Louis Proyect: The Unrepentant Marxist

August 1, 2015

Aspartame versus sugar (a lose-lose situation)

Filed under: food,health and fitness — louisproyect @ 5:48 pm

On June 27th I reviewed a film called “Our Daily Poison” that persuaded me to stop drinking Diet Coke. It seems that aspartame, the artificial sweetener that was invented by G.D. Searle, a company that was purchased by Monsanto in 1985, was not very good for you. Among the companies that sell products based on aspartame, NutraSweet is probably the best known. It is used in Diet Coke and is ubiquitous as a sugar substitute for use in coffee in restaurants everywhere. My review cited a Huffington Post article that explained how aspartame dodged the FDA regulations:

Ronald Reagan was sworn in as president January 21, 1981. Rumsfeld, while still CEO at Searle, was part of Reagan’s transition team. This team hand-picked Dr. Arthur Hull Hayes, Jr., to be the new FDA commissioner. Dr. Hayes, a pharmacologist, had no previous experience with food additives before being appointed director of the FDA. On January 21, 1981, the day after Ronald Reagan’s inauguration, Reagan issued an executive order eliminating the FDA commissioners’ authority to take action and Searle re-applied to the FDA for approval to use aspartame in food sweetener. Hayes, Reagan’s new FDA commissioner, appointed a 5-person Scientific Commission to review the board of inquiry’s decision. It soon became clear that the panel would uphold the ban by a 3-2 decision. So Hayes installed a sixth member on the commission, and the vote became deadlocked. He then personally broke the tie in aspartame’s favor.

I wasn’t that happy about switching back to regular Coke but it was hard for me to break with a habit of drinking this crappy soft drink going back sixty years or so. Maybe there was still something going on in this rather addictive product dating back to its origins as I pointed out about 15 years ago:

One of the most notable attempts to use cocaine in this way led directly to the formation of the Coca-Cola company, which to this day uses non-intoxicating residues of the coca leaf for flavor. John Smith Pemberton, the Civil War veteran and morphine addict who invented the drink in Atlanta in 1886, thought that the soft drink was the answer for old-fashioned American malaise, as well as being a good substitute for opium addiction, including his own. It was also intended to be a substitute for alcohol, which was under attack from the temperance movement. As his hometown Atlanta was threatening to soon go dry, he saw the need for a soft drink that might prove as a substitute for beer, wine and whiskey. His solution, a fruit flavored sugar syrup that combined the caffeine kick of the kola nut and the narcotic buzz of the coca leaf, was initially designed to be mixed with plain water. Only when it was diluted with seltzer did it become the monstrously successful drink that eventually dominated world markets. It can also be used to remove rust from automobile radiators reputedly.

But now I have a medical professional telling me to switch back to Nutrasweet just one month after I cut it out. It is sugar that is bad for me, not aspartame or even saccharine for that matter, says Aaron E. Carroll who is a professor of pediatrics at Indiana University School of Medicine that blogs at The Incidental Economist. Directing his comments to parents who are concerned about their children’s addiction to soft drinks, he advises them to go artificial:

A 1998 randomized controlled trial could detect no neuropsychologic, neurophysiologic or behavioral effects caused by aspartame. Even a dose at 10 times the normal consumption had no effect on children with attention deficit disorder. A safety review from 2007, published in Critical Reviews in Toxicology, found that aspartame had been studied extensively and that the evidence showed that it was safe.

Since I have a long-standing tendency to double-check everything I read, I wanted to find out more about that safety review from 2007, whose principal author is one Bernadene Magnuson, a reviewer paid by the aspartame industry according to Wikipedia. In a letter to the journal that published Magnuson’s article, Morando Soffritti, a member of the Ramazzini Institute that focuses on food safety, offered this rebuttal:

Magnuson and Williams’s letter is substantially a repetition of the arguments set forth in a recent article (Magnuson et al. 2007), which was a “safety evaluation” sponsored entirely by Ajinomoto, the manufacturer of aspartame. Their article (Magnuson et al. 2007) and this letter contain numerous erroneous statements about the long-term carcinogenesis studies on aspartame conducted by the European Ramazzini Foundation (ERF).

First, Magnuson and Williams imply that our findings (Soffritti et al. 2007) should be discounted because the incidence of lymphomas/leukemias in the high-dose group “were within or near the reported historical control ranges.” As reported in our study (Soffritti et al. 2007), the incidence of lymphomas/leukemias observed in both sexes treated with 2,000 ppm aspartame is nearly double the concurrent control (Soffritti et al. 2007). The suggestion that concurrent control data should be ignored is contrary to the widely accepted standard of good laboratory science.

Second, Magnuson and Williams attribute our findings (Soffritti et al. 2007) to some kind of bias (i.e., infection) that would affect only treated animals but not the controls. We have responded in detail to this hypothesis in our article (Soffritti et al. 2007) and in an earlier letter (Soffritti 2006). To support their assertion, Magnuson and Williams mislead readers by stating that “the lung was often the site of lymphoma again in this [second] study.” However, we actually reported that

we observed the diffusion of neoplastic tissue not only in the lung but also concurrently in various organs (liver, spleen, mediastinal and other lymph nodes). (Soffritti et al. 2007)

As it turns out, Magnuson took the tack that many scientists paid for by the tobacco companies took in the 1950s and early 60s when studies concluded that cigarettes caused cancer. As is so often the case, it is almost impossible to establish a direct link between smoking or drinking aspartame-laced soft drinks and cancer because the exact biochemistry of cancer has not been established. When a hired hand of R.J. Reynolds or Nutrasweet claims that there might be some other explanation for someone getting lymphoma, capitalist politicians are inclined to give the corporation the benefit of the doubt, especially in a period when deregulation is the name of the game.

If you are inclined to give scientists the benefit of the doubt, regardless of who funds them, it is worth considering the “Survey Of Aspartame Studies: Correlation Of Outcome And Funding Sources” conducted by Ralph G. Walton, M.D., who is the Chairman of The Center for Behavioral Medicine Forum at Northeastern Ohio Universities College of Medicine. He observed:

Studies of aspartame in the peer reviewed medical literature were surveyed for funding source and study outcome. Of the 166 studies felt to have relevance for questions of human safety, 74 had Nutrasweet® industry related funding and 92 were independently funded. One hundred percent of the industry funded research attested to aspartame’s safety, whereas 92% of the independently funded research identified a problem. A bibliography supplied by the Nutrasweet® Company included many studies of questionable validity and relevance, with multiple instances of the same study being cited up to 6 times. Questions are raised both about aspartame’s safety and the broader issue of the appropriateness of industry sponsorship of medical research.

Well, maybe it is just a coincidence but something tells me that there was the same kind of crap going on that I discussed in my article on “Merchants of Doubt”. You know, he who pays the piper gets to call the tune.

I also wonder about the timing of Dr. Carroll’s article. Just three days before it appeared in the NY Times, there was news about the sugar manufacturers going bat-shit because of the FDA’s new rules. NPR reported:

Sixty-five grams of added sugar. That’s how much you’ll find in a 20-ounce bottle of Coca-Cola.

But can you picture 65 grams? It’s about 16 teaspoons worth of the sweet stuff.

The Food and Drug Administration wants to make it easier for Americans to track how much added sugars we’re getting in the foods and beverages we choose.

So, in addition to a proposed requirement to list amounts of added sugars on the Nutrition Facts panels, the FDA is now proposing that companies declare a daily percent value, too.

What this means is that, instead of just listing the 65 grams of added sugar in that Coke, soda companies would be required to list that it represents 130 percent of the recommended daily intake. In other words, that one bottle contains more added sugar than you should be eating in an entire day.

Just on a hunch, I Googled Aaron E. Carroll and “GMO” since he seemed to be the kind of guy who would give it his blessing. Sure enough, this Youtube clip on his website is an unabashed defense of GMO with some very minor quibbles:

I was particularly intrigued by his reference to his citation of the Institute of Medicine’s (IOM) statement that GMO’s were safe, perhaps as safe as Nutrasweet come to think of it. As it happens, the director of the IOM is one Victor Dzau, who is also the Chancellor for Health Affairs at Duke University and President and CEO of the Duke University Medical Center. Now how can you not trust the word of a prestigious think-tank that picks someone like that to run it? Well, there’s one guy out there who has connected the dotted lines between big Pharma and the madcap deregulations over past decades:

In 2010, a group of Duke students protested the hefty compensation being given to some Duke officials, Dzau included. He received more than $2.2 million in total compensation from Duke in 2009, an amount some felt was excessive especially when financial difficulties were being reported at the University. However, that figure is nothing compared to the compensation Dzau is receiving from his corporate connections outside of Duke. As reported by Forbes,8 Dzau served on several corporate boards in 2009, including:

–Alnylam Pharmaceuticals: Dzau received more than $234,000 in compensation in 2009, along with owning more than $424,000 worth of company shares

–Genzyme (a biotechnology company now owned by Sanofi): Dzau received nearly $413,000 in compensation plus owned shares worth more than $5.3 million

–Medtronic (a medical devices company): Dzau received nearly $174,000 in compensation plus owned shares worth nearly $494,000

–PepsiCo: Dzau received $260,000 in compensation and owned shares worth more than $1.6 million

In case you lost count, this amounts to more than $1 million in compensation from serving as a director for these companies, in addition to stock valued at more than $7.8 million… and that’s in addition to the $2.2 million from Duke. And, remember, these are 2009 figures. Today, it’s estimated that Dzau owns:9

–90,000 shares of stock in Alnylam Pharmaceuticals, worth more than $8 million

–More than 25,000 shares of Medtronic stock, worth more than $1.4 million

–More than 36,000 shares of PepsiCo stock, worth more than $2.8 million

How Can IOM Provide Unbiased National Health Advice with Corporate-Backed Leaders?

The issue here, of course, isn’t how much money Dzau has… it’s how a person with such extensive corporate board memberships can realistically uphold the IOM promise of providing unbiased health information. As reported by Health Care Renewal:

“Even though Dr. Dzau will apparently exit his board memberships before he becomes IOM President, the IOM has been providing such analysis and recommendations under the supervision of a Council member who had fiduciary duties to the stockholders of two pharmaceutical companies, a medical device company, and a company that makes sugar-laden soft drinks and snack foods. It will continue to provide such analysis and recommendations under the supervision of a President who became a multimillionaire by virtue of the stock holdings he acquired through his board positions.”

July 20, 2015

Still Alice

Filed under: aging,Film,health and fitness — louisproyect @ 3:24 pm

“Still Alice” is now the fourth narrative film that I have seen dealing with Alzheimer’s and by far the best. (Brief summaries of the other three appear at the end of this review.) Starring Julianne Moore as Alice Howland, a 50-year old Columbia University linguistics professor with early onset, the film is blessed by an exceptionally intelligent screenplay and direction by the late Richard Glatzer whose wife died of ALS. Some critics feel that his own family tragedy helped him shape the material but probably the most important element was the novel upon which it was based.

Written by Lisa Genova in 2007, the novel not only benefited from the author’s expertise as a neuroscience researcher with a PhD from Harvard but her familiarity with the mandarin life-style of her characters. Given the main character’s lofty perch in an Ivy League school, her husband’s own privileged status as a medical researcher, and their familiarity with Manhattan’s exquisite but pricey restaurants and other luxuries, her descent into an illness that would rob her of both her livelihood and—worse—her identity is unimaginably steep. In a key scene, when she and her husband are at their Hamptons summer home, she wets her pants because she cannot remember where the bathroom was.

Moore’s performance won her an Academy Award for best performance by an actress in 2014 and was one I would have supported if I had seen the film that year. Now that is available on Amazon streaming, I cannot recommend it highly enough. At the age of 55, Moore manages to convey the desperation of a world-class intellectual trying to keep her wits about her in the face of insurmountable odds. Her life begins to revolve around her IPhone, which is used to remind her of how to bake a cake or to take the pills she needs for a suicide when the smart phone no longer can bail her out.

Alex Baldwin, who plays her husband, is also very good as a man who does his best to run interference for his wife but finally comes to the sad realization that nothing will make up for her not being able to recognize her own daughter after she has seen her perform in an off-Broadway production of a Chekhov play.

Given the ineluctably predictable nature of the disease, any such film will lack the suspense element that is found in most tragedies. Indeed, it is open to question whether a film about Alzheimer’s can be called a tragedy since it lacks the “fatal flaw”, especially hubris, which is common to the classic tragedy from Sophocles to Shakespeare.

Some scholars believe that King Lear suffered from dementia although it impossible to pin down which kind. What made his downfall a tragedy was not his illness but his hubris, demanding more from his daughters than they were willing to give. There is an element of this in “Still Alice” to be sure. Alice constantly nags her youngest daughter Lydia (played superbly by Kristen Steward, the star of the insipid Twilight vampire movies) about abandoning her career as an actress and doing something more practical. When Lydia finally makes it relatively big in a Chekhov play, mom cannot recognize her—at least momentarily.

While the film is primarily a character study of how a dreaded illness takes down a very successful and self-possessed overachiever, it is also has universal meaning for any human being, particularly those over the age of sixty. 1 out of 9 Americans over the age of 65 has Alzheimer’s disease, increasing to one out of three over the age of 85. Scary odds. A week ago on the first night of my wife’s arrival at her parents’ home in Istanbul, her 87-year old father wandered off and ended up in a neighborhood far from home. When it became obvious to a young couple on a bus that he was lost, they were fortunate enough to find his phone number in one of his pockets. He is safe and at home now, much to my relief.

I hold out hope that my mother’s genes will hold me in good stead. Just a few days before her death in 2008, she was as lucid as ever. It was her circulatory system that was her undoing, an outcome of the wrong foods and a long time lack of exercise. Of course, sooner or later something will do you in whether it is Alzheimer’s, a circulatory system collapse, cancer or some other event associated with being in the “mortality zone” as Tom Brokaw put it in a column dealing with his battle against multiple myeloma.

In one key scene, Alice bemoans the fact that she has Alzheimer’s rather than cancer since at least cancer will not rob you of your identity. It is a disease like no other in that it transforms you into a stranger as if a zombie has taken possession of your body. Perhaps the best way to describe films such as “Still Alice” is as a subcategory of the horror movie with the monster being made up of the plaque in your nervous system rather than one stalking you with a butcher knife.

Other films in this genre:

The Savages”: a brother and sister cope with an ailing father in a nursing home. It is bittersweet comedy/tragedy directed by Tamara Jenkins who had the experience of putting her own father into a nursing home when she was in her 30s. Philip Seymour Hoffman and Laura Linney turn in fine performances as the feckless brother and sister. The DVD can be purchased for pennies on Amazon.com.

Away from Her”: Based on an Alice Munro short story, the wife has entered a nursing home and soon falls in love with another Alzheimer’s patient leaving her husband in the lurch. When he visits her, she has no idea who he is and prefers the company of her new companion. I found the film preposterous but you can make your own evaluation through Amazon.com streaming.

Memories of Tomorrow”: A Japanese film about a successful and hard-driving “salaryman”, who the disease takes down, just like Alice. It is much more of a love story than a tragedy since he depends on a newly kindled relationship to his long-neglected wife to help him through his vicissitudes. Ken Watanabe, one of Japan’s best-known actors, plays the lead character. It is a very fine film that can be only be seen through a Netflix DVD rental.

July 17, 2015

Another insane person found guilty of murder

Filed under: crime,health and fitness — louisproyect @ 12:56 am

Screen Shot 2015-07-16 at 8.47.27 PM

Years from now, when socialist historians of the future examine the dead carcass of US capitalism, they will pay special attention to the growing barbarism of the penal system. While most attention will obviously be paid to the reintroduction of the death penalty and a racist judicial system that incarcerates minorities disproportionately, there will also have to be a close look at the tendency to treat mentally ill people as common criminals.

For all practical purposes, the insanity defense is a thing of the past. It was first introduced in Great Britain in the 1840s, a time of child labor and other cruelties that figure large in the novels of Charles Dickens. The insanity defense was first used in the case of an 1843 assassination attempt on British Prime Minister Robert Peel by a psychotic individual named Daniel M’Naghten. When a physician testified that M’Naghten was insane, the prosecution agreed to stop the case and the defendant was declared insane despite protests from Queen Victoria and the House of Lords.

The M’Naghten Rule can be simply described as a “right and wrong” test. The jury was required to answer two questions: (1) did the defendant know what he was doing when he committed the crime?; or (2) did the defendant understand that his actions were wrong?

When psychotic individuals were on trial without a prior history of professional treatment, it was somewhat more difficult to find them not guilty by reason of insanity but it could be done. Now it makes no difference if someone has been under treatment for a psychiatric illness. So what happened?

In a word, John Hinckley.

After Hinckley was found not guilty by insanity of his assassination attempt on the beloved reactionary US President Reagan, committees of the House and Senate held hearings regarding use of the insanity defense within a month of the verdict.

Within three years of Hinckley’s acquittal, Congress and half of the states enacted laws limiting use of the defense and one state, Utah, abolished the defense outright. In 1986 Utah was joined by Montana andIdaho, two other “frontier justice” states. Congress passed revisions in the defense embodied in the Insanity Defense Reform Act of 1984, which reads:

It is an affirmative defense to a prosecution under any federal statute that, at the time of the commission of the acts constituting the offense, the defendant as a result of a severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his acts. Mental disease or defect does not otherwise constitute a defense.

As a rule of thumb, schizophrenics who are in a “severe” condition are too detached from reality to go out and kill somebody, let alone cross the street. People who are this dysfunctional are generally hospitalized. The more typical occurrence is somebody who goes off their medication when they are not hospitalized, but who are sufficiently in touch with reality to use a knife or some other weapon. And even if such an individual is in a “severe” state at the time of the crime, they will pump him full of medications during the trial to effectuate a “sane” condition sufficient to win a conviction. Another factor that militates against a successful defense is that psychiatrists are no longer allowed as expert witnesses in many cases.

After 21 years of confinement in a mental hospital, Hinckley had been allowed to visit his aging parents on weekends under stringent conditions. That had outraged all the rightwing talking heads on AM hate radio and the Fox cable news. Meanwhile, all of the top officials of the Reagan administration who broke all sorts of laws in backing the murderous Nicaraguan contras did token time in country club prisons. I guess the lesson is if you are going out to kill people, you should do it on a wholesale basis and wrap yourself in the American flag.

August 29, 2014

Cancer, Politics and Capitalism

Filed under: Counterpunch,health and fitness — louisproyect @ 12:00 pm

Dissenting Opinions

Cancer, Politics and Capitalism

by LOUIS PROYECT

After working for a series of unsavory financial institutions for 15 years, I accepted a position as a database administrator at Memorial Sloan-Kettering Cancer Center (MSKCC) in 1983 with an eager sense of anticipation. Finally I would be doing something professionally that was more in sync with my political values. Instead of using my skills to keep track of pension trust portfolios, I would be creating a data infrastructure for patient care.

For more than a year I worked on developing a data model based on “normalized” relationships that sought to eliminate redundancies and provide a reliable foundation for applications development. A few months after I presented the model to management, I learned that all my work was in vain. The hospital had decided to buy a package from SMS, inc. that was considered nonpareil when it came to debt collection. As happened too often, a loved one would check into the hospital for a couple of months of very expensive and painful treatments that came to an end with the patient’s death. Since the survivors often had a tendency to ignore the astronomical bills that went along with such an exercise in futility, the hospital decided to purchase a system that was very good at dunning if nothing else. That decision left me feeling deflated. Once again money ruled.

When I received an invitation to review “Second Opinion: Laetrile at Sloan-Kettering”, a documentary described as “the remarkable true story of a young science-writer at Memorial Sloan-Kettering Cancer Center, who risked everything by blowing the whistle on a massive cover-up involving a promising cancer therapy”, I knew that this was one I could not miss. (The film opens at Cinema Village in NYC on August 29, and at Laemmle Music Hall in LA on September 5. A national release will follow.)

read full article

August 1, 2014

A letter to the author of “The Cancer Chronicles”

Filed under: Ecology,health and fitness — louisproyect @ 1:37 pm

Dear George Johnson,

I am currently reading “Cancer Chronicles” and am really impressed by both the elegance of your writing and your erudition.

I am a film critic and am doing some background research for a review of “Second Opinion: Laetrile at Sloan-Kettering” that opens in NY on Aug.29. I used to work as a database administrator at Sloan-Kettering in the late 80s on patient registration systems and became interested in the “politics of cancer” as Samuel Epstein puts it, mostly as a function of my Marxist orientation. I read Epstein’s book while there and Robert Proctor’s “The Cancer Wars” much later on.

I noticed that–unlike Epstein–Proctor was hesitant to make a link between pollution and cancer. All this was in the back of my mind when I began reading your account of Love Canal yesterday that to my surprise concluded that there was no greater occurrence of cancer there than in the rest of NY state. I know that it is hard to argue with the data but I wonder whether your case would have been strengthened by a somewhat broader perspective.

I have been paying pretty close attention to China over the past 30 years ever since the country abandoned socialism (even a distorted version) and plunged full speed ahead into capitalist development with zero concern over health and safety. I seemed to have recalled many reports on cancer clusters–so to speak–over the years.

Refreshing my memory, I did a quick search and came up with this:

http://igov.berkeley.edu/content/water-pollution-and-digestive-cancers-china

> Water Pollution and Digestive Cancers in China
> author(s): Avi Ebenstein
> 2008
> Following China’s economic reforms of the late 1970s, rapid industrialization has led to
> a deterioration of water quality in the country’s lakes and rivers. China’s cancer rate has
> also increased in recent years, and digestive cancers (i.e. stomach, liver, esophageal) now
> account for 11 percent of fatalities (WHO 2002) and nearly one million deaths annually. This
> paper examines a potential causal link between surface water quality and digestive cancers
> by exploiting variation in water quality across China’s river basins. Using a sample of 145
> mortality registration points in China, I find using OLS that a deterioration of the water quality
> by a single grade (on a six-grade scale) is associated with a 9.3 percent increase in the death rate
> due to digestive cancer, controlling for observable characteristics of the Disease Surveillance
> Points (DSP). The analysis rules out other potential explanations for the observed correlation,
> such as smoking rates, dietary patterns, and air pollution. This link is also robust to estimation
> using 2SLS with rainfall and upstream manufacturing as instruments. As a consequence of the
> large observed relationship between digestive cancer rates and water pollution, I examine the
> benefits and costs of increasing China’s levy rates for firm dumping of untreated wastewater.
> My estimates indicate that doubling China’s current levies would save roughly 29,000 lives per
> year, but require an additional 500 million dollars in annual spending on wastewater treatment
> by firms, implying a cost of roughly 18,000 dollars per averted death.
>
> Attachment Size
> Pollution_in_China.pdf 904.88 KB

I know that you were not trying to write a comprehensive study of pollution and cancer but I was left with a worry that you were giving too much credence to an analysis I have seen over the years from Gina Kolata, your colleague at the NY Times,  who has downplayed environmental factors to the point where she seems like a pro-chemical industry hack.

October 14, 2013

Dollars and Dentists

Filed under: health and fitness — louisproyect @ 3:03 pm

NY Times October 13, 2013
Patients Mired in Costly Credit From Doctors
By JESSICA SILVER-GREENBERG

The dentist set to work, tapping and probing, then put down his tools and delivered the news. His patient, Patricia Gannon, needed a partial denture. The cost: more than $5,700.

Ms. Gannon, 78, was staggered. She said she could not afford it. And her insurance would pay only a small portion. But she was barely out of the chair, her mouth still sore, when her dentist’s office held out a solution: a special line of credit to help cover her bill. Before she knew it, Ms. Gannon recalled, the office manager was taking down her financial details.

But what seemed like the perfect answer — seemed, in fact, like just what the doctor ordered — has turned into a quagmire. Her new loan ensured that the dentist, Dr. Dan A. Knellinger, would be paid in full upfront. But for Ms. Gannon, the price was steep: an annual interest rate of about 23 percent, with a 33 percent penalty rate kicking in if she missed a payment.

* * * * *

About a month ago I began to feel some pain in a molar on the lower right side of my mouth. I was puzzled since the pain was only felt biting down, unlike the nonstop pain that usually accompanies a cavity.

A visit to my dentist revealed the problem. My tooth had a hairline fracture that extended beneath the gum line. Bacteria was penetrating through the opening in the tooth and causing an infection inside the tooth that was oozing out into the gums. He referred me to a root-canal specialist who took one look at the tooth and told me it had to be extracted.

I went back to the dentist and discussed my options. I could get a bridge, either permanent or removable like the denture described in the Times article above. A permanent bridge involves drilling holes into the two teeth bordering the one that is removed in order to support the bridge and the false tooth it supports. But the best option was what they call a dental implant. This involves putting some bovine bone into the pit beneath the removed tooth to replace the bone that bacteria had eaten away. Once the bone fused with my own, the oral surgeon will put in some hardware into the bone that could support an artificial tooth. I have already had the tooth removed in a procedure that costs $1390. I go back to his office in February to get the implant, which will cost around $3000. That’s just one tooth. What if I develop other fractures? An old friend from Bard College, who was featured in a video I did about Hurricane Sandy’s impact on his neighborhood in Rockaway, is 5 years older than me and just had implants to replace three teeth. The cost? Including extractions, it will come to $20,000.

Puzzled by the fracture itself, I asked my dentist how it could have happened. My wife warned me from time to time about eating hard candy, but more I suspect because the crunching sound annoyed her late at night rather than any threat it posed to my teeth. Could that have been the cause, I asked the dentist. He replied that teeth tended to have a life span. Oh great, another sign of my approaching demise.

And so he plays his part. The sixth age shifts
Into the lean and slippered pantaloon,
With spectacles on nose and pouch on side;
His youthful hose, well saved, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion,
Sans teeth, sans eyes, sans taste, sans everything.

William Shakespeare, “All’s Well that Ends Well”

I can’t remember exactly when my old friend Tony Long, the creator of massive minimalist sculptures who died of leukemia in 2002, told me this but it has stuck with me over the years. “Louis, you have to take care of your teeth. Can you picture what it will be like if you end up with dentures that you have to put into a glass of water at night? What would some younger woman think of that when you take her to bed?”

Ironically, I have led a charmed life dentally. Except for a wisdom tooth that I had pulled about a decade ago, I have never had an extraction before this one. Not only that, I have not had a filling since living in Houston in 1974. My trips to the dentist for the past forty years have been for cleaning and exams. My dentist told me that it is much more typical for someone my age to be enduring root canal work and bridges or implants on a regular basis.

Despite this, I have had bad dreams over the years of my teeth decaying. My guess is that these dreams and an irrational fear I have of having a tooth pulled (there is zero pain involved plus you get the benefit of a Vicodin prescription) are some kind of Freudian neurotic projection of castration fears. There’s actually a website called http://www.teethfallingoutdream.org/ that tells you everything you need to know, including this:

Dream Psychology: Freud and Jung

The interpretation of teeth falling out in dreams has been widely covered in psychology. Freud associates this symbol to sexual references, such sexual repression or fear of castration for men.

Jung and many other contemporary dream interpreters have a wider perspective and focus their analysis on symbols of personal power and the ability to renew oneself. For instance, they prefer to talk about the representation of loss or the process of releasing the old to give place to the new, as opposed to focusing only on more Freudian sexual references.

On a more mundane level, there’s also my memory of a woeful tale my mother told me when I was 9 years old or so, about to go to a dentist for my first filling. She told me about having a tooth pulled when she was in her teens. It was a painful disaster with the tooth breaking as it was being pulled and the dentist being forced to cut the remainder out with a scalpel—at least that’s the way I remember it.

Leaving aside all the existential dread summed up in the phrase that my Rockaway friend told me–“We are falling apart”–there’s the economics. When I retired from Columbia University, I lost my dental insurance. My wife has a plan through her workplace that covers me but it is utterly useless. I tried to make an appointment about six months ago for a routine checkup but the fucking dentist did not even return my call. In a way, this besides the point since dental insurance generally does not cover implants as a September 30, 2010 NY Times article explained:

An implant to replace a single tooth can cost $3,000 to $4,500, depending on where you live. Implants to replace a full or partial set of teeth can run from $20,000 to as much as $45,000.

Why so much? Implants typically involve the work of both a surgeon and a dentist. Several office visits may be needed to put in the screws and to add the prosthetic teeth.

More dental insurance plans are covering the costs, but the annual reimbursement limit is typically $1,500, an amount that hasn’t changed in four decades. That may be enough to cover half the cost of a single implant; you will end up paying the rest.

Fortunately I don’t need to apply for credit (my oral surgeon thankfully is not set up for this) or borrow money to have the implant done but what if the rest of my teeth start to develop problems? I like the idea of having implants if necessary but not if the cost approaches that of a hip replacement. Maybe going toothless (sans teeth, as Shakespeare put it) is not the worst thing in the world, especially for someone like me who has been married for more than a decade and whose only hope is that I can enjoy another couple of decades of marital bliss.

PBS aired a documentary on “Dollars and Dentists” last year that can be seen at http://www.pbs.org/wgbh/pages/frontline/dollars-and-dentists/. This is much more about how poor people are being screwed through the new business model of corporate dental chains that cater to poor people on Medicaid, often run out of storefronts like Kool Smiles. If you’d prefer to read a transcript of “Dollars and Dentists”, you can go to http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/transcript-23/. Be prepared to see just one more example of how the wealthy are screwing the poor on every level, from home foreclosures to dental work:

MILES O’BRIEN: [voice-over] FRONTLINE and the Center for Public Integrity have spent the past year investigating the business of Medicaid dentistry and the new corporate model for treating America’s poor kids.

We were able to obtain and analyze Medicaid data from two states, Virginia and Texas. We found that, on average, Kool Smiles used crowns more frequently than other providers on children 8 and under.

In Texas, half of all the restorative care on kids 8 and under, stainless steel crowns, 50 percent more than the state average. Virginia, 50 percent more crowns than average. That’s a big difference than other Medicaid providers. Why?

Dr. POLLY BUCKEY: Our focus is looking at each and every child and looking at where their decay is, what their risk for getting cavities.

MILES O’BRIEN: It’s not because the crown pays more?

Dr. POLLY BUCKEY: The focus on each and every child we see is to restore that child to a state of good oral health.

MILES O’BRIEN: Then how do you explain that discrepancy, that difference?

Dr. POLLY BUCKEY: All I can tell is what we do. I can’t tell you what someone else does.

MILES O’BRIEN: [voice-over] Kool Smiles later gave us data comparing itself favorably to other providers. But the company did not address whether kids who visit Kool Smiles are more likely to leave with a crown.

Kari Reyes was not happy with what happened when Marissa went to get her crowns.

KARI REYES: The doctor was shoving the crown into Marissa’s gums, and her gums were bleeding just everywhere. She started screaming like, painful, like a shrieking, painful, scary scream for a mother to hear come out of her child.

MILES O’BRIEN: Kari says she thought Marissa’s local anesthetic had worn off.

KARI REYES: I asked Dr. Collins, I said, you know, “Could you stop and numb her mouth?” She ignored me. So I, you know, just kind of sat there, and I was rubbing Marissa’s legs. And she’s crying and screaming this whole time.

What a nightmare. And certainly a lot worse than anything a middle-class man like me would ever have to put up with. Capitalism sucks, especially when it comes to health care.

October 13, 2013

Obamacare’s Achilles Heel

Filed under: computers,health and fitness,technology — louisproyect @ 7:14 pm

Signing up for Obamacare

My political career (for lack of a better word) began in 1967 just one year before my professional career as a programmer/analyst. The software career came to an end in August 2012 but I am still going strong politically. With such a background, I probably had a keener interest in the lead article in the NY Times today titled “From the Start, Signs of Trouble at Health Portal” than the average person. The lead paragraphs should give you an idea of the depth of the problem. While it is too soon to say if the technical flaws of the Obamacare website will doom a flawed policy, it cannot be ruled out.

In March, Henry Chao, the chief digital architect for the Obama administration’s new online insurance marketplace, told industry executives that he was deeply worried about the Web site’s debut. “Let’s just make sure it’s not a third-world experience,” he told them.

Two weeks after the rollout, few would say his hopes were realized.

For the past 12 days, a system costing more than $400 million and billed as a one-stop click-and-go hub for citizens seeking health insurance has thwarted the efforts of millions to simply log in. The growing national outcry has deeply embarrassed the White House, which has refused to say how many people have enrolled through the federal exchange.

Even some supporters of the Affordable Care Act worry that the flaws in the system, if not quickly fixed, could threaten the fiscal health of the insurance initiative, which depends on throngs of customers to spread the risk and keep prices low.

“These are not glitches,” said an insurance executive who has participated in many conference calls on the federal exchange. Like many people interviewed for this article, the executive spoke on the condition of anonymity, saying he did not wish to alienate the federal officials with whom he works. “The extent of the problems is pretty enormous. At the end of our calls, people say, ‘It’s awful, just awful.’ ”

I got my first inkling of how screwed up the system was from my FB friend Ted Rall, the well-known leftist editorial page cartoonist who started off as an engineering student at Columbia University and who is technically proficient. You can find his scathingly witty account of trying to enroll here. I got a particular chuckle out of how the system responded when he entered his SS number:

Screen shot 2013-10-13 at 2.08.01 PM

Once he got past the SS number snafu and began the enrollment process he was shocked at the rates he would have to pay for “affordable” health care.

For this 50-year-old nonsmoker, New York State’s healthcare plans range from Fidelis Care’s “Bronze” plan at $810.84 per month to $2554.71 per month. I didn’t bother to look up the $2554.71 one because if I had $2554.71 a month lying around, I’d buy a doctor.

$810.84 per month. $10,000 a year. After taxes. Where I live, you have to earn $15,000 to keep $10,000.

Not affordable. Did I mention that?

I was surprised to see that the primary consultant for the Obamacare website was CGI, a Montreal-based company that was one of the chief competitors of Automated Concepts Inc., the consulting group I worked for in the late 70s and early 80s. I have no idea when ACI went out of business but CGI has obviously become a major power. What I found most shocking was the late date at which programming began: “The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process.”

For a project of this size, it would be difficult to meet a target date of Fall 2013/Winter 2014 if it had started in Spring 2012 let along Spring 2013. I am amazed that it is even 70 percent complete, as the Times reports. My guess is that is probably only half-done.

There’s a lot of ass-covering going on now. Oracle, the company whose registration software gave Ted Rall such headaches, says, “Our software is running properly.” Oracle’s CEO is Larry Ellison, the third richest man in America whose yacht just won the America’s Cup in San Francisco. After 9/11 Ellison offered to supply a National Id card system to help weed out terrorists. With all of Ted Rall’s SS number woes, we can be thankful that his offer was turned down. Or else half the population would be in Guantanamo right now.

Like Bill Gates, Ellison got rich exploiting the intellectual breakthroughs made by others. Oracle was one of the first relational database systems marketed to corporations in the early 80s, along with Sybase, the proprietary software I supported for twenty years at Columbia University. Relational databases (basically a rows/columns approach similar to the spreadsheet concept) were invented by the mathematician E.J. Codd who made much more of a contribution intellectually than Ellison but never had ambitions to be a billionaire.

The Times has a graphic to illustrate the problems of the Obamacare website at http://www.nytimes.com/interactive/2013/10/13/us/how-the-federal-exchange-is-supposed-to-work-and-how-it-didnt.html.

This particular feature would seem to explain not only the technical challenges that make the system difficult to implement but also a fatal policy flaw:

Screen shot 2013-10-13 at 2.38.01 PMThe government is offering what is called a “many-to-many” relationship in database terms: many applicants choosing from many plans. This is historically a challenge to implement in financial systems such as the kind found typically in investment plans.

It would have been a lot easier to simply extend Medicare to the entire population. Not only would the private insurance companies be eliminated, the existing software would have only required a relatively minor change—eliminating the 65 year old criterion.

And going one step further, what is the purpose of having a bunch of different insurance companies competing with each other to provide the same service? Why not a single payer like in Canada that can be run on a nonprofit basis? And, then, to make it even more manageable why can’t we implement a public health system like in France with doctors functioning more as servants of the public rather than entrepreneurs? This sounds rather utopian, I realize, but only in terms of the resistance we would meet rather than the feasibility. Instead of policies that are economical and rational, we get jury-rigged, Rube Goldberg systems that can barely get off the ground like Howard Hughes’s plywood super-plane.

As long as we are talking in utopian terms, managing an economy would be a whole lot easier if we eliminated the profit motive that pits private enterprises against each other basically offering the same goods and services. I defy anybody to tell me why he or she picks one detergent against another. There will always be a need for small businesses such as restaurants (something the Cubans unfortunately did not realize until too late—not too late, one hopes) but the commanding heights of the economy?

If you think in terms of spreadsheets (or relational database systems), planning an economy is not that big a deal. You think in terms of resources, labor, and social needs that can be arranged in rows and columns. From that you allocate on a rational basis and according to the priorities a democratically elected government deems wise—such as spending more on public transportation than automobiles.

Of course, until an aroused population takes control of the economy and puts people like Larry Ellison and Barack Obama on a secluded island where they will be stripped of the power to exploit and to destroy, those hopes will remain utopian. For me, the need to defend such an orientation will remain with me with every living breath.

September 6, 2013

Fire in the Blood

Filed under: Film,health and fitness — louisproyect @ 2:09 pm

(This opens today at the IFC in NY. I am too swamped with other projects to write a review but recommend it highly.)

http://www.villagevoice.com/2013-09-04/film/fire-in-the-blood/

In Fire in the Blood, It’s Big Pharma vs. AIDS Patients
By Daphne Howland Wednesday, Sep 4 2013

Fear, greed, and cowardice have a way of sullying things like medical breakthroughs. In the mid-1990s, the antiviral drugs that checked the AIDS crisis separated the meaning of “HIV positive” from full-blown AIDS because, for the first time, the existence of the virus in the blood was not a death sentence. That was a triumph of an unprecedented amount of focused research, largely paid for by government agencies like the National Institutes of Health. But it felt like a miracle.

In Fire in the Blood, his documentary on the pharmaceutical keep-away that perpetuated the AIDS emergency in Africa and elsewhere, director Dylan Mohan Gray describes how protective patent laws guaranteed not only profits for drug companies but also the deaths of more than 10 million AIDS sufferers. He maintains a merciless calm throughout, aided by William Hurt’s low, slow, careful narration, as he documents a case of stupendous disregard for humanity.

Because miracles are wondrous and rare and patents are ironclad, drug companies could charge $15,000 per person per year for the new cocktail. That gouged anyone who could pay it—health insurance companies, the well-off and well-insured, government programs like Medicaid and Medicare—and left out anyone who couldn’t. Yet even if they had charged just five cents per pill, the companies would have still seen a profit, a fact that is just one of many maddening details in this story.

Gray’s images are exquisite and unsparing, in the style of the best National Geographic photography. Especially disheartening is the helplessness of doctors, who knew about the combination therapy but couldn’t offer it to their patients. “There were nonstop funerals taking place on a daily basis. The orphan population had exploded,” says Peter Mugyenyi, a Ugandan physician. “I saw so many people who’d have lived. I saw them die painfully, excruciatingly, and yet their death was not inevitable.”

The film’s sources maintain impressive composure in relating the repeated obstructions, sophistries, and obfuscations they faced, but their frustration is palpable. The drug companies cowed the United States, the United Nations, and us all, really, with ludicrous arguments that stoked fears and abetted inaction. It took years and a great deal of stubbornness for a coterie of smart, caring, connected people from all over the world, including Bill Clinton and Nelson Mandela, to finally begin to deliver the drugs to stem what was, essentially, a genocide. (In the film, Clinton pulls a fast one that helps turn things around.) While it’s hardly a joy to watch, Fire in the Blood is artful in nearly every frame, perhaps so we don’t avert our eyes. We can’t; Big Pharma is relentless and, thanks to a new international trade agreement that once again favors its patents, this isn’t over.

August 11, 2013

Off Label

Filed under: Film,health and fitness — louisproyect @ 11:19 pm

“Off Label”, now playing at the Cinema Village in New York and on-demand (nationwide screening info is here), is about the human guinea pig—those people forced by economic circumstances to take part in clinical trials, the first of whom is a young Asian man who became homeless after losing his job as a bus driver. Back in the sixties I knew many radicals who used to sell blood from time to time to augment the paltry wage they were making in the antiwar movement but eventually they moved on. The typical human guinea pig, like the pet he or she is named after, never gets off the treadmill.

There was a time when big pharma had free rein in exploiting prison labor for clinical trials. Jusef Anthony, an African-American victim of these Josef Mengele type experiments, states that the true nature of the drugs he was taking was never revealed to him. In addition to the $30 pay he was rewarded with pus-filled sores that broke out all over his body in Job-like fashion, not what he would have expected from a dermatology clinical trial. He thought it might have had something to do with hand lotion. It turns out that he was just one of the victims of Dr. Albert M. Kligman, a University of Pennsylvania dermatologist who was in partnership with Johnson and Johnson in developing Retin-A, a medication to treat acne. Kligman used Holmsburg Prison in Philadelphia in the same way that Mengele used Auschwitz—a place to conduct experiments on untermenschen. That Kligman was Jewish was just one of history’s ironies. When Kligman first stepped into Homsburg, he was practically delirious when he spotted “acres of skin”.

We also hear from Mary Weiss, the mother of Dan Markingson who was a student at University of Minnesota who took part in a clinical trial for Seroquel, an anti-psychotic medication. The trial was carried out under the auspices of AstraZeneca, the drug’s manufacturer in a clear case of conflict of interest. Most students dropped out after a few months but Dan stayed on mostly under duress. While he was not destitute or behind bars, he was basically coerced by his psychiatrist who warned him that unless he continued taking Seroquel he would be put in a mental institution. Unlike the other students, he had a history of psychotic episodes.

Evidently the drug only made things worse. Finally driven off the deep end, he took his life with a box-cutter. After slashing his throat, death was not coming quickly enough so he used the blade to open his abdomen. When his corpse was discovered, his hand penetrated his belly up to his wrist. As Mary Weiss put it, if he simply wanted to take his life, he would have found some other way to go. His death turned her into an activist, helping to enact “Dan’s Law” in Minnesota that prevents conflicts of interest in clinical trials.

“Off Label” is the second documentary from Michael Palmieri and Donal Mosher. Their first was “October Country”, about the Mosher family itself that lives in the Mohawk Valley Region in upstate NY, a hard-scrabble area that will be familiar to Russell Banks readers.

The San Francisco Chronicle described “October Country”:

The Moshers, working-class residents of the depressed Mohawk Valley in upstate New York, suffer multiple wounds, many of them self-inflicted. The sheer quantity of trouble, parceled out among four generations, might lead you to conclude that the family is cursed. Domestic abuse, teen pregnancy, missing fathers, abortion, co-dependency, scrapes with the law – a virtual catalog of dysfunction is on view.

You can probably extract a sociological or political message from the film, but I don’t think that was the intention. This lack of an agenda seems to add to the movie’s intensity. “October Country” doesn’t have any program in mind and doesn’t ask us to do anything but simply watch and remember.

This affinity for common folk would seem to motivate everything they do. Michael Palmieri and Donal Mosher are truly in the vanguard of filmmaking today.

March 4, 2013

Food, Fasting and Health–the personal and the political

Filed under: food,health and fitness — louisproyect @ 9:11 pm

miami_fattyThe Unrepentant Marxist in South Beach, January 2011: 160 pounds

skinny_louThe Unrepentant Marxist today: 145 pounds

Back in 1989 I read a terrific novel by Oscar Hijuelos titled “The Mambo Kings Play Songs of Love” about a couple of Cuban-American brothers who co-led a band in the 1950s whose greatest achievement was an appearance on the “I Love Lucy” show. After one brother dies in an auto accident, the other stops performing and takes a job as super in Washington Heights. Most of his free time is spent listening to old records of the Mambo Kings and hanging out in the neighborhood, playing dominoes, eating comidas tipicas, and drinking beer.

As happens to many people in their 60s, the surviving brother’s health starts to decline. After he survives a heart attack, the doctor puts him on a strict diet. No more comidas tipicas–just salads, fresh vegetables and lean meat. And absolutely no beer and no salt. After a month or so of this regimen, he develops such a craving for a Cuban sandwich (ham, pork, and melted cheese topped with a nice salty pickle) and a bottle of beer that he decides to go out in a blaze of glory. He brings home a Cuban sandwich, a quart of Budweiser, and dies in the middle of enjoying them while a Mambo Kings record plays away reminding him of his well-spent youth.

I really loved the novel and that particular passage. But that was nearly 25 years ago when I was 44 years old and fairly blasé when it came to matters of health, aging, and the big D. (That’s death.)

As you will learn as you hit your fifties and sixties, the weight tends to accumulate over the years, largely a function of a slowing metabolism. About 10 years ago I took a blood pressure test at work and learned that it was “slightly elevated”. And then around a year ago my taking naps on a nightly basis for a month got my wife so worried that she pressured me into seeing a doctor. I tried to explain to her that I don’t like going to doctors because I don’t want to get any bad news like I have cancer or something. Apparently medical experts are divided on most questions including the value of yearly checkups.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

NY Times, January 21, 2013

I was not surprised to learn that I still had elevated blood pressure but also too much of what they called “bad cholesterol”. Now my diet was nothing like the Mambo Kings guy but I do confess to enjoying eggs on the weekend and a buttered bagel. The bigger problem for me, however, was finding some healthy food to eat at lunch when I was still working at Columbia University. The only place that was convenient to my outpost in Manhattanville, where the school was colonizing as if it were the West Bank, was a Fairways grocery store that had food to take out at lunch. Yes, I will bare my soul. Many days I brought back sausages and peppers or meat loaf with mashed potatoes back to my desk. Plus I confess to having a half-muffin each morning. The feelings I get over this now are similar I’m sure to what somebody who kicked a $200 per day heroin habit must feel. How can I have been so stupid?

But what makes this all the more disconcerting is the memories I have of my mother’s last 2 or 3 years as she battled congestive heart disease. Yes, she was in her mid-80s when things got bad but who would want to do anything that makes hardening of the arteries more likely? I know I have to go some day but the idea of being a stroke victim or some other circulatory disease scares the pee out of me. When I used to visit my mother at the special nursing unit of the local hospital, I was always shook up when I saw Milt Brizel my high school geometry teacher who was paralyzed from the neck down, the aftermath of a stroke identical to the one depicted in the 2012 movie “Amour”, directed by Michael Haneke.

Haneke’s typical plot involves some deeply painful setback to a comfortable petty-bourgeois family, from home invasions to environmental collapse. The virtue of “Amour” is its willingness to describe exactly what befalls an elderly couple when one becomes incapacitated. At a certain point the wife demands to die but the husband keeps her alive, a challenge to notions about what really defines “love”.

As a sign of how backward American society is, the right of someone to end their own life in dignity is excluded in all but three states: Washington, Oregon and Montana. A truly civilized country would allow someone suffering some painful and terminal disease to take a couple of pills to end their misery. But the grip of organized religion is so great that it was capable of making someone as saintly as Jack Kervorkian to serve 8 years of a 10-25 year second-degree murder conviction sentence.

When I had my physical a year or so ago, I weighed 160 pounds. The doctor told me that he saw no need to put me on the kinds of medications that are advertised relentlessly on the network news each evening. He advised me to change my diet and get more exercise.

Once I retired on August 31, 2012, it became a lot easier to make those life-style changes. To start with, I cook my own food and not the junk they prepared at Fairway. Each morning starts with a bowl of steel cut oatmeal mixed with flax seed. When I first read that steel cut oatmeal was good for reducing bad cholesterol, I decided to get on board even if it reminded me of the Garrison Keillor radio show’s spiel for the fictional Raw Bits cereal: “It gives you the strength to get up in the morning and do the things that need to be done.”

Now, just a bit more than 6 months after retiring, I am down to 145 pounds and wearing size 32 trousers, that are actually a bit baggy on me. In a few months I will make another appointment with the doctor even though the NY Times does not think it is necessary (nor do they think that criticisms of Napoleon Chagnon are valid.) So, you ask, how did I do it? I imagine that most of you except the most morbidly curious have stuck with this post since it would remind you of the typical geezer telling you about his or her latest surgery.

Well, it has been the result of fasting every Monday and Thursday. Back in March 2012, a most remarkable article appeared in Harper’s magazine titled “Starving your way to vigor: the benefits of an empty stomach”. Written by Steve Hendricks, who embarked on a fasting regimen himself, it is an eye-opening account of its history as a medical treatment rather than a guide to spiritual elevation (something that interests me about as much as Lena Dunham’s “Girls” on HBO.)

In the 1960s a professor of medicine at the University of Pennsylvania named Garfield G. Duncan be came troubled by the epidemic of American obesity, which then afflicted a shocking one man in twenty and one woman in nine. (Today it afflicts one in three men and women alike.) Like other researchers, Duncan fasted obese patients and studied how many regained their lost weight. Unlike other researchers, he noticed that the blood pressure of every patient who was hypertensive fell to within normal limits during these fasts. He reported, for illustration, the case of a man of fifty-three years and 325 pounds whose unmedicated blood pressure was 210/130 and whose medicated pressure was 184/106—still menacingly high. The man fasted for fourteen days without drugs, and his blood pressure fell to 136/90. Six months later, it was 130/75. Duncan did not record how many of his patients sustained such improvements after their fasts, but the possibility of a simple cure for some forms of hypertension seemed well worth pursuing.

Not until 2001, however, was there a definitive follow-up to his work. Its au thor, Alan Goldhamer, had fasted thousands of patients at his TrueNorth Health Center in Santa Rosa, California, and had seen high blood pressures trill downward like Coast Range streams. He studied 174 hypertensives who fasted for ten days; 154 of them became normotensive by fast’s end. The others also enjoyed substantial drops in pressure, and all who had been taking medication were able to stop. In patients with stage 3 (the most severe) hypertension, the average drop in systolic pressure was 60 mmHg. In all patients, the average drop in systolic/diastolic was 37/13. According to Goldhamer, this was and remains the largest reported drop in blood pressure achieved by any drug or therapy. Like Duncan, Goldhamer did not formally study how long his subjects maintained their newly lowered blood pressures, but he surveyed forty-two subjects six months after their fasts, and their average blood pressure had risen hardly a jot.

For me the best part of fasting is that is really easy. You don’t have count calories. All you need to do is not eat. Can anything be simpler? What I learned almost immediately is that you don’t get any hungrier 12 hours into the fast than you were in the first hour. Plus, you can eat pretty much normally on other days, which for me consists of the sort of food that the Mambo King guy hated. For me, there’s nothing more satisfying than some beans and a glass of red wine.

As my readers know, at least those who have stuck around long enough to read this ponderous piece, the issue of food and health has reached a crescendo of late, largely having to do with Michele Obama’s hypocritical campaigning. As a huckster for Walmart’s Healthy Food Initiative, she is just as shameless as her husband who just put a long-time Walmart executive in charge of the White House budget office. That shows where the second coming of Herbert Hoover’s head is really at.

Last Saturday morning Chris Hayes had a special food show on MSNBC. His featured guest was Tom Colicchio, the celebrity chef and host of the hit TV show “Top Chef”. He was there to promote “A Place at the Table”, his new documentary on hunger that reflected his deep-felt concerns about poor people getting adequately fed, just like our First Lady. Colicchio told Hayes:

People look at feeding programs whether it’s snack or whether school lunches a handout as a charity program. And we have to look at it as sort of a tool to prepare our children to eat, especially when you look at breakfast programs. There`s a new study that just came out by Deloitte that was done with Share a Strength and No Kid Hungry.

And they`re showing when kids eat breakfast in school, their math scores go up by 17 percent. They have less incidence of being absent. And so, there`s all kinds of benefits. And so, the school lunch program is just — right now, it`s just not funded. And that clip that you showed actually set up the — I actually testified in front of Congress on behalf of the school lunch program.

Colicchio joined a panel in the second half of the show that took up other questions related to food and the poor, in this instance the lowly paid workers who often had to rely on tips. Hayes introduced the segment this way:

In 1960, according to the CDC, Americans spent just 26 percent of their food budget eating away from home. By 2011, that figure had almost doubled to 49 percent.

Food retail and service is one of the healthiest growing industries in the country. For the past decade food industry job growth has far outpaced totally sector job growth.

And yet by almost any measurements, most of these are simply not good jobs. They are some of the worst jobs in the country. In fact, food industry workers use government assistance programs like Medicaid and food stamps in much higher than the general workforce does.

Over 27 percent of the food industry workers on Medicaid, compared to 19 percent of the general workforce, and over 13 percent of food service workers receive food stamps compared to just 8 percent of the general workforce.

According to Food Chain Workers Alliance, a workers advocacy group, nearly 80 percent don`t have paid sick days or don`t know if they do. Eighty- three percent of food industry workers do not receive health insurance from their employer, and 58 percent do not have any health insurance at all.

Given his familiarity with the terrain, or at least what his researchers fed to him over the teleprompter, one wonders why Hayes failed to grill Colicchio on this:

NY Times December 13, 2008

Lawsuit Accuses a Top Chef of Wage and Tip Violations

By STEVEN GREENHOUSE

Tom Colicchio, the celebrity restaurateur and judge on Bravo’s popular “Top Chef” television show, was sued in federal court on Thursday by a former waitress who accused his company of misappropriating employee tips, withholding some overtime pay and sometimes failing to pay minimum wage. Mr. Colicchio’s restaurants — including Craft, Craftbar and Craftsteak — were also named in the lawsuit.

In the lawsuit, the waitress, Nessa Rapone, who used to work at the bustling Craftbar restaurant at 900 Broadway, between 19th and 20th Streets, asserted that Mr. Colicchio’s company, Craft Worldwide Holdings, improperly shared employee tips with supervisors, did not keep proper time records and fired her when she protested.

The lawyers for Ms. Rapone, a Brooklyn resident who worked at Craftbar from March to May 2007, are seeking class-action status for the lawsuit, which was filed in Federal District Court in Manhattan. It accused management of federal and state wage law violations, including failing to pay workers time and a half for all hours worked beyond 40 a week. It also asserts that management shared employee tips with other workers who were not eligible under federal and state law to share in the tip pool.

Ms. Rapone’s lawsuit also accused the company of not compensating her for the cleaning and care of the uniform that she was required to wear at Craftbar.

“The Craft restaurants, all upscale establishments designed by well-known architects and catered by award-winning chefs, have earned Mr. Colicchio and his partners great success,” one of Ms. Rapone’s lawyers, Justin M. Swartz, said in a statement on Friday. “This success, however, has come at the expense of the restaurants’ hourly service workers to whom the defendants have denied proper minimum wages, overtime compensation, and tips they earned from customers.”

If you go to Craft’s website, you’ll see a bunch of farms that supply locally grown and organic meat, fish and vegetables with names like Cavendish Game Farm—not a supplier to TGIF’s, you can be sure. Colicchio says, “Please enjoy some of the great ingredients grown, raised and caught by our friends that share our commitment to serving great food. We feature their bounty on this evening’s menu.”

All this “localism” got started, as you probably know, at Alice Water’s Chez Panisse Restaurant in Berkeley where reservations have to be booked months in advance and where a typical entrée is $85, and where the rhetoric is quite Green:

Alice and Chez Panisse are convinced that the best-tasting food is organically and locally grown and harvested in ways that are ecologically sound by people who are taking care of the land for future generations.

Chain-smoking and hard drinking celebrity chef and TV star Anthony Bourdain, who would have probably sought out the Mambo King’s favorite restaurant, is unimpressed with Waters to say the least:

I’ll tell you. Alice Waters annoys the living shit out of me. We’re all in the middle of a recession, like we’re all going to start buying expensive organic food and running to the green market. There’s something very Khmer Rouge about Alice Waters that has become unrealistic. I mean I’m not crazy about our obsession with corn or ethanol and all that, but I’m a little uncomfortable with legislating good eating habits. I’m suspicious of orthodoxy, the kind of orthodoxy when it comes to what you put in your mouth. I’m a little reluctant to admit that maybe Americans are too stupid to figure out that the food we’re eating is killing us. But I don’t know if it’s time to send out special squads to close all the McDonald’s. My libertarian side is at odds with my revulsion at what we as a country have done to ourselves physically with what we’ve chosen to eat and our fast food culture. I’m really divided on that issue. It’d be great if he [Obama] served better food at the White House than what I suspect the Bushies were serving. It’s gotta be better than Nixon. He liked starting up a roaring fire, turning up the air conditioning, and eating a bowl of cottage cheese with ketchup. Anything above that is a good thing. He’s from Chicago, so he knows what good food is.

I know little about the cable TV comedy Portlandia, except that it pretty obvious from this clip that they are as fed up with “local” and “organic” food pretensions as Bourdain:

Having said that, I of course believe in environmentally sustainable farming, ranching, and fishing. I own Mark Bittman and Michael Pollan books on healthy food and Green practices and swear by them.

But ultimately, like any other intractable social problem like global warming, food and health are ultimately a function of the mode of production. As long as there is profit in industrial farming and the peddling of sugar-laden fast food to the masses, the nation will continue to endure an epidemic of diabetes, heart disease, and all the rest.

The 90 year old Sidney Mintz, one of my favorite Marxist historians and political theorists, wrote a book in 1996 titled “Tasting Food, Tasting Freedom” whose final pages are worth quoting in their entirety as a coda to this post.

What does the American future hold, so far as eating is concerned? In a series of brilliant recent papers, Cornell University scientist David Pimentel and his colleagues have predicted sweeping changes in American agriculture, and hence in American eating patterns over the next half century!’ Indeed, the changes that these scientists forecast, if they do occur, will be more radical in their effects on American eating than even those of the last half century—which is to say a very great deal. Demographic, agricultural, and other factors enter in. Pimentel and his colleagues, working from present trends, predict a doubling of the national population by 2064; a reduction in arable land (through both erosion and urbanization) in the neighborhood of 180,000,000 acres, or 38 percent, in the same period of time; and a total exhaustion of national fossil fuel resources in not more than two decades. The figures on rapidly diminishing water supply are similarly worrisome.

This is an unbelievably grim scenario. If it eventuates, food exports (now calculated at an average of about $155 per person per year, given our present population) would be reduced to zero. For Americans, food costs would increase by a factor of between three and five—at worst, up to more than half of total income. Should these calculations prove correct, however, the composition of the American diet would also have to change substantially. While nearly two-thirds of the national grain product of the United States, grown on over two million acres, is now used as livestock feed, by 2060 all of it would have become food for us, not for our cattle and pigs and poultry. In effect, Pimentel sees North Americans coming to eat as most of the rest of the world eats, with meat representing a much reduced fraction of our total caloric and protein intake. Since India’s nearly one billion people and the People’s Republic of China’s even larger population get 70 to 8o percent of their calories and nearly all of their protein from grains and legumes, such a change in the States would be in the direction of aligning North American consumption with that of the rest of the world. It would also contribute to a vast improvement in American health. Substantial farmland could be returned to agriculture; the number of bypass and cancer operations would certainly decline.

But will it happen? As I write, McDonald’s looks ahead to a rapid expansion of its enterprises in such places as the People’s Republic of China, where it aims to add 600 retail establishments in the next decade; and Japan, where it now boasts more than a thousand. Whatever the scenario for the United States, many companies are working hard to spread our way of eating world-wide. Nor is there evidence that many Americans are much concerned, either about our fossil fuel consumption or our diet. Driving cars and eating meat are highly valued acts; though both involve the expenditure of unimaginably large quantities of water, soil, cereals, and fossil fuel, there is no collective indication that anyone is deeply concerned. Only sudden shortages reveal, as if in lightning flashes, how deeply held such consumption values are; Operation Desert Storm was a case in point. Indeed, one solution” to the Pimentel prophecies is war. Successful aggression could keep meat and gas available and affordable, at least for a good while longer. Its effects on American moral integrity would be utterly disastrous. But the enormity of the decisions involved in such trade-offs would not be clearly grasped until after the decisions were made. There is a real trap in our not separating what we are free to do, but need not do, if it is a bad idea—from what we cannot help doing, even though it is a bad idea, because we think someone is trying to stop us from doing it.

No one can look down the road and predict how the American people will behave, fifty years from now. One sinister prophecy is embodied in the words of Josef Joffe, the editorial page editor of Suddeutsche Zeitung, who writes: “It is profligacy—being hooked on the sweet poison of consumption—that might yet lay low the American economy and thus American might.” But the worry is not that we will let our consumption gluttony destroy our economy; it is, rather, that we might let our obsessive notions of individual freedom destroy our democracy. The long-term lessons of our economic and agricultural policies are there to be learned now. But we have to be willing to learn them.

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