for
"Instead,
the schools are at a crisis point, and the main cause is beyond their control:
High housing prices are spurring many families to leave the city.
"As
a result, enrollment is declining, schools are closing, and officials are
concerned the turmoil will reinforce negative perceptions that have helped give
Dr
Rosen pointed out the fallacy of all government programs. The disconnect
between the paragraphs above is that if all those families leaving SF stayed
and placed their children in private schools, the percentage would be much
greater. Or the converse, the exodus of
children had nothing to do with the high housing prices as the cause of the
alleged crises.
We
should brace ourselves for the same thing with government medicine. Since
school taxes should be in abundance with 29 percent of the students not
requiring government (formerly known as public) educational moneys
euphemistically called resources, the school districts should be happy with the
huge surplus in moneys. But they don't see it that way. They want to control
all of education so that there is no alternative to their ineptness. Hats off to the 29 percent of parents that still pay those onerous
school taxes and also pay tuition. He also pointed out that there are
many private and parochial schools that charged a tuition
equal to about half the tax dollars the government (formerly known as public)
schools required to teach each student.
Dr
Rosen feels that government medicine is deteriorating in quality in the same
manner as government education. The worst doctors, just like the worst
teachers, get paid the same in a government-funded program as the best. As
government health care continues its descent to mediocrity, Medicare recipients
will have to begin obtaining health insurance to make sure that they get
quality health care even though they are paying onerous Medicare taxes. Just
like responsible parents pay tuition without educational tax relief.
To
read further about SF unaffordable housing, please go to www.ncpa.org/newdpd/dpdarticle.php?article_id=3396.
* * * * *
8.
Voices of
Medicine: Many Perversions of Peer Review Process by
Philip R. Alper, M.D.
Death and
complications conferences during training introduced me to peer
review. At
The
first variation on the theme that I encountered occurred years ago, when a
rogue anesthesiologist tied the hospital medical staff up in knots as they
sought to restrict his privileges for cause. The legalities dragged on for
years and put the reviewers at personal risk due to accusations of malice and
violation of antitrust laws. This was hardly a sordid quirk. The pages of Medical
Economics Magazine regularly describe similar cases.
From
such humble beginnings, peer review has gone on to extend, for better or worse,
into almost every aspect of medical care. In the process, it has become
perverted by misuse. The original purpose of peer review was the protection of
patients and enhancement of the quality of care. Its scrupulous implementation
has served as the basis for public trust and trust among colleagues. Honesty
and fairness are assumed.
That
is the ideal. Where peer review has taken a severe turn for the worse, in my
opinion, is in the co-opting of the peer review process by numerous parties --
government, insurers, hospitals, and even medical journals, to name just a few
-- to serve ulterior purposes. Medicare employs peer review with dual motives
-- no doubt to seek the best care for the dollars it pays out, but also to
serve as a moral basis to enforce dubious fraud and abuse laws that leave
physicians in a perpetual state of debilitating uncertainty. Although this is
difficult to explain to nonphysicians, it is
intuitively understood by anyone practicing medicine today.
But
much further back, at the source, where we obtain the very knowledge we need to
remain at the state of the medical art, we have reason for misgivings. Medical
journals, including the very best of them, have come under attack recently for
bias that includes commercial and political motivation. The lead editorial in
the Wall Street Journal (
I
find this criticism credible. Shortly after I was appointed a Visiting Scholar
at Stanford's Hoover Institution, I arranged an even-handed study of the impact
of managed care on physicians in
It's
a given that money, fame, and power tend to corrupt. That applies most
obviously to fraudulent scientists, particularly in stem cell research. The
process is more complex in the current case of the Cleveland Clinic, where
conflict of interest has been taken to new heights. It involves the promotion
of a controversial surgical technique to treat atrial
fibrillation, the patented instrument needed to perform it, stock investments
by the institution in a company set up to sell it and partly owned by its
inventor, who, in turn, became the chief executive of the Clinic.
More
subtle is the case of Arnold Relman, M.D., former
editor of the NEJM, and the scion of the
Dr.
Relman is still beating the drum for yesterday's
ideas -- essentially, socialized medicine with medical academic control at its
core -- all emanating from Boston, where managed care has treated medical
institutions (if not physicians) far more kindly than elsewhere in the country,
and from Harvard, the beneficiary of the world's largest university financial
endowment (by far) . . .
