Monthly Archives: December 2008

Paging Dr. Frankenstein

A scant few hundred years ago we began to believe we could understand the world through reason and science. Not only that, we believed we could bring it under our control. These new beliefs brought many wonderful things: Electricity, modern medicine, iPods.

Risks have always been with us: natural disasters, wild animals, accidents, epidemics, and other ‘acts of god’. But over the last century, especially since World War II, new categories of risk emerged. These modern risks follow from the negative byproducts and side effects of the very same science, technology, industrialization, and global economy that we otherwise benefit from and enjoy.

Global warming, environmental carcinogens, toxic waste disposal – all these effects of technology reach forward in time to touch future generations. Such trans-generational risk is uniquely post-industrial. Some of these, like species extinction – which can now result from human activity – are irreversible.

But modern risk has not only expanded through time. Tainted products from anywhere in the world – food, toys, or jewelry for children – can end up on any local store or pantry shelf. These modern risks are not merely medical and ecological, but psychological as well: Is this can of tuna safe to eat?

As our dependence on technology and a global economy increases, the negative consequences are more difficult to predict, or to control when prediction fails. What are the implications of mapping and sequencing the human genome? Perhaps we’ll recreate a long-extinct species. Will these make nice pets or nice nightmares?

Before and after science

frankenstein-shelleyIn the heady days of the Enlightenment we looked towards a Utopian future, the promise of science, technology, rationalism. Yet only in Frankensteinian fiction did we ever consider the down sides of this brave new world. It’s a bit like how the Bush administration failed to plan the post-invasion phase of the Iraq war. Compared to the impacts of industrialization, globalization, and mass media, that one should have been a no-brainer.

Today’s risks get defined by scientists, lawyers, and politicians, whose differing interests are often reflected in those definitions. “Yes, there’s mercury in your salmon and melamine in little Jenny’s formula, but not enough to do any real damage.”

Risks are communicated, breathlessly and repeatedly, by a media whose interests may not be identical with those of “viewers like you.” Perhaps a lack of confidence in our information sources is an even greater risk than lack of confidence in our food supply.

Humans could never control natural disasters. Now we are losing control of the man-made ones. But we try to control what we think we can. So we regularly lift weights and practice yoga, or at least try to. We buy organic food and avoid trans fats. We practice a ‘healthy lifestyle’ (or at least try to), even though behavior has less influence on overall health than genetics, social status, economic inequality, and environmental degradation. Those are all beyond the direct control of individuals. So we drink pomegranate juice instead, distracting ourselves from the complex and real issues at the root of our suspicions, outrage, and despair.

Related posts:
The earth’s scars
Negative knowledge: Remembering Alfred Schutz
Melamine, cadmium, and Heidi Montag
To make more money
Melamine update
Eat fish? Don’t read this

Reources:

Ulrich Beck, Risk Society: Towards a New Modernity

Deborah Lupton, Risk

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Happy Holidays!

A few holiday gifts to share.
Here’s one of my favorite YouTube videos, Free Hugs. It’s 3:39 minutes, the length of the Sick Puppies song, All the Same.


This one, Free Parking, has a theme similar to Free Hugs, but it’s by filmmaker Kurt Kuenne and is quite a bit longer, 16:23. Watch the beginning and see if you want to continue. It has a (minimal) plot.

Here’s a description of Appreciative Inquiry, an organization development practice related to the message of Free Parking:

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Eat fish? Don't read this

The LA Times had a story today on melamine in farmed fish from China, the source of 70 percent of farm-raised fish. This isn’t exactly breaking news. Recent melamine-in-milk stories have mentioned melamine in animal feed, which means fish, shrimp, beef, pork, and poultry were likely to be contaminated. Melamine-in-fish stories go back to the 2007 pet food recall. On that occasion, melamine was an ingredient in gluten and rice protein, found in pet food and animal feed.
Another disturbing source of melamine in fish was suggested by Bill Hubbard, a long-time associate commissioner at the FDA and now an adviser for the consumer advocacy group Coalition for a Stronger FDA. The quotation is from a June 2008 Adweek.

[Hubbard] contends the fish are farmed in “polluted” coastal lagoons in the South China Sea, alongside chicken farms. The fish are fed feces from the chickens and eat algae blooms that grow from the waste …. When they get fungal and bacterial infections, … the Chinese use anti-fungals like melamine (banned in the U.S.) that keep the fish alive long enough to harvest.

What was new (to me) in the LA Times story was the claim that while pigs and cows, like humans, excrete melamine in their urine, “fish appear to be different.” This from Jim Riviere, a toxicologist who has published papers on melamine in pigs. I’m not surprised that fish metabolism is different from that of cattle and pigs and that melamine ends up in salmon steaks but not beefsteaks. I haven’t yet been able to determine exactly why there’s a difference.

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The need for health and the right to health

Bernard Madoff

Bernard Madoff

Source: The Wall Street Journal

There’s something ghoulishly fascinating about pulling off a $50 billion Ponzi scheme. When Bernard Madoff revealed the big secret to his two sons earlier this month, they reported him to authorities, and the chimera collapsed.

It was the Ponzi angle, with its image of collapse, that attracted me to an Eric Novack post on The Health Care Blog, The Medicare Ponzi Scheme. Novack argues that Medicare’s “unfunded liabilities” – the promise to provide benefits in the future – are the equivalent of an $85 trillion Ponzi scheme.

This is not an argument I’d care to meet in a dark alley, but for balance I recommend the Century Foundation’s paper The “Unfunded Liabilities” Ruse.
What I found highly valuable about the Novack post was a reply by Rob Oakley that was a refreshing mixture of honesty and compassion. (You can find the reply by searching for “Posted by: Rob” at this link.)

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Direct-to-consumer: The ads we love to hate

Last week the CEO of Roche Pharmaceuticals had some candid comments on direct-to-consumer advertising:

Direct-to-consumer promotion [of drugs] was the single worst decision for the industry. … When industry says we’re spending all the money on R&D but actually it’s spending it on TV advertising to preserve margins, it doesn’t get much credibility.

William Burns went on to say the “marginally different and market-it-like-hell model [of prescription drugs] is over.”
Who besides the pharmaceutical industry thinks direct-to-consumer DTC advertising is a good idea? Doctors object to patients who self-diagnose and then insist they know just what the doctor should order.

So what happens is they come into the office, and they’ll say: ‘I need a certain drug.’ And a lot of times we’ll spend more time either negating the diagnosis that they’ve made just by the commercial, in addition to explaining why that certain medication is not appropriate for the following reasons.

The public actually sees some advantages to DTC ads. They educate, raise awareness and reduce stigma (think Viagra). But the public also understands that these ads raise prescription drug prices, stimulate unnecessary demand, and do a poor job of explaining the negative side effects.
Personally I think it’s one thing for an ad to sweet-talk me into buying a Lexus, but when it comes to my health, someone – the FTC perhaps? – should just say no. DTC ads are only allowed in the US and New Zealand. There’s a good reason.

Osteoporosis and the flying nun

Sally Fields as The Flying Nun

Burns’ company Roche sells the once-a-month osteoporosis drug Boniva, whose spokeswoman is Sally Fields. For Fields, promoting Boniva is part of her feminist cause:

I want to help change the way women live as they age. We have fought so hard in our lives for things to be better, not to accept the status quo. We surely can’t stop now that we are entering this next part of our lives

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Melamine update

After my last melamine post, a visitor to the site wrote to me:

My wife and I had a baby two weeks ago. We’ve had some problems getting breastfeeding going. The hospital had us on one type of formula and then another (don’t remember the name of the first but the second was Nestle’s Good Start). So we’ve had him on a combination of breast milk and Good Start since we took him home on 11/20.

Then, I read yesterday on Daily Kos that trace amounts of melamine have been found in most domestic formula, and also that the FDA has issued some kind of flash advisory indicating that the detected levels of melamine are ‘safe’. So naturally, being the upstanding post-boomer parents that we are, we did a hard stop on the aforementioned formula and went to an organic powdered brand instead.

I’d still like a little more info about the underlying science of melamine. It’s an organic chemical. Check. What does that mean? It has 66 percent nitrogen. Check. Well, the air I breathe is 70 percent nitrogen. I guess I’m asking you to do my homework for me — but then, that’s your new job as a blogger, right? ;-) Net, why has this chemical wrought the death and illness that it has wrought? What more can you tell us about the underlying chemical processes?

Thanks for asking, Suneel, and congratulations on that new baby boy!

Melamine combines with cyanuric acid

From what I can determine, the problem is not melamine by itself. If an infant eats melamine, it gets absorbed through the digestive tract, goes into the blood stream, and is excreted in the urine. It doesn’t become part of the body, i.e., it’s not ‘metabolized.’ In three hours, half the melamine would be gone.

But melamine can interact with a substance called cyanuric acid. This is a white, odorless solid used to make bleach, disinfectants, and herbicides. If you add water to a cyanuric acid tablet and drop in a pair of dentures, you get bleached-white teeth. If an infant eats both melamine and cyanuric acid, the two can combine to form a crystal called melamine cyanurate.

Melamine and cyanuric acid

I need to say a few simple words about chemical bonding. In the diagram on the left, the melamine atoms are in green and the cyanuric acid atoms are blue. Together they form melamine cyanurate. Notice that the melamine and the cyanuric acid are joined at hydrogen (H) atoms. These hydrogen bonds are quite strong.

In the larger diagram below, you can see that when you get a whole bunch of melamine and cyanuric acid together, they form a more complex crystalline struture. These crystals do not dissolve easily.
And that’s the problem.
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Economic recovery and healthcare reform

President-elect Obama has called healthcare reform an “integral part” of economic recovery. What about Bill Clinton’s healthcare reform package in 1993? Was that also tied to the broader theme of economic recovery? In a comment on an earlier post, a reader asked this question, along with a request for information on the general positioning of the 1993 Clinton plan. Here’s what I’ve found.

Hillary Clinton 1993

Sept. 28, 1993. First lady Hillary Rodham Clinton,
Capitol Hill testimony on health care reform.
AP Photo by Doug Mills

To set the scene: There was a great deal of concern about the growing federal budget deficit at the time. The government had bailed out the savings and loan industry in the late 1980s (sound familiar?). There had been an unexpectedly large increase in Medicaid costs in the early 1990s. Rising health costs could endanger the new economic programs Clinton planned to propose. And so the Clinton plan was definitely tied to the broader economic situation of the early nineties.
Clinton saw healthcare costs as a “national imperative” precisely because of the economic implications.

The economic angle was not a major selling point to position healthcare to the public, however. It was part of Clinton’s strategy for overall political success. The positioning involved a great many bargaining chips aimed at every conceivable constituency.

Something for everyone, nothing for anyone

For consumers, the Clinton plan offered:

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