Stay awake, not woke.

Normally, I wouldn’t be reading Refinery29, a digital media source established in 2015. It’s owned by something called Vice Media which in turn is Disney, A & E, and other media investors.   It’s for young fashionistas in New York. But then, it’s the modern version of Woman’s Day or Ladies Home Journal which influenced women of the last century with heath and fashion while being obedient to the needs of the marketing department. 

One of the founders and CEOs Christine Barberich  (the other 3 are all males) resigned in June because a minority employee had said bad things about her and the toxic work atmosphere on her Twitter account. Twitter users can say anything and the accused is toast.  Twitter has so much power it has silenced the President of the U.S., and because it is a private company, freedom of speech does not apply.  Maybe you think that’s great because you don’t like the president.  Just keep in mind there is someone out there who doesn’t like YOU too, maybe an ex-, or a member of your club, or even an adult child. The laws about employee and management put in place over the years to protect you, don’t apply to gossip and whispers on social media. Your union or employer will not protect you if the charge (no hearings or trial) contain the magic word, RACIST.  You could have your life’s purpose and meaning closed out and cancelled by Twitter.

But back to Refinery29—why was I reading a digital style magazine for shallow, young New Yorkers? Because it was quoted in the Ohio State University  “OSU HealthBeat” which I received in e-mail. Elizabeth Gulino in Refinery29  was quoting in “The COVID-19 Vaccine Won’t Make You Infertile” the OSU Iahn Gonsenhauser, MD, chief quality and patient safety officer at The Ohio State University Wexner Medical Center.  Then HealthBeat also linked to two other articles that quoted R29 which quoted an OSU doctor. This raises R29’s credibility as a serious journal, and OSU’s appeal to the younger set. A two-fer.

Here’s the kicker (I actually did some further research on this issue, and completely agree with Dr. Gonsenhauser who is quoted in many other popular websites.)  Refinery29 is so woke and so alert to every possible misstep of intersectionalism, it has begun to cancel women by referring to “pregnant people.”  You may skip right over that when you read about pregnancies (the way God designed the plan for males and females to procreate).  That change has moved into the language and fanciful unscientific beliefs because of women calling themselves men while still hanging on to all their lady parts. It’s along the same line as Pelosi destroying the “gendered family.”  It’s all about cancelling women and their uniqueness.

“There is limited data about the safety of receiving COVID vaccinations during pregnancy. Pregnant people are typically excluded from clinical trials due to concerns about harming the fetus (although many argue that keeping pregnant people out of trials leads to their health needs being underrepresented). Twenty-three of the participants in Pfizer's trial became pregnant over the course of the study, but that's too small of a sample to tell us much. Dr. Olulade says that people who are pregnant, breastfeeding, or trying to become pregnant [paraphrase] should talk to their doctor before getting the vaccine (everyone should!). "Ultimately it’s about weighing the risks of the unknown when it comes to the vaccine in pregnant women [direct quote] versus the known dangerous risks of COVID."

You and I are awake, not woke.  We know that pregnant people are women, and that people who are pregnant or breastfeeding are women. Every time you read about “pregnant people,” or see an adjective in front of the word “justice,” you are being manipulated. When the kettle heating the water to boil the frog for dinner gets hot enough, it’s too late for you to jump out and save yourself.

Update:  Facebook gave me a black mark for posting this link to my own blog (owned by Google) to my FB wall.  I'm directly quoting a source that quoted an OSU doctor speaking on Covid, yet Facebook fact checkers find my opinion about being woke objectionable.

Dr. Fontana—do your research and rewrite your blog

From the website, KevinMD.com: "Health care workers need to start talking about white people killing black people, and here’s why: every victim of racial violence will be seen by a health care professional at or near the time of the event."

Except, Dr. Elizabeth Fontana, MD, (the author), you've not given the facts. 93% of the injured or killed or assaulted black people you will see who called the squad or the police have had a black assailant, NOT white. Not police. Even so, fatal injuries caused by police officers is miniscule and you as a health professional/provider are more likely to treat a police officer hurt by a black youth or gang member than the other way around.

All criminal violence has been reduced drastically, about 50%, since the early 90s. Millions of black lives have been saved because the crime rates for blacks reduced more than whites after the Omnibus Crime Bill of 1993. By 2010, the rate of firearm homicide for blacks was 14.6 per 100,000, compared to 1.9 for whites, a decline of 51% for blacks and 48% for whites. Nationwide, there were over 1.5 million firearm non-fatalities in 1993 compared to about 478,000 in 2011. Because of the bias in research based on political and religious views, it’s difficult to tease out the details, but one thing is for certain, the media distort reports of violent crime and despite your excellent education, you've fallen for the big lie.

That said, millions of black babies die in the womb from chemical and surgical abortions. That's at genocidal levels. Rates for heart disease, hypertension, diabetes and obesity are much higher for blacks than whites, and yes, that IS something you as a doctor can tackle, but with them, not me. I have my own health problems.

Violent crime is committed close to home; black on black, white on white, Hispanic on Hispanic, gay on gay. Except for women. And you Dr. Fontana, should be concerned about all young male victims (usually), not just those black men assaulted by whites or police. When George Floyd was killed, there were many other black men killed that same day in Minneapolis, Chicago, Cleveland, and LA, but because a black man killed them, you didn't hear about it on the news. 24/7. But it's in the statistics. Their families grieve also. So too, if they died of a stroke or heart attack. Get to work, doctor. You have a job to do.

https://www.kevinmd.com/blog/post-author/elizabeth-fontana

Feeling the Bern

"Senator Sanders points to the Scandinavian model as an example of what it means to have health care as a right. Senator Sanders has traveled widely in his life — he found much to praise in the Soviet Union while honeymooning there, and said so — but he is, like many American progressives, almost completely parochial. As is the case with the United Kingdom and much of Europe, Sweden, Norway, and Denmark are in the 21st century markedly different from the countries they were in the 1970s, when Senator Sanders’s awareness of the world seems to have congealed into the impenetrable clot of ignorance on such ghastly display in his current political career."

https://www.nationalreview.com/2019/02/bernie-sanders-health-care-rhetoric-rights/?

That's a great turn of phrase, and one I've noticed with some of my friends and acquaintances who seem fascinated, but blind, with socialism of the 70s-- "congealed into the impenetrable clot of ignorance."

I used to translate medical articles from the USSR back in the 1960s when I worked for a professor of sociology--free medical care from feldshers (фельдшер), who'd had 6 weeks of training. Bernie loved the USSR of his youth--maybe that's where he got the idea.

Doctors squabble over editorial on Gaza

The August 2 The Lancet, published online July 28  (prominent medical journal) carried an editorial, not only supporting Hamas, but condemning Israel. Now there is a petition circulating to dismiss Richard Horton as Editor-in-Chief of The Lancet .

Here is a sampling of comments from subscribers and readers of Medpage,  where I noticed the controversy, which asked readers to comment on whether medical journals should be political.  The editors of Medpage also seemed to miss the bias—being political isn’t the problem.  Hating Jews and Israel definitely is:

“The editor is an ignoramus-Gaza and Hamas are daggers poised as Israeli's jugular vein. Hamas has declared it will destroy Israeli and all Jews. This idiot sitting behind a desk at a safe distance has the nerve to comment on the ability of a free people to defend itself. For 1800 years western Europe raped, murdered , and vilified Jews. The best of you turned your heads from the slaughter. The worst said so what. Anti-semitism is bred in your marrow. But not this time. Kill one of us and we will kill 1000 of you. No slight will go unanswered. If you want to wallow in blood and slaughter than so be it. OUR LEADERS HAVE SAID IT-NEVER AGAIN!”

“This is a rather prejudiced and hypocritical article, to say the least. Israel is indeed, far from perfect. But Israel is too small and outnumbered, surrounded as she is by enemies funded by Iran, to allow herself to be destroyed. (Like the Yazidis in Iraq). The terror tunnels, built over the past 5 or 6 years, ironically with cement that came from Israel, posed a direct threat to Israel's survival. 500 Hamas terrorists were preparing to launch a huge Mumbai style attack on Israeli civilians this Yom Kippor. There may be tunnels to the north as well, built by Hezbollah and coming from Lebanon. This is being investigated now. The editor might save some of his anger for the UN, who has permitted Hamas to build tunnels on UN premises, and who allows poisonous anti-Semitic lessons to be taught in UN schools in both Gaza and East Jerusalem. The editor might also reflect on Britain's history of anti-Semitism, going back to the the 13th Century in York and elsewhere. Not to mention British soldiers who armed Arabs while simultaneously disarming the Jews in 1948 when the State of Israel was declared a nation. I suggest this editor might want to widen his outlook by reading Brendan O'Neill's excellent online article in Spiked, "There's Something Ugly in This Rage Against Israel."

‘'I strongly suggest you read the balanced response from the Chair of the Israel Medical Association and the Director of the Israel Ministry of Health to the letter recently published in the Lancet. http://www.ima.org.il/Ima/FormStorage/Type8/response.pdf This issue should be of interest to readers of Retraction Watch - not just the dismay felt by medical academics at the political hijack of the Lancet by supporters of Hamas but also the lack of editorial discretion and the non-disclosure of conflict of interest - where the authors of the letter did not acknowledge their long-standing activism against Israel and in favor of Hamas - including apparently the support of some of them for acts of international terrorism: http://townhall.com/columnists/dennisprager/2014/08/05/lancet-a-home-for-evils-useful-idiots-n1874715/page/full. It is a very nasty and dangerous world we live in. There comes a point where you have to stand up and speak up.’'

Being political about moral issues is nothing new in medical journals, from climate change to abortion to causes of poverty. Apparently everything medical is also political.  Reminds me of my career field.  Librarianship leans left perhaps because it is so dependent on government largesse.    Getting published outside the approved opinion or research direction is difficult.

There is good news out there.

"In a 24/7 news cycle, sometimes we miss the good news. Another disease is close to being licked, maybe not on schedule (1995), but real progress. In 1986 there were about 3.5 million cases of Dracunculiasis in 20 countries of Africa and Asia. In 2011 there were 1,058, and the first 9 months of 2012, only 521 cases were reported. This nasty thing comes from drinking stagnant water with larvae which then grow in the body and come through the skin of the foot or leg and is terribly painful and debilitating.

JAMA, Jan. 9, 2013 and WHO, Oct. 2012 http://www.who.int/wer/2012/wer8743.pdf"

"Does anyone on the VP's task force read the reports we pay for? In December 2012 Bureau of Justice report: from 2001 to 2010, the rate of violence committed by strangers declined 47 percent and the rate committed by offenders the victims knew declined by 41 percent. Of the violence by stranger 10% used a gun; known assailant, 5% used a gun. Huge drop in 20 years.

http://www.bjs.gov/content/pub/press/vvcs9310pr.cfm"

MedCity--Get an entertainment rundown of medical culture

If these guys can make it in the media with such a narrow focus, then NPR and PBS should be able to find investors and listeners to cough up enough to put their stuff out there.

"MedCity Life is a city guide for the healthcare industry, providing insights into the social side of the country's most important medical cities. It's a directory of where the people in healthcare are seen and the history of the life sciences was written. MedCity Life also fits the overall goal of MedCity Media Web sites: to cover local medical industries like communities or, better yet, scenes, where industry leaders can be known and in the know. Our motivation comes from what we've heard from our readers. They know deals are made over dining rooms as often as they are across board rooms. While stakeholders know the business reputation of our medical cities, they are less informed on the work-play-life aspects of these markets. They don't know which bars and events naturally attract their peers."

Isn't this clever? They know their market and go after it. (Cleveland, Twin Cities (MN) and Research Triangle (NC) NPR could do that--they already go after liberals and Democrats--why not ask them to pay for the programming and leave the rest of us alone?

Get an entertainment rundown of medical culture in the healthcare industry.

But they also cover the medical news. Who are benefitting the least from Obamacare? Those ages 55 to 65, low-income adults and the unemployed. More men are having facelifts, botox and breast reduction. I didn't know Cleveland Clinic was building a 360-bed Abu Dhabi hospital that's projected to open late next year. What? We're now outsourcing medicine for the mega-rich? And here's a really messy story about a 15000% price increase in a pregnancy drug.

Behavior, income and health

Because I knew the March 24/31 issue of JAMA contained that dreaded article that we need 60 minutes a day of exercise to maintain a normal weight (I'm barely managing 40 min. 3-4x a week), I didn't look at it until today. I discovered in that issue another, far more interesting article on socioeconomic status, personal behavior and health outcomes done in Britain, which has a single payer, government health care system and far more government interference in personal lives than we experience here.

Let me back up. One of the most frustrating features in reading JAMA is the constant emphasis on "the gap" and not on improved health outcomes for all groups over time. There's usually a PhD, MSoc or MSPH among the authors, which means the article will dredge up the obligatory difference between Blacks and Whites, or Blacks and Latinos or 10 years of education vs. 14 years, or inner city hospitals vs. suburban rather than lives saved by advances in technology, surgery or new miracle drugs. In many articles, there is at least the suggestion that the top two quintiles are somehow to blame for the bottom two in health differences, and more government funding (taking from the top 2) would somehow equalize this.

I'm guessing publication of this one was held up, and certainly not promoted in 2 minute summaries on the evening news. "Association of Socioeconomic Position with Health Behaviors and Mortality," JAMA, Vol. 303, no. 12, pp 1159-1166 with editorial content on pp. 1199-1200. CONCLUSION: "In a civil service population in London, England [i.e., white collar but from different social classes], there was an association between socioeconomic position and mortality that was substantially accounted for by adjustment for health behaviors, particularly when the behaviors were assessed repeatedly."

Let me translate. Smoking, drinking, over eating and little physical activity are not good for you, whether one or all four, and you are more likely to do these things if you have lower/working class origins. Health insurance doesn't change you or the outcome of your bad behavior. You don't become poor and less educated because of the degree of access to health care, and it's terribly hard to change behavior whether rooted in the genes or the early life culture.

Thanks to President Bush, Afghan women now in medical school

JAMA Nov. 18, 2009, p. 2081: "Afghan Military medical school reopens, enrolls women in first class of cadets." Obama dithers, quivers and crumbles for 10 months. Bush freed the Afghan women.

"The recent reopening [of Afghanistan's military medical school closed by the Taliban] in Kabul, in the spring of 2009, could help change the shape of medicine in Afghanistan. . . about one-quarter of students are women. Allowing Afghan women to attend medical school, or any school for that matter, was unheard of in the past [before Bush freed them from the Taliban]. . . Most Afghan women have not been allowed to learn to read and therefore cannot pass an entrance examination. However, the 9 female cadets accepted for medical training passed all entrance exainations and met all stringent scholastic and physical requirements for admission to the National Military Academy of Afghanistan. "Girls in Afghanistan sometimes have acid thrown in their faces for going to school," said CDR Gary Harrison, MC, USN.

"We're at the very beginning, but the legacy we leave here will have an influence for decades to come," said LCDR Sunny Ramchandani, MC, USN, who helped establish the medical school's curriculum.

Thank you, Mr. President.

Medical marijuana

I'm sure most conservative commentators and bloggers will jump all over Obama for this one--the new federal guidelines. Not me. Maybe there is no benefit, maybe medical marijuana is just another placebo, but we'll never know until there are large clinical studies, and there won't be any if we make criminals out of the doctors and patients who are trying to ease chronic, debilitating pain. It certainly can't be worse or more addictive than some of the prescription medications like Oxycontin. Is this another follow the money fight? Now let's see if the state and federal regulations can control this as a medical treatment. Probably not.

Medical news Obama can use to ration or change health care

Nearly 50,000 older adults are treated for injuries related to falls involving a walker or cane each year in the USA.

Cancer drugs that produce only a marginal survival benefit are much too expensive. The NIH and the NCI are urging limits on the use and pricing of such drugs.

There have been reports of impaired renal function in people taking a once-yearly infusion of zoledronic acid for the treatment of osteoporosis and Paget disease.

Removal of organs from the dead donor is the norm in the West, but internationally, that's not the case.

Diet and exercise intervention in older, long-term survivors of colorectal, breast, and prostate cancer can reduce functional decline.

"Obama has to provide strong reasons for the average individual in our society for wanting to embrace health reform," said MSU Medical Ethics Professor Dr. Leonard M. Fleck. Fleck advocates in his writings the theories of John Rawls (Karl Marx lite).

Every year in the USA tens of millions of prescriptions are dispensed and billions are spent for antithrombotic medications and acid-suppressing drugs. Elderly patients can be at risk from prolonged use.

Past use of hormone therapy with estrogen plus progestin increases the risk of dying from non-small cell lung cancer for women who develop the disease. Especially for smokers.

Thousands of veterans may have been exposed to contaminated endoscopic equipment (hepatitis B, hepatitis C and HIV).

Three health insurance companies CEOs were grilled by Congress about rescission if the information supplied at application is inaccurate or misleading (cancelling coverage of policyholders). The committee noted it is legal, but unfair, so they smacked them anyway.

Bottled water and tap water are regulated by 2 different government entities. Requirements for bottled water (FDA) are less stringent than tap (EPA).

There are 2.8 million new cases of chlamydia each year, about half in females aged 15-25. The solution seems to be more screening, not responsible behavior or education. Certainly not chastity pledges!

The Mediterranean-type diet has been associated with healthful outcomes including reduced risk of cariovascular disease, cancer, and mortality, and more recently with cognition. Mid-life obesity, diabetes and hypertension are risk factors for late-life dementia and influenced by diet.

The most common reason for referral to adult protective services by "first responders" required through Title XX of the Social Security Act, is self-neglect, not abuse by a care giver (4 to 1). Society and the health care system have failed the most vulnerable older adults. While we look for evidence and solutions, we must act NOW!

Women physicians who travelled to Chad (Africa) heard stories of women living in Farchana Camp (UN) of rape, torture, beatings and stigma after fleeing genocide in Darfur at the hands of the Sudanese Army and Janjaweed militiamen (Arab Muslim against black Muslim). The American researchers themselves were in great danger during their time in Africa.

The increase in drug-related homicides in Mexico (400 a month) is a result of the Mexican government's crackdown on drug trafficking organizations, but it's really the fault of the demand in the US, not the supply in Mexico.

Although they can't find any evidence of health benefits for "intimate partner violence" screening, it should be implemented and rigorously tested anyway. It's the thought that counts. And the grant money.

All stories taken from JAMA August 2009 issues.