Coming
closer to home and to our everyday lives, hospital medical staff actions
constitute the form of peer review that is most familiar to us. There is a long
history of argument over legitimate indications for various surgical
procedures, usually with fairly wide latitude for differences of opinion. In
years past, self-promotion was considered anathema. I thought it a bit strange
when internationally renowned physicians in our community were treated locally
as nobody special. But those were the days when advertising was not supposed to
be used to seek professional advantage.
How
far we have come! Now, our own hospitals promote individual physicians,
procedures, and equipment with the undisguised goal of revenue enhancement.
Continuing controversies over the safety of minimally invasive procedures,
whether orthopaedic or cardiac, are glossed over. As
the radio and television ads are broadcast, issues of visibility and credit
make the difficult job of assessing professional excellence even harder. I am
told that surgical departments were given monthly status reports detailing
their relative place as revenue-generators for the hospital until at least one
department rebelled. As one physician put it, "It's as if the indications
and outcomes weren't even relevant." . . .
Intraprofessionally,
orthopaedists are unhappy that primary physicians can
vote on requiring other specialties to take night call at annual staff meetings
when many primary physicians no longer admit patients to the hospital. Indeed,
why do such physicians maintain privileges and what do those privileges
signify? Perhaps it's because hospital staff privileges are required by PPOs
for accrediting primary physicians into their networks. And since primary
physicians refer lucrative cases to the hospital, there is little incentive for
anyone to make waves. On the other hand, nobody seems to much care that the
burdens of implementing the costly clinical guidelines mandated by
pay-for-performance programs fall almost exclusively on primary physicians.
A word about insurers.
Every one of them is developing surveillance programs to assess physician
performance and "increase compliance." Meticulously detailed
literature sources and recognized clinical guidelines based on the peer-review
process mix the science and the money in such inscrutable ways that they are
difficult to argue against. Blue Shield of California has gone to the head of
the class with its "Relative Efficiency Scores (RES)" that rate
individual physicians on a "Resource Utilization Grid." The scores
aggregate the physician's use of resources (a euphemism for cost) in treating
selected diagnoses. Clinical outcomes are not relevant…
To
summarize: peer review has been compromised in many ways -- by politicization,
introduction of other agendas, hidden financial considerations, and misuse of
the "peer-reviewed" imprimatur to promote dubious practices.
Consequently, this process that all doctors could automatically subscribe to in
the past, now needs to be re-validated.
Dr.
Alper has a practice in internal medicine and endocrinology in
To
read Dr. Alper's entire article, or to read other
articles on Peer Review, please go to www.smcma.org/Bulletin/BulletinIssues/Feb06issue/FeaturedArticlesFeb06.html.
The
Hidden Meaning: "Clinical
outcomes are not relevant" means quality of care is not relevant.
* * * * *
9. Book/Movie Review: The Da
Vinci Code: Does History Matter? By James J Murtagh, M.D.
Warning: Movie spoiler
alert. If you have not seen Da Vinci Code, consider seeing the film before
reading further. However, since almost every person on the planet knows the
plot of Da Vinci, this spoiler alert may not be necessary.
In my beginning
is my end -TS Eliot
Is it easier to
believe in the historical divinity of Mary Magdalene than the historical Jesus
Christ? Does it matter?
After all, Tom
Hanks says, "the only thing that really matters is what you believe
yourself." The film's heroine thinks for a minute, considers whether she
might be Christ's sole living descendant, puts her foot in the water, then
realizes, no, she can't walk on water. Drat, history got in the way.
History is more
than bunk. Myth is important, but not all myths can be equally true. Truth, to
be true, must be verifiable, or at least, there must be, in the phrase of Karl
Popper, falsifiable.
Religious claims
are indisputably most difficult. But two completely different sorts of religious
truths exist: first, historical claims, and second, value claims. We cannot
prove values, which are ultimately a matter of faith.
But historical
claims can be verified or falsified. "Did King Solomon build a
temple?" or "Did Mohammed raise an army?" or "Does the
earth go around the sun?"
Apologetics
(both Christian and non-Christian) have wrestled with the search for a historical
Christ for centuries. C.S. Lewis described in "Mere Christianity"
what he called "the trilemma": "Jesus
claimed to be the Son of God. It follows that he was either a
liar, a madman, or the Son of God."
Bertrand Russell
examined the trilemma and decided he was an atheist.
Pascal considered roughly the trilemma and decided to
wager to believe. But all realized that the historical existence of a divine
Christ is historical claim that is either true or false. But Dan
Brown seems to put more credence in the divinity of Mary Magdalene than in the
divinity of Christ.
