Saturday, March 31, 2012

President Obama vs. Mr. Obama

When George Washington was first elected he was formally addressed as: "His High Mightiness, the President of the United States and Protector of their Liberties."

This was quickly changed to "Mr. President" because the colonists didn’t like how much it sounded like the British Monarchy.

The 2nd President, John Adams, supported very formal titles but lost the battle to change it - so the title of "Mr. President" remained.

Now as I listen to the radio, watch the news, and read political news stories, I'm amazed at how often I see the President referred to simply as "Mister."

It happened with President Bush, and it is happening with President Obama.

I am dumbfounded.  Of all the people who deserve their Title - It has to be the one person who was elected by a nation wide vote.  The one public servant who was chosen by the people, with everyone having the chance to voice their opinion.  Doesn't he deserve to at least not be called by the general term for all adult males "Mister?"

We call him "Mister" yet we call Laura Schlessinger "Doctor" because she earned a Ph.D in physiology in 1974. (Her doctorate is not in psychology, or anything having to do with marriage or family relations.  Her doctoral thesis was on insulin's effects on laboratory rats)

We refer to her as "Doctor" because she once earned a doctorate that has NOTHING to do with her current line of work.  She met the requirements of one University, earned her degree, and we call her by her Title - "Doctor."

Yet we call the rightfully elected President of our nation by the common term - "Mister."


Thursday, March 29, 2012

Is “Prozac” just “Placebo” misspelled?

A few facts:
In 2010 the top 5 antidepressants were prescribed 115 million times in the USA.

Antidepressants have side effects, the most common being weight gain, sexual dysfunction, and upset stomach. The most severe being suicidal thoughts and fatal birth defects.

Conclusion: These are not benign medications.

About me – I did not read just one article about antidepressants and then write a blog post about it. I have researched this topic. I have read many articles, and read the Newsweek article including the drug companies responses. I have read studies sponsored by drug companies as well as those with no “Pharm” funding whatsoever.

I wrote before about the publication bias in antidepressant research.
If we look at EVERY published and unpublished study submitted to the FDA for a set of antidepressants and compare the drug response with placebo response, guess what we find?

I'll give you a's depressing.

Everyone in the studies took a "depression rating test" before and after the drug trial.
If patients on Prozac said they got got better by 10 points, those on Placebo got by 8 points. Yes, Placebo had 80% of the effect.

You want the exact numbers?
There is a scale for rating depression called HAM-D which has been used since 1960 for pretty much all antidepressant trials. The higher you score, the more depressed you are.

0-7 = No Depression

8-13 = Mild Depression

14-18 = Moderate Depression

19-22 = Severe depression

>23 = Very Severe Depression

So you take the test before the drug trial. Then you get either an antidepressant or placebo and take it for a few weeks. Then you take the test again. How much lower your score is = your improvement.

Average improvement on antidepressants: 9.6 points (that would move you 1-2 levels up on the scale, like from severe to mild, and from moderate to mild or none.)

So that’s some real improvement

Average improvement on Placebo = 7.8

So the medication works better than placebo – but not much. How do we tell if that difference matters? Does a difference of 1.8 points matter?  If you do a statistical analysis – YEP, it’s significant.

If you do a clinical analysis (do the patients notice any real difference?) – NOPE, it's insignificant.

It turns out that to be clinically significant the drug needs to be at least 3 points better than the placebo. (So says the National Institute for Clinical Excellence)


Americans are taking drugs for depression and their depression is getting better. If they were getting a sugar pill (but thought it was the drug) they’d do just about as well.

So you tell me - Knowing the side effects and the costs – is it worth it?

Tuesday, March 27, 2012

Book Review: Anna Karenina

I determined many years ago that I wanted to read many "Classic" novels.  My favorite by far is Les Miserables.  I have enjoyed A Christmas Carol, as well as many others.  I thought The Scarlet Letter was dull.  I loved The Three Musketeers but couldn't finish The Count of Monte Cristo,etc...

Now I have finished the complete and unabridged Anna Karenina by Leo Tolstoy.

After reading all 864 pages I can now say that it was absolutely NOT worth it.  This is obviously a character driven book and not a plot driven book.  There are more inane descriptions and pointless conversations than there are relevant ones.  There is so much time spent in character development that I lost the plot line entirely at times.
When this happened in Les Misearbles - at least there was a good plot to get back to.
Anna Karenina offered no such plot.  The plot of the entire book with it's nuances and important moments can all be given in about 5 minutes.  The rest is fluff and conversation. 

Some people don't mind that.  I wouldn't mind it so much if only the conversations and descriptions served some purpose.

The point at which I really became dissatisfied with the book was almost exactly half way through.  The novel is divided into 8 parts, and at the end of the 4th part a very important thing happens.  Actually - the rest of the book revolves around a decision made by Anna at that point.  Tolstoy has spent 400 pages on description and dialogue to get to this point.  And when the big decision happens, it is one sentence long.
He does not describe it, does not describe the reasoning behind it.  He doesn't do anything other than say that the decision was made, and then we send the last 400 pages discussing the repercussions of that decision.

It is MIND BOGGLING!  How can Tolstoy spend that much time describing every thought, every head tilt, every look of the eyes for every unimportant moment in the book - and not that one.  He literally spends pages and pages describing other details such as how to best use laborers during harvest season and how to choose the best spot for bird hunting.  His lack of description in that vital moment made the rest of the book miserable for me as a reader. 

Otherwise the book was all right.  The ending was predictable, though not in the details.  The characters were interesting.  The family ties were very well done and the intentions and loyalties of each character made the story intriguing.  The descriptions of Anna and how she interacted with different groups of people on different occasions made her seem very real.

I can see one reason the book is a "classic" - it describes people and their motives and thoughts very well...most of the time.

But the plot is not engaging, there are holes, and there is only enough material a 300 page book, not 800. 

My advice - if you feel the need to read this book, find an abridged version - the full version is not worth it.

Favorite Quote: 

“A free thinker used to be a man who had been educated on ideas of religion, law, morality, and had arrived at free thought by virtue of his own struggle and toil; but now a new type of born freethinker has been appearing, who’ve never even heard that there have been laws of morality and religion, and that there are authorities, but who simply grow up with negative ideas about everything, that is savages.” – Golenishchev – p. 499-500

Saturday, March 24, 2012

Foster Kids: Over-Medicated or Under-Treated?

On December 1st 2011 Diane Sawyer reported on foster children and how many are on psychiatric medications.  She showed them tracking down doctor’s in parking lots as if it were “To Catch a Predator” and asking the doctor about his treatment of a foster child.
The story was very sad, but the spin on the story was even worse.

It speaks of a child and says “Both his father and mother had ended up in Jail.”
It then asks “What would drive a 7 year old to kill himself?”
While no one really knows the answer, they certainly seemed to imply that it had nothing to do with a horrific childhood, rather it was due to medications.

Let’s examine the evidence concerning foster kids and psychiatric treatment.

According to a GAO report in 2011: Foster kids are prescribed psychiatric medications 2.7 to 4.5 times more than non-foster children and often at much higher doses.

That is alarming.  Are we over-medicating these kids?  Are they being given medicines with serious side effects to "calm them down" so they're easier to deal with?

Another study published in 2010 gave us statistics on mental health disorders among adults who were once in foster care.  It turns out that kids in foster care are more likely to have mental illnesses as adults.

PTSD: 3.9 times more likely (30% in foster kids v. 7.6% in the general population)
Major Depression: 1.95 times more likely (41.1% v. 21% in general population)
Panic Disorder: 4.39 times more (21.2% v. 4.8%)
Generalized Anxiety: 2.7 times more (19.1% v. 7%)
Drug Dependence: 4.6 times more  (21% v. 4.5%)

So if we look at these two studies - it looks like kids in foster care are between 1.9 and 4.4 times more likely to have a mental illness, and they are prescribed medications for these conditions 2.7 to 4.5 times more often.
Those seem to correlate pretty well.

But still - isn't it possible that because foster kids automatically have health insurance from the government, that they are seen more and thus prescribed more medication that other kids?

Another 2010 study addressed this:  They found that 96% of all foster kids on psych meds were on them before they entered foster care.  Only 4% were started on psychotropic medications AFTER entering foster care.  And that's the number receiving medications.  The study also showed that 85% of foster kids who saw a psychiatrist ended up with limited or no medication use over time. 
The lesson I learn from this - there is a reason these kids are in Foster care, and it's usually the same reason they end up with a mental illness.  Something about their life before foster care was VERY VERY WRONG.

There was another scary part to this story - the real concern and what Diane Sawyer saw.  The problem is not necessarily how many foster kids are being prescribed medications, but rather how these medications are prescribed.  Some studies showed infants under the age of one receiving medication - in my opinion this should NEVER happen.  There were also small number of kids taking 4 or 5 medications at once.  This should be the RARE exception, and even when needed should still cause the prescribing doctor to worry.

In my estimation - that is where our focus should lie.  There should be more standardized guidelines for the diagnosis and treatment of foster kids.  They are a high risk group, we need to at least be aware that they are more likely to need help than other kids, and it should be available.  But we should also be aware of possible polypharmacy - over medicating of our foster kids.

One last parting thought:  Texas has more foster kids on more medications than any other state.  Minnesota has the least.  Which state do you think is scarier for foster kids? 

Friday, March 23, 2012

Hunger Games – The Movie

Was the movie inappropriate for kids?  – Maybe, we’ll get there.

Were the previews before the movie inappropriate for kids?  Definitely

Before seeing it last night I had read the books, I knew what was going to happen.  I know it is a story of courage and defiance in the face of a horrific death match for kids.  I knew beforehand that I would be watching kids kill each other, that it would be disturbing, and that that was part of the movie.

At one point I had to stop and think to myself – “Am I watching this like someone from the districts, or someone from the Capital?  Am I watching because I want to see the rebels win, and see the hunger games overthrown?  Or am I watching because it is good sport, and good film making?

I am now reading stories about “Is the Hunger Games film too much for children.”  The answer should be obvious – it’s inappropriate for kids under age 13 for sure, and for kids over 13 it should be up to the parent’s discretion.  There are some 15 year olds I would NOT take to this film.
Before the film there were multiple previews.  There was Snow white and the Huntsman, there was Twilight 4.2, and they were okay.

Then there was one for the new ABC television show “Don’t trust the B---- in apt. 23”
I had to sit and watch a “fuzzed out” topless woman on the big screen.  I had to listen to horrific sex jokes and terrible comments.  There were 12 year old girls and boys in the theater.  That was the time in the entire night when I felt the most uncomfortable.

        Hunger Games is a gruesome tale about an oppressive government that keeps the people in control by holding gladiator games for kids.  We know they’re bad, we know why we hate the Capital.  I didn’t know I was going to have to hate ABC or a “network television show” while I was at it.

Wednesday, March 21, 2012

Book Review: The Anatomy of Peace

        I read...a lot.  Yes I have a busy life – but much of my leisure time is spent reading books because I love them.  I try not to recommend books very often.  When I recommend a book, I want it to be something special, something worthwhile.  I want people to trust me and think my recommendation is worth something.

        I whole-heartedly recommend The Anatomy of Peace.  It is the best book I have read this year.

        The Arbinger Institute has now written two books.  The first was quite good.  When I started this book I was afraid it was just going to be a re-hashing of that book: “Leadership and Self-Deception.”  What I found fascinating is that IT IS the same material; they cover the same topics and teach the same lessons.  But they do it so well, and teach it with such REAL LIFE examples, that I couldn’t stop reading the book.  I was only supposed to read 65 pages before our book club meeting – I read all 224.  It really is that good, that helpful.

        The book starts with a bunch of parents all arriving at a “reformation camp” for wayward kids.  This is for those parents who have already tried everything else because their kid is on drugs, in jail, failing school, violent, belligerent, etc…
        The parents are asked not only to bring their children to the camp, but stay themselves for a few days.  The parents have to spend two days being taught by the two men who run the camp: Yusuf al-Falah, an Arab; and Avi Rozen, a Jew.  The book covers the two days with the parents, hearing their stories, and being taught by two men who should be the most bitter of enemies, but have found a way to make peace.
I know it might sound cheesy, and yes the story is kind of a lecture – but trust me, it’s worth it.

Here are a few Reviews of the book by people more well known.

Here are my favorite quotations from the book:

Lumping everyone of a particular race or culture or faith into a single stereotype is a way of failing to see them as people. – p. 29

When we start seeing others as objects we begin provoking them to make our lives difficult.  We actually  start inviting others to make us miserable. – p. 43

We provoke in others the very comments and behaviors we are accusing them of. – p. 49

Another characteristic of conflicts…is the propensity to demonize others.  One way we do this is by lumping others into lifeless categories – bigoted whites, lazy blacks, crass Americans, arrogant Europeans, violent Arabs, manipulative Jews, and so on.  When we do this we make masses of unknown people into objects and many of them into our enemies. – p. 54

The deepest way in which we are right or wrong is in our way of being toward others. – p. 57

If we can’t put an end to the violence within us, there is no hope of putting an end to the violence without. – p. 64

Sometimes we might be forced to defend ourselves…but that is different than saying that we are forced to despise, to rage, to denigrate, to belittle. – p. 80

Self Betrayal. It is a betrayal of my own sense of the right way to act in a given moment in time – not someone else’s sense or standard, but what I myself feel is right in the moment. – p. 90

A choice to betray myself is a choice to go to war. – p. 91

I needed to be justified for violating the truth I knew in that moment. – p. 94

What need would I have to be justified if I wasn’t somehow crooked? – p. 95

If I am worried that others are getting a pass, am I also worried about whether I am giving myself one? – p. 95

Whenever we need to be justified, anything that will give us justification will immediately take on exaggerated importance in our life. – p. 106

I can notice people’s relative strengths and weaknesses when I’m seeing them as people.  What’s different when I’m in the box however, is that I feel superior to or better than others because of these strengths or weaknesses…I’m doing more than simply noticing differences; I’m making judgments about peoples’ worth based on those differences. – p. 108

If I need to be seen as smart...I will get anxious whenever I think my intelligence might be at issue. – p. 132

Think of the privileges we may retain for ourselves while we apply other standards to those who work for is – privileges regarding vacation time, for example, the choice parking spot, the special perks, the public spotlight, the differences between what we have to do to get something to happen and what everyone else in our organization has to do.  Which of these are necessary or unavoidable, and which of them do we retain because we think we are better than others, more vital, and deserve special treatment? – p. 158

What’s more important to you now – flaunting your well-earned important status or building a team and organization that will outlive you, surpass you, grow beyond you, and ultimately thank and revere you? – p. 160

Try thinking about the people who have had the greatest influence for good in your life and why? – p. 175
 Simply the memory of those people can take you to a different vantage point. – p. 175
 Or maybe there is a particular book or book passage that has a powerful effect on you. – p. 175
You need only to identify the relationships, places, memories, activities, book passages, and so on, that have that kind of power for you, and then remember to search them out when you feel war rising within you. – p. 177

Most people who are trying to put an end to injustice only think of the injustices they themselves have suffered.  Which means they are not really concerned with injustice but with themselves.  They hide their focus on themselves behind the righteousness of their outward cause. – p. 186
·What are this person’s or people’s challenges, trials, burdens, and pains?
·How am I, or some group of which I am a part, adding to these challenges, trials, burdens, and pains?
·In what other ways have I or my group neglected or mistreated this person or group?
·In what are my better-than, I-deserve, worse-than, and must-be-seen-as boxes obscuring the truth about others and myself and interfering with potential solutions?
·What am I feeling I should do for this person or group?  What could I do to help?
We need to honor the senses we have rather than betray them. – p. 196

It is no good trying to teach if I myself am not listening and learning. – p. 205

We want to spend most of our time actively helping things go right. – p. 214

When our teaching is going poorly, we often try to rescue it by talking more and insisting more…If I am correcting and correcting but problems remain, that is a clue that the solution to the problem I am facing will not be found in further correction. – p. 215

Sunday, March 18, 2012

It’s not about the “M.D.” anymore

Everyone knows what M.D. stands for.  When I was growing up I loved watching a T.V. show about a child genius – The show was called “Doogie Howser, M.D.

Then in medical school I watched another popular medical show called “House M.D.

If you’re going to include the initials – they’re going to be M.D.  That’s a doctor, that’s a physician…right? 

Not quite 

In the late 1800’s one doctor decided there was more to medicine than what he was taught as an M.D.   So he started a new type of medicine, Osteopathic Medicine.  In 1892 he opened the first “School of Osteopathic Medicine.” 

Over the next century there would be many political and professional disputes, but the result today is that one quarter of all Medical School graduates in the U.S. is NOT an M.D., but rather a D.O.

You have likely been to see one, and never knew the difference.  Just like most people have no idea if their dentist is a DDS or a DMD, the same thing is happening in the world of medicine.  

Yes – they are surgeons, pediatricians, dermatologists, and every other medical specialty.  To most people – they are indistinguishable from their M.D. counterparts. 

The ratio of M.D. to D.O. is changing, and it’s changing fast.
 In 2008, 20% of all US graduates were D.O.’s 
In 2011, it was up to 24% of all graduates.  And the enrollment numbers tell us that the trend won’t stop anytime soon.  
In 2011, 30% of all first year medical students were D.O.’s 

The world of medicine is changing.  I am waiting for the day my grandkids call me into the room to watch a new television show, and it’s entitled something like “Doogie Howser, D.O.”

Thursday, March 15, 2012

Right to Die V. Right to Prevent Suicide

There is a difficult and cumbersome conundrum in mental health.  There are two opposing forces which are strongly supported and have many laws and policies to support them, and once in a while – they collide.


We cannot be kept alive against our will.  In 1990 the supreme court ruled in Cruzan v. Director: "A competent person has a liberty interest under the Due Process Clause in refusing unwanted medical treatment.”

In other words – any “competent” person can refuse medical treatment.  If you’re dying of cancer, or kidney failure, or anything else – you can refuse medical treatment because you have a right to die.

The Supreme Court clarified further in 1997 in Washington v. Glucksberg that we have a “constitutionally protected right to refuse life-saving hydration and nutrition”

This is why Advance Directives have become so prevalent.  If we don’t want to be kept alive on a ventilator and a feeding tube – we can refuse it ahead of time.  We can specify if we ever want to be intubated, if we want CPR, etc…


There is another law - the one that says we don’t have the right to kill ourselves.  In most every state there is law that states that anyone who threatens or attempts to kill themselves may be held against their will.  Yes.  If a police officer, nurse, doctor, social worker, therapist, or psychologist hears you say you are suicidal or you've attempted – they can fill out a form that binds you legally.  If a psychiatrist or any other physician agrees, you can be transferred to a psychiatric facility to be assessed and treated until you are “no longer a danger to yourself .”

Call it a "381", a "5150", a "Legal 2000" or whatever you want.  Most states will commit you to a psych hospital if you try to kill yourself.  You don't have the right.

So – You can’t kill yourself – or you can’t get caught planning it or attempting it.  It is considered a public safety issue.


What if someone has an advance directive saying they don’t want life saving treatment?  They don’t want to be intubated, they don’t want CPR.  It's in writing.  That person is found after a suicide attempt and taken to the hospital.  Their health is deteriorating and they go into respiratory failure.  A frantic family begs the doctors to save them.   The person is dying, which they have a right to do.  It’s because of suicide – which they do not have the right to do.

What does the doctor do?  There is a legal document from the patient that says they DO NOT want to be saved.  To intubate them or do CPR could be considered battery in this case.  Doctor’s are not to mess with individual rights and liberty – you do not ignore a DNR order. 

You also don’t let people commit suicide.  You save them, you treat them.   

Can a person obtain an advance directive stating their wish NOT to be treated, then make a suicide attempt and have that order honored?

Is a suicidal person a "competent" person?  Can they make a Do-Not-Resuscitate decision?

Wednesday, March 14, 2012

What President Obama Missed (BYU-Iona)

Last Night was the "First Four" in the NCAA tournament. 

President Obama was there with British Prime Minister David Cameron.  They watched the first game of the night, and they thought they'd seen a greatest comeback when Western Kentucky recovered from a 16-point deficit to beat Mississippi Valley State.
The President and Prime Minister decided to call it a night - because honestly they probably have better things to do than watch college basketball all night.

The NCAA tournament is also called March Madness...and there is a reason.
Turns out Obama and Cameron missed the biggest comeback in the history of the tournament.  BYU was down by 25 points in the first half.  I watched - and it was ugly.  They flailed as they failed to guard, to shoot, to do ANYTHING!
Then I watched as they changed their game.  I watched the zone defense come alive, and their two big men go to work.  I was facebooking with friends, I was texting my brother-in-law and my dad while I was on the phone with another brother.  I cheered too loud and nearly woke my sleeping children.

My wife was snickering at me as I was fully decked out in my BYU shirt...and jacket, which were shimmering in the glow of the computer screen 

It was beautiful. 

I know I shouldn't judge the Commander-in-Chief for leaving a basketball game.  But I hope when he went to bed last night he felt a little twinge of regret of not having stayed for the second game.  It's like my dad taught me as a kid.  If you don't stay till the end, you'll miss the greatest games, because the improbable end is what makes them great.

Here are a few highlights.


Saturday, March 10, 2012

Book Review: Crucial Conversations

It seems like every business book nowadays has a foreword by Stephen R. Covey.  It’s almost like – if he didn’t endorse it - it’s not worth reading.  

This book is not an easy read like Leadership and Self-Deception, Who Moved My Cheese, or The Myth of Multitasking.  It is however worth reading because it has many gems and pearls of wisdom along the way.  

A few of them I already knew:
        Remember, to know and not do is really not to know. – p. xvi
        “He that complies against his will is of his own opinion still.” – Samuel Butler p. 23

A few startled me as I read them because I realized they are problems I have but never noticed:
        Do you hold in ugly opinions only to have them tumble out as sarcastic remarks or cheap shots? – p. 13
        Labeling is putting a label on people or ideas so we can dismiss them under a general stereotype or category. – p. 53
        By employing a handy label, we are now dealing not with a complex human being, but with a bonehead. – p. 108

Some were very humorous:
        Individually smart people can do collectively stupid things. – p. 22
        If others would only change then we’d all live happily ever after. – p. 29

Some felt like ancient proverbs that had been modernized:
        “Lord, help me forgive those who sin differently than I.” – p. 72
        Respect is like air.  If you take it away, it’s all people can think about.  The instant people perceive disrespect in a conversation, the interaction in no longer about the original purpose – it is now about defending dignity. – p. 71
        When you feel a measure of respect for the other person, you’re ready to begin. – p. 195
        You and only you create your emotions. – p. 94

And of course – there are the rest of the quotes I loved that don’t fit in a prior category:
Most people have trouble pulling themselves away from the tractor beam of the argument at hand. –p. 55
When you tell a “Victim Story” you ignore the role you played in the problem…you speak of nothing but your noble motives. – p. 107
We cite information that supports our ideas while hiding or discrediting anything that doesn’t. – p. 138
Our honest passion kills the argument rather than supports it. – p. 139
Back off your harsh and conclusive language, not your belief. – p. 140
Don’t pretend to consult – p. 168
When you find yourself saying “All right, we’ll never agree so let’s vote” you’re copping out. – p. 171
Nothing is quite so annoying as having someone agree on a choice (their second choice perhaps) and then cry “I told you so!” when it doesn’t work out. – 173
People often assume that trust is something you have or don’t have…Trust doesn’t have to be universally offered.  In truth, it’s usually offered in degrees and is very topic specific. – p. 200

Wednesday, March 7, 2012

How to Make a Crushing Victory Seem Like a Sign of Weakness

How would you describe a competition where the winner scores twice as many points as his opponent?

Let’s say it’s a golf game, and the winner had 10 under while the next closest was 5 under.  How would that victory be described?

Okay – let’s say it’s not one game but a best of seven series in Baseball.  When one of the games ends 12 – 6, what would be the headline the next day?  Would it talk about the crushing victory the night before?  Would it talk about how the winner of that game is winning the series over-all?

I can tell you how the major news outlets would describe it:

Wall Street Journal: Winner Ekes Past Second place
New York Times: With No Knockout Punch, a Bruising Battle Plods On
Los Angeles Times: Winner’s Slim Victory Leaves Race Uncertain
USA Today: Winner and Second Place See Momentum
CNN: No Knockout Blow for Winner
Reuters: Winner Narrowly Wins, Fails to Knock Out Second place

Yep.  Mitt Romney won 6 states on Super Tuesday compared to Santorum’s 3. 
Romney earned 211 delegates, Santorum earned 84 (that’s 2.4 times fewer)

Why does the Media seem to hate Romney?  Why do they feel obligated to spin his wins as losses?  It really makes you wonder.

Here are the actual Headlines:
Wall Street Journal: Romney Ekes Past Santorum in Ohio
New York Times: With No Knockout Punch, a Bruising Battle Plods On
Los Angeles Times: Battle in Ohio Reinforces GOP Divide; Romney’s Slim Victory Leaves Race Uncertain
USA Today: Romney, Santorum See Momentum
CNN: No Knockout Blow for Romney
Reuters: Romney Narrowly Wins Ohio, Fails to Knock Out Santorum

Monday, March 5, 2012

An Honest Question to the Supporters of Gay Marriage

Many times I have tried to explain why I am opposed to gay marriage. Each time I am told that my argument is invalid. It’s faith based, it’s biased, it’s personal, it’s antiquated, etc…

Therefore, I have decided instead to pose a similar set of questions to the supporters of gay marriage.

Do you support Polygamy?

Honestly.  If the only criteria for marriage is that it’s consenting adults who love each other and want to be married, why can’t it be 3 people instead of 2? Why can’t any number of consenting adults agree to all marry?

If you don’t like plural marriage, then what about marriage between siblings? It’s still just 2 consenting adults. Who are we to say it’s wrong because they’re brother and sister? Are we really going to say it’s not natural, or that genetics show they should marry because of possible birth defects?  Would that imply that marriage and child birth are related?

Every argument I have heard in support of gay marriage would also have to allow for plural marriage and incestual marriage.

So – to the supporters of gay marriage:  Do you also support plural marriage and incestual marriage?

If not – why?

TED Talk - The Power of Vulnerability

A friend of mine encouraged me to watch this video.  I've heard of TED before, but never watched their videos.  After watching this one - I think I'll watch more.

It worked to hear someone who is a researcher and also an engaging story teller explain this topic.  It speaks to the heart of what I see every day with every patient.  I hear mostly sad stories.  I hear of horrific lives, betrayals, suicide attempts, toxic relationships, and the like.  I hear of people living day to day, but being miserable though they appear functional. 

This video is 20 minutes long.  If you're unwilling to give up 20 minutes of your time - watch the first 5 minutes and see if you want to continue.

I'd love to explain more about this talk, but the presenter does a better job than I ever could, so hear she is:

Sunday, March 4, 2012

Star Wars concept artist: Ralph McQuarrie

While I appreciate George Lucas for his story - it never would have worked without the imagination and art of Ralph McQuarrie.  He drew the concept art for the original Star Wars Trilogy - Here are my favorites.


Friday, March 2, 2012

The Princess Bride - in 5 minutes

I am working on this to perform for a talent show -  I thought it might be fun to re-enact the movie "The Princess Bride" in 5 minutes.  Here's my current script. (Suggested changes are welcome)

Nintendo Music
Grandfather: Heyyyy!!
Grandfather: How's the sickie?
Grandson: A book? I'll try and stay awake.
Grandfather:  Oh. Well thank you very much."The Princess Bride, by S. Morgenstern,  Chapter One. 
Grandfather:  Buttercup was raised on a small farm
Buttercup:  Farm boy!  Fetch me that pitcher.
Westley: As you wish.

Grandson: Hold it, hold it! Is this a kissing book?
Grandfather:  Keep your shirt on, let me read.  His ship was attacked by the Dread Pirate Roberts
Grandson:  Murdered by pirates is good....

Buttercup:  I will never love again.

Humperdinck:  My people, the Princess Buttercup.
Vizzini: A word, my lady. We are but poor, lost circus performers.
Fezzik:  Who's Guilder?
Vizzini:  I've hired you to help me start a war. It's a prestigious line of work, with a long and glorious tradition.
Fezzik:  I just don't think it's right, killing an innocent girl.
Inigo:  Fezzik, are there rocks ahead?
Fezzik:  If there are, we'll all be dead!
Vizzini:  No more rhymes now, I mean it!
Fezzik:  Anybody want a peanut?
Vizzini:  DYEAH!!

Inigo:  You are sure nobody's follow us?
Vizzini:  Probably some local fisherman out for a pleasure cruise at night... through eel infested waters.
Vizzini:  Whoever he is, he's too late. SEE?


Fezzik:  He's got very good arms.

Inigo:  I do not mean to pry, but you don't by any chance happen to have six fingers on your right hand?
Man In Black: Do you always begin conversations this way?
Inigo:  You seem a decent fellow. I hate to kill you.
Man In Black: You seem a decent fellow. I hate to die.
Inigo:  I admit it, you are better than I am.
Man In Black:  Then why are you smiling?
Inigo:  Because I know something you don't know.
Man In Black:  And what is that?
Inigo:  I am not left-handed.
Man In Black:  There is something I ought to tell you.
Inigo:  Tell me.
Man In Black:  I'm not left-handed either

Fezzik:  I did that on purpose. I don't have to miss.
Man In Black:  I do not envy you the headache you will have when you awake. But, in the meantime, rest well, and dream of large women.

Vizzini:  So it is down to you, and it is down to me. Have you ever heard of Plato, Aristotle, Socrates?
Man In Black:  Yes.
Vizzini:  Morons
Man In Black:  In that case, I challenge you to a battle of wits.
Man In Black:  What you do not smell is called Iocane powder
Vizzini:  Iocane comes from Australia, as everyone knows, and Australia is entirely peopled with criminals, and criminals are used to having people not trust them, as you are not trusted by me, so I can clearly not choose the wine in front of you.
Man In Black:  Truly, you have a dizzying intellect.
Man In Black:  Then make your choice
Vizzini:  I will, and I choose-- What in the world can that be?
Man In Black: You guessed wrong.
Vizzini:  You Fool! I switched glasses when your back was turned!
Vizzini:  Ha ha ha ha ha ha ha!! Ha ha ha

Humperdinck:  Iocane. I'd bet my life on it.

Buttercup:  You're the Dread Pirate Roberts, admit it!
Dread Pirate Roberts: With pride.
Buttercup:  You mock my pain!
Dread Pirate Roberts:  Life is pain Highness.
Buttercup:  And you can die too for all I care
Dread Pirate Roberts: As...
Dread Pirate Roberts: You...
Dread Pirate Roberts: Wish!!
Buttercup:  Oh my sweet Westley, What have I done?
Buttercup:  Oh
Buttercup:  Ow
Buttercup:  Ah

Westley:  Ha! Your pig fiancĂ© is too late. A few more steps and we'll be safe in the fire swamp.
Buttercup:  Westley, what about the R.O.U.S.s?   Westley:  Rodents Of Unusual Size? I don't think they exist.

Albino: The Pit of Despair. Don't even think—HACK -  Don't even think about trying to escape.

Humperdinck:  I present to you your Queen, Queen Buttercup!
Ancient Booer:  Boo! Boo! Boo!

Grandson:  See? Didn't I tell you she'd never marry that rotten Humperdinck?
Grandfather:  Yes, you're very smart. Shut up.

Westley:  t-r-u-e  l-o-v-e.
Miracle Max: True Love is the greatest thing in the world,
Miracle Max: Except for a nice MLT--- mutton, lettuce and tomato
Miracle Max: :But that's not what he said--- he distinctly said "To blave"
Valerie:  Liar! Lia----r!
Miracle Max:  Get back, witch!
Valerie:  I'm not a witch, I'm your wife, Humperdinck Humperdinck! Humperdinck! Humperdinck! Humperdinck! Humperdinck!
Miracle Max:  Have fun storming the castle! Valerie:  Think it'll work? Miracle Max:  It would take a miracle. Miracle Max:  Bye-bye!!

Clergyman:  Mawwage. Mawwage is what bwings us togevah today.

Westley:  Give us the gate key.
Yellin:  I have no gate key.
Inigo:  Fezzik, tear his arms off.
Yellin:  Oh, you mean this gate key

Inigo: Hello. My name is Inigo Montoya. You killed my father. Prepare to die. Hello. My name is Inigo Montoya. You killed my father. Prepare to die. HELLO. MY NAME IS INIGO MONTOYA.  YOU KILLED MY FATHER, PREPARE TO DIE.

Humperdinck: To the death.
Westley:  No! To the pain.
Humperdinck:  I don't think I'm quite familiar with that phrase
Westley:  To the pain" means I leave you in anguish, wallowing in freakish misery forever.
Humperdinck:  I think you're bluffing.
Westley:  It's possible, pig. I might be bluffing. It's conceivable, you miserable vomitous mass,
Westley:  Drop... your... sword.

Grandfather: And as dawn arose
Grandfather: Westley and Buttercup reached for each other--
Grandson:  What? What?
Grandfather:  Naw, it's kissing again, you don't want to hear that.
Grandson:  Well,
Grandson:  I don't mind so much.
Grandfather:  Okay, there have been five kisses that were rated the most passionate, the most pure. 
Grandfather:  This one left them all behind.
Grandson:  Grandpa? Maybe you could come over and read it again to me tomorrow.
Grandfather:  As you wish.

Health Insurance Makes Sense! (yeah right)

        A friend called me this week after his wife had a baby, their fifth.  They’ve been through this before, they know the drill.  My friend now works in a small family business with a total of five employees.  They all have “catastrophe insurance,” but they pay for everything else out of pocket. 

        SO – their baby was born, everyone is fine and healthy.  Mom says she’s ready to go home.  Mom and Dad know they are paying for the entire delivery with cash, so they ask how much they’d save if they left today instead of tomorrow?

        They’d save nothing, the cost is the EXACT same.  The nurses are very kind and tell the mom that she should relax and stay through the next day.  The nurses are being very honest.  They don’t get paid any more if she stays an extra day.  They are really are just thinking about what’s easiest on the mom.  So stay the extra day – the cost is the same.

        My friend calls me asking: “How is that possible?  How can another night in the hospital for both mom and baby not change the cost at all?”  He asks me who he should talk to get an itemized bill so he can see how much cheaper it would be if his wife decided to leave that day instead of the next day.

        An Itemized bill?  It exists but it doesn’t matter.  Don’t get me wrong - The hospital knows how much it costs for every piece of equipment.  They know how much it costs to keep the lights on, the hourly wages of the nurse and CNA.  They know how much they pay the resident, the OB/GYN, and the Pediatrician.  They know the cost of each meal, each medicine, each cup of soda, each popsicle.  The administrators know the exact costs, because they pay for all these things every day.

         But the cost to them does not determine the customer price.  The two are hardy even linked.  Medicaid has determined how much they will reimbursed the hospital for a normal delivery.  They pay “x” amount for mom and baby to be treated the day of delivery and one day after.

        That’s how the hospital determines the price of a delivery – by how much government insurance pays.  They won’t charge you per item, they won’t charge you per day.  If it’s a normal healthy birth, they’ll charge you the flat fee…no matter what.

        WHAT?  How does that make sense?  I know plenty of businesses use flat rates, but that is determined by costs.  If a customer is willing to incur less costs, shouldn’t the business offer to charge them less?
How did all this start?  I don’t really know.  I do know that our view off health insurance is completely wrong.

        Most of us have health insurance but we never, EVER, use it.  We use pre-paid health care.  We pay our monthly fee to Blue Cross and then when go to the doctor we pay our co-pay (maybe $20.)  We pick up a prescription and pay another co-pay ($20), and we go home.  We take the pills, we get better, and the whole system worked.  Woo-Hoo!

        How much did the doctor’s visit cost?  Usually neither the doctor nor the patient have any idea.  This is the way it should be.  This way the doctor can treat the patient without thinking about costs, and just give them the best possible treatment…right???

        This system is moronic.  People pay, and they pay, and they pay – their insurance company.  As long as their visit to the doctor is cheap and their prescription is “covered” they don’t care that they’re paying 10 times more to the insurance company than the whole visit and prescription would have cost.

We don’t use health insurance, we use Pre-Paid Health care.

        Imagine if patients paid full price for all their regular visits - just like with your car. You pay for all the maintenance: oil changes, brakes, tires, belts, spark plugs, etc... The car insurance is used when you're in an unexpected accident and your car is totaled.

        Health care should be the same way. If you take care of your body you'll pay a little for maintenance (Regular check-ups, occasional labs, and a prescription here and there.)  You’ll pay $60-$120 per visit and your prescriptions will vary.   You’ll need health insurance when out of the blue you have kidney failure, a heart attack, or an emergency C-Section.

        Health Insurance is for the unexpected - kind of like your Fire Insurance on your house.  You pay out of pocket for the monthly expenses, the new paint, the patch in the wall, the hole in the carpet, the replaced door, etc…  Everyone in the neighborhood pays a little to fire insurance.  Then when one house has a terrible accident and is consumed in a fire – that house is rebuilt with all the money pooled in fire insurance.  Most people will never use their fire insurance, but they pay it just in case.

        Health Insurance should be the same way.  It should never be involved with routine things.  Health insurance should never cover kids with ear infections, or even healthy births.  It should apply to kids with Diabetes, cranial bone fusions, etc.  It should apply to EMERGENCIES.

        So – why can’t my friend’s wife decide to save some money by leaving the hospital a day early?  Because everyone else has pre-paid the set amount for their deliveries.  Everyone else has pre-paid health care and the hospital prefers to stick with one price - set by the insurance companies.

It’s moronic, it’s annoying, but good luck changing it.