As I described in the last post, the parents of Isaiah James May, who has been declared brain dead, are engaged in a legal battle to keep their son on life-support. At their last court appearance on January 27 they were granted an extension of their appeal. The next court date is set for February 19, when a medical expert will testify.

For updates on baby Isaiah, there is a Facebook page (available if you're a member of Facebook). The page mysteriously disappeared on Friday, but was restored on Sunday. Curious. The site includes three videos: A diaper change, baby Isaiah moving his leg, and a thank you from the parents. Although the parents find the movement of his leg an encouraging sign, I found that particular video - which shows the baby's feeble movement, as if in slow motion -- quite sad.

Unlike the US, where a turkey dinner is traditionally associated with Thanksgiving, the United Kingdom dines on turkey at Christmas. So when the British or Australians accuse you of acting like "a turkey voting for Christmas," they mean you're going against your own best interests.

The BBC has a new radio series that addresses the question: Why turkeys vote for Christmas. David Runciman writes the first installment, in which he asks: Why is it Americans who would benefit the most from health care reform are the most opposed? One third of Texas residents have no health insurance, for example, but 87% oppose reform.

There are many opinions on why Obama's reform didn't pass, and pundits will be arguing this issue for months, if not more. Texans, for example, are likely to oppose government involvement in any aspect of their lives, and that opposition can easily outweigh the value they place on health insurance.

Isaiah James May was born last October in a small town (population 7,000) in Alberta, Canada. For Rebecka May, age 23, this was her first child. The pregnancy was normal, and both mother and child were healthy at the time of delivery.

Labor was difficult, however. It went on for 40 hours, including four hours of pushing. It's not clear why a Caesarian section was not performed. When baby Isaiah finally appeared, his umbilical cord was wrapped around his neck. This had deprived him of oxygen, and he suffered severe and irreversible brain damage.

The child was flown to a children's hospital in Edmonton, where he was placed on a ventilator. After evaluating Isaiah's condition, doctors recommended removing him from life support. His parents took the matter to court, and Isaiah remains on a ventilator and feeding tube, pending a legal decision.

Melamine in milk is in the news again. Is this totally inexcusable or what?

Products from three Chinese companies were removed from shelves in southern China after they tested positive for melamine. Products included not just milk, but candy that used milk as an ingredient. Two of the companies had been cited in the last melamine scandal of 2008. That event was responsible for the deaths of six children and illness for 300,000 others.

It appears that milk contaminated with melamine in 2008 was not destroyed and was subsequently repackaged and sold. According to Reuters, "[H]ealth officials have continued to crack down on distributors who sell melamine-tainted milk to stores, but some distributors, wrongly assuming that the government has scaled back its crackdown, continue to sell it."

The Food and Drug Administration (FDA) has a new video on health fraud awareness. A worthy topic. It touches on weight loss products, HIV scams, cures for cancer and diabetes. What's noteworthy about the video is that it's SO boring. The inflections of the voiceover are totally inauthentic. It has the pacing of a 1970s newscast. There's almost no music. It's not sufficiently interesting to grab and hold anyone's attention.

News - and not just TV news -- has become infotainment. I would be the first to complain that this is a tragedy with major implications. But it's also a reality. To compete for attention, you need some creativity. The chances that this video had any input from a decent ad agency are slim.

Source: Sacramento for Democracy

Climate change

Copenhagen climate summit: Five possible scenarios for our future climate (The Guardian)
Concise summary of what we can expect for each increase of one degree Celcius (1.8 degrees Fahrenheit) in global temperature. Here are a few of the health implications.

1C: "Most of the world's corals will die, including the Great Barrier Reef. Glaciers that provide crops for 50m people with fresh water begin to melt and 300,000 people are affected every year by climate-related diseases such as malaria and diarrhoea."

2C: "The heatwaves seen in Europe during 2003, which killed tens of thousands of people, will come back every year. ... More than 60 million people, mainly in Africa, would be exposed to higher rates of malaria. Agricultural yields around the world will drop and half a billion people will be at greater risk of starvation. ... Glaciers all over the world will recede, reducing the fresh water supply for major cities including Los Angeles."

The body as machine

Inventor spends Christmas with his perfect woman - a £30,000 custom-made fembot (The Daily Mail)

"Inventor Le Trung spent Christmas Day with the most important woman in his life - his robot Aiko. ... Her touch sensitive body knows the difference between being stroked gently or tickled. ... 'Aiko is always helpful and never complains. She is the perfect woman to have around at Christmas.' "

Celebrity health advice

Are celebrities crossing the line on medical advice? (USA Today)

"Many doctors say they're troubled by stars who cross the line from sharing their stories to championing questionable or even dangerous medical advice. ... Actress Suzanne Somers-- already well-known for her diet books and ThighMaster products -- in October released her 18th book, Knockout, which experts describe as a catalogue of unproven or long-debunked alternative cancer 'cures.' ... [Celebrities] 'can spread misinformation much faster than the average person with a wacky theory. ... Correcting that misinformation -- even with a mountain of evidence -- can be a challenge. ... 'It's much easier to scare people than to unscare them.' "

There's a long article in Sunday's New York Times on palliative sedation. I've also listed some older stories on the subject and an educational site.

Aging, end-of-life, and death

Source: The Why Files

Hard Choice for a Comfortable Death: Sedation, (The New York Times)
"Among those [end-of-life] choices is terminal sedation, a treatment that is already widely used, even as it vexes families and a profession whose paramount rule is to do no harm. Doctors who perform it say it is based on carefully thought-out ethical principles in which the goal is never to end someone's life, but only to make the patient more comfortable."

Part two of this post discussed disillusion with the idea of progress and a yearning for a higher purpose. How did we end up in this unsatisfactory situation and is there hope that things will change for the better?

I recently read Robert Reich's book Supercapitalism. I was impressed with the clarity with which he described economic history, from the "Not quite Golden Age" (between the end of World War II and the 1970s) to the supercapitalism that followed.

Supercapitlaism refers to the technological, globalized, deregulated, and privatized economy of the present. Under supercapitalism, politics is dominated by business firms and financiers who successfully lobby government to act in their narrow interests. Meanwhile, this leaves no one responsible for the broader public interest.

Part one of this post noted Paul Krugman's take on the health care legislative process and the political practice of soliciting money in exchange for votes. Beneath these surface issues, however, there's a deeper sense of disillusion with 20th century progress and with a lack of purpose to modern life.

We may tinker with a dysfunctional political process - whether it's the filibuster or corporate lobbying - but our efforts may amount to little more than putting a finger in the dyke. Americans are increasingly dissatisfied with the inability of their government to be effective. The problem is not simply a matter of two political parties with opposing ideologies and the influential economic interests that politicians represent.

After all these months of acrimony and hand-wringing, it appears there will be something called health care reform. It may be equally disappointing to both supporters and opponents, but that comes as no surprise.

It's now abundantly clear that the legislative process is hopelessly inadequate when it comes to things like health care, climate change, and economic inequality.

New York Times editorialist Paul Krugman considers the Senate, with its filibuster, "ominously dysfunctional."

Consider what lies ahead. We need fundamental financial reform. We need to deal with climate change. We need to deal with our long-run budget deficit. What are the chances that we can do all that -- or, I'm tempted to say, any of it -- if doing anything requires 60 votes in a deeply polarized Senate?

Some people will say that it has always been this way, and that we've managed so far. But it wasn't always like this. Yes, there were filibusters in the past -- most notably by segregationists trying to block civil rights legislation. But the modern system, in which the minority party uses the threat of a filibuster to block every bill it doesn't like, is a recent creation.

Every "aye" vote in the Senate remains critical for the final passage of health care reform, and Senator Byrd's health is described as fragile. Earlier this year he spent six months in the hospital with a staph infection, and he has used a wheelchair for his recent trips to the Senate to cast important votes.

The New York Times reports on the Senator's most recent vote on health care reform:

"When the roll was called Thursday morning, the mood was solemn as senators called out 'aye' or 'no.' Senator Robert C. Byrd, the 92-year-old Democrat from West Virginia, deviated slightly from the protocol. 'This is for my friend Ted Kennedy,' Mr. Byrd said. 'Aye!' "

When did we start calling the whole day before Christmas "Christmas Eve?" I thought Christmas Eve was the evening before Christmas. But no. Senators voted on health care reform at 1:00 AM on Thursday December 24th. To me, that's still Wednesday night, but it was widely reported as happening on Christmas Eve. Perhaps publishers want to save ink. Or we live in such fast times that it takes too long to say "The day before Christmas."

Anyway, here's a flock of interesting stories I've come across recently.

Aging, end-of-life, and death

The Breadth of Hope, Selling Hope, and More on Quelling Thanatophobia, (Pallimed: A Hospice & Palliative Medicine Blog)
One unspoken message behind the "sell hope for a cure" ads is "we will not only cure your cancer so that you can avoid death, but we'll also make it so it's a non-issue in your life so that you can return to the way things were before. It'll kind of be like getting your car's air conditioner recharged."

Last week it looked like Big Pharma had won the latest skirmish over importing low cost drugs from Canada and other countries. But the battle isn't over yet. As FiercePharma told its drug company readers today: "And you thought you could stop worrying about re-importation."

Senator Dorgan's amendment to the health care reform bill went down to defeat on Tuesday, but on Sunday David Axelrod, senior political advisor to President Obama, told CNN that "the president is committed to moving forward" on this issue. "Let me be clear," he said. "The president supports re-importation ... safe re-importation of drugs into this country. ... There's no reason why Americans should pay a premium for the pharmaceuticals that other people in other countries pay less for."

Prescription drugs are much more expensive in the US than they are in other countries. Americans pay 36 percent more than Canadians, on average. We pay 39 percent more than Europeans and 43 percent more than the Japanese. Mevacor, a commonly prescribed statin for lowering cholesterol, costs $200 for 100 pills in the US. In Mexico, the cost is $8-$10. By charging US customers the highest price the market will bear, the US subsidizes the low cost of drugs in other countries.

At least once a year, some brave Senator proposes an amendment that would allow Americans to buy prescription drugs from other countries. Spokesmen for pharmaceutical companies, such as Glaxo and Merck, readily admit that the drugs they manufacture and sell in the US are the same as those they sell outside the US. Whenever the issue of importing drugs comes up, however, they cry: "Imported drugs aren't safe! We have to protect the public!"