What kind of
paradox is this? Who would ever have heard of Magdalene if she had not been the
follower of Christ? More to the point, if Magdalene was a goddess,
and Christ was not god, how could Magdalene find that Christ had left his tomb,
and why would she proclaim he had risen? Was the goddess Magdalene defrauding
humanity? Was she starting a false religion? Brown is asking us to believe and
not to believe at the same time.
Some of my Christian
friends have told me the Da Vinci code has strengthened their religious faith.
What! The Da Vinci code postulates Christians have worshipped the wrong deity
for 2,000 years. Essentially, Brown is claiming that traditional Christianity
is a fraud, roughly equivalent to a form of devil worship.
You can
understand how this has some people's blood boiling. After all, a simple
cartoon of another religious figure almost started a war recently. So, both the
religious and non-religious may have a stake in the controversy.
The end of King
Arthur's grail quest, and all other grail quests from Indiana Jones to T.S.
Eliot was the womb of Magdalene? Tosh.
It should be
clear to atheists, Christians, and every one else that if Magdalene were a
goddess, she would not have been so easily fooled. The goddess could not allow
Christians to persecute her true following. Why would a goddess reveal herself
only to a small Priory of Sion? Shouldn't salvation
be for everyone, not just a few Gnostics?
Even conspiracy
theorists ought to be suspicious of this conspiracy.
Don't get me
wrong. I loved Brown's book. The places, the paintings, the ideas are
magnificent and fascinating. Brown loves to stir up a hornet's nest, and I love
hornet's nests. I love the debate and the dispute..
But Brown should
have also paid attention to the fundamentals of logic. There is such a thing as
verifiable or falsifiable truth . . .
To read this
entire review, click on The Da Vinci Code at www.delmeyer.net/CinematicOpEdReviews.htm.
* * * * *
Caremark as
well as the other pharmacy benefit managers (PBMs) send a ton of paper to each
office telling doctors how to practice. Usually they are offering alternatives
to the prescriptions we write. As we heard in section 2 of our last issue, the
CEO of Caremark sold $185 million of stock last November. The CEOs of the PBMs
are some of our wealthiest CEOs. Each letter they send to doctors has a
disclaimer stating that since Caremark doesn't have the entire medical chart,
there may be other issues of which they may not be aware. How did they get my
patient's x-ray file?
If a pharmacy knows so much about what an x-ray
facility does with my patients, they must have an unbelievable sleuthing
network. We should have the CIA hire Caremark to keep tabs on all the
terrorists. The $185 million the CEO made in November may be cheaper.
[Actually, it is probably HIPAA which allows almost
everyone access to a patient's medical record without disclosure to the patient
except doctors and hospitals who really need them. Stalin, Hitler, Mussolini,
Saddam and others would have drooled with access to such private information in
their totalitarian police state?]
How fathers teach their sons
to kill. At the Century theatre, I
took a stroll through the arcade gallery to see what the attractions were. It
was amazing to find men with such determination to kill the "bad guys"
on the screen. What really tore at my heart was a father teaching his son to
"kill the bad guys" on the screen. The child was practically turning
inside out saying to his father pleadingly, "Daddy, I don't want to kill
those guys." The father told him to act like a man and do it. The boy was
now really squirming. I told the son,
"Good boy. I wouldn't want to either." The father started to make a
fist and I just leaned forward a few inches to stand by my assertion and he
then took the boys hands and left. Personal responsibility will always be more
effective than all the laws that Feinstein and her cohorts can possibly dream
up to prevent such behavior. With most new laws running into hundreds of pages,
it may take an attorney a hundred hours at $300 an hour to sort out a lawsuit
and another set of attorneys that much time to defend a lawsuit. And in the
process, no one wins and behavior doesn't change. Since lawsuits cannot
occur with a law, can't we just put a moratorium on new laws for a decade or
so?
How parents teach their
children to steal. At a church picnic, the two
families at the next park table were preparing their cookout. The lady, as she
was laying out the blanket for the children to sit on, mentioned that they had
obtained the blanket at a company outing. The children, having gotten out of
Sunday School a short time earlier, looked at their
parents and at each other. They obviously had not missed this immoral
turpitude. As my mother remarked after a similar incident, "Your actions
speak so loudly that I can't hear what you're saying."
* * * * *
11. Organizations Restoring Accountability in HealthCare,
Government and Society: