Monday, August 29, 2005

Blogcritics Pick of the Week

My commentary on James Fenimore Cooper's The Pathfinder was chosen by the editors of Blogcritics as a Pick of the Week. Neat!.

The post is here two posts previous (below) or at The Pathfinder: Action, Adventure and Romance

Saturday, August 27, 2005

Painful Medicine

We believe in our medical system as progressive, technologically advanced, always available and ready to relieve pain and danger. We may worry about the soaring costs, fat insurance company executive salaries, and unwillingness to provide the country with a health care safety net. But we still have faith that the doctors will still give us some "medicine" to cure the illness and take away the pain.

They used to come to your house to do it but we cannot hope for the moon. They used to give you some of their time and concentration rather than forming groups and seeing 3 people at a time: a few minutes with one, run out, a few minutes with another. It would be nice to feel special but we cannot hope for the stars either.

The fact is that American medicine is now being overseen and sometimes controlled by businessmen (HMOs) and cops. In an article on "Pain Management" from George Mason University,

The question is, what are the 10-20 million Americans who suffer chronic pain to do? The only non-narcotic painkiller left, aspirin, remains an option. However, long-term use of painkilling doses can lead to potentially fatal gastrointestinal bleeding. Some 16,000 people die each year from bleeding related to aspirin and other NSAIDs.

That is a lot of people, a lot of pain (which is difficult to quantify) and very few medications left for the average person. There are also people with an intense allergy to aspirin; even fewer alternatives for them. This present round of worries comes after the big loss in court suffered by Merck, the maker of Vioxx. The drug makers of COX-2 drugs like Vioxx and Celebrex have been linked to "an increased risk of heart attack and stroke". Later the NSAIDS (non-steroidal anti-inflammatory drugs) such as Advil and Ibuprofen were found to increase these risks were seen as part of the genre of medication to which belong the Vioxx and Celebrex meds. Since it is a tiny risk factor, we won't mention that people allergic to aspirin are usually allergic to NSAIDs.

So no Vioxx, no Advil, no aspirin. At least for the little aches and pains there is Tylenol (acetominophen). Nope.

And now, the last hold-out, Tylenol (acetominephen) has been linked with kidney problems and with a significantly increased risk for high blood pressure in women in an analysis of the Nurses’ Health Study.

The New York Times reported on the $253 million suit won against Merck but noted that Merck, Novartis, and GlaxoSmithKline continue to invest in these cox-2 drugs and hope to prove their safety. Click over to the David Nalle post on Blogcritics on The Vioxx Verdict. Mr. Nalle's article is less a polemic about the state of pain medication than a reasoned discussion of this high an award and the future for Merck as well as the drugs themselves.

See $253 Million for the New York Times Business section take on the Merck decision and the state of the industry.

Aspirin and Tylenol are not even strong enough painkellers to be classed for more than "mild" pain. What, then, is left? The answer is opoids. Opium derivatives.

"Unfortunately, the National Institute on Drug Abuse has recently gotten into the anti-opiate act, with director Nora Volkow claiming that medical education misleads doctors into believing that there is little risk of addiction when prescribing opoids for chronic pain because those who use them for acute pain treatment are not likely to become addicted.

In an interview with Psychiatric Times (7/05), Volkow said that "5-7%" of chronic pain patients given opioids become addicts. That means, of course, that over 93% do not, which many would see as a low risk. But other studies have found the risk to be lower than that claimed by Volkow. The risk for people without a prior history of drug problems, for example, has been found to be less than 1%. Furthermore, the risk of accidental addiction declines with age, which, given that many pain patients are middle aged or older, is an important consideration in considering any potential risk for accidental addiction. None of that, however, is mentioned in the Psychiatric Times piece."

Do note that the prescriptions of physicians are being controlled by an agency led by a Nora Volkow . She doesn't appear to have an M.D. or Dr. attached to her name but has the power or influence to help create painful medicine -- the present situation where "50% of dying patients in the U. S. are still under-treated for pain"-- at least according to the World Health Organization.

Note that quotations were from a release from George Mason University at Pain Management. I was led to this article by the excellent science site (similar to Blogcritics arts, culture and politics site), SciTechDaily

Other studies have shown that the vast majority of people who need pain medication for severe pain do NOT develop an addiction. If you are suffering a heart attack, believe me, morphine in huge doses is wonderful to stop the pain that is enough to kill by itself. But the morphine itself is unpleasant and nauseating and will forever remind me of the intense pain that caused me to take it. Addiction tends to require some pleasure associated with the subject -- morphine, nicotine, caffeine, fast food...

The fact is that opium derivatives do the job. A number of years ago when Jackie Kennedy Onassis was dying of painful cancer, the papers reported that she received enough painkillers to die without suffering. Essentially because she was rich, famous and an American icon. One should not have to be that rich nor famous to be kept from suffering needlessly.

It is time to reexamine our national priorities. We really cannot afford to have foreign wars and this artificial war on medications and recreational drugs at the same time. The nation's resources, veracity and safety are compromised by using valuable resources to watch physicians, cause recreational drugs to be so expensive that people kill for them, castigate older, sick people for looking for alleviation of suffering. Further, this "war" is totally non-productive. Billions have been spent and nothing has been produced except fear, pain and death. It is time to fight terrorists, if fight we must, and stop fighting the medical profession and the people it tries to serve.

Check the post with its comments at: Painful Medicine.

Sunday, August 21, 2005

The Pathfinder:Adventure, Romance and Action

James Fenimore Cooper (of The Last of the Mohicans fame is great fun. Yes, fun and romance and adventure and excitement. He is a bit out of fashion like black and white movies from the thirties but that doesn't mean that you wouldn't be missing a great experience by reading him.

Granted there are dated turns of phrase and he is a master of the forever long sentence like Henry James and Gertrude Stein, but these are small prices to pay for adventures in the wilderness. That wilderness is anything west of the Hudson River and north of Albany. The country was still small and its corners were not rounded into suburbs and federal highways.

These days Cooper is relegated often to being seen as the writer behind Daniel Day-Lewis in The Last of the Mohicans, a fine movie. Reading his stories of la longue carabine as the Indians of the French called him and "pathfinder" to the colonists is a struggle through some muddiness at first and then the adventures take over, the sentences make sense even though they often run on and the scenes of battle and the wilderness are trips on their own. These were planned as adventures and adventures they are.

I am not competent to review Cooper. He is an American classic and the stuff of academic discussions and classes, criticism and scholarship. I call this a "commentary" or perhaps just a reminder that all classics are not "school books". Read him for fun and for a sense of the history of our nation when it was young and the world was simpler.

Perhaps I love the Leatherstocking Tales with Natty Bumppo (Pathfinder) because the rules of the game were, like the first Superman, a simple goodness of spirit of which we are today losing so rapidly in the world. Natty Bumppo had wasn't just a prince of the virgin continent; his code of conduct was definite -- faithful, moral, fearless and he was an example of a "just minded and pure man might be."

Cooper describes him about a third of the way into the book as:

"... the most striking feature about the moral organization of Pathfinder was beautiful and unerring sense of justice. This noble trait -- and without it no man can be truly great...As might have been expected... his fidelity was like the immovable rock; treachery in him was classed among the things which are impossible; and as he seldom retired before his enemies, so was he never known... to abandon a friend..."

OK. This is not a short excerpt and the paragraph goes on and on. Still, this is the man we need now and men like him to rid the world of the bad guys and remind us who the good guys really are.

If the classics of American literature have turned you away; give Cooper a chance. Visit the adventure of a previous time. There is fun to be had and suspense without a serial killer in sight.

Saturday, August 20, 2005

Open Water Swimming updated

There is a new post with links (even to a "fiction") on blogcritics. Catch it.

Sunday, August 14, 2005

Tourist Heaven: The Down Side

Review: Live Well in Mexico

Ready to change your life, your retirement or your occupation? A really big change.

We are expatriates in Mexico and have been for more than seven years. It has been both wonderful and horrible beyond imagining. We ended up here at the southern frontier for a few reasons: health, a slow life on a higher level than our income would allow in the States and because it reminded me of the Cuban area of Tampa where I grew up.

It was a great decision. It was a great mistake. One never knows which unless they did both things. It has been the best of times; it has been the worst of times to paraphrase the English master of fiction. Dickens never even went to Mexico to learn that line.

I might call this a recurring theme to this "sinister cabal". I have written on Manuel Alvarez Bravo, the great Mexican photographer, Edward Weston & Tina Modotti's love affair
with each other and with Mexico, Alan Riding's book, Distant Neighbors and Bernal Diaz del Catillo's story of the Conquest.

My new photoblog is "Expatriate Diaries" and replaces an older one. The first
included a guide for foreigners in Mexico that I thought of turning into a book. However, Ken Luboff did something similar in Live Well in Mexico: "How to Relocate, Retire, and Increase Your Standard of Living". Ken Luboff's book has its own site: Live Well in Mexico

How does his book stand in the pantheon of gudes and self-help works? Sometimes good and complete but too often weak and limited, I think.

We must start with the pictures since I, a photographer, always look at the pictures. They are black and white in a country and culture of color, amateurish and lacking in the most important thing they would bring to this book -- information. OK. He is not a photographer but around San Miguel Allende there is little excuse for visually ignoring Mexico.

For a quick tour of some interesting places not in his guide; try my albums at Architecture and
Tropical Flowers.

Next is a reason the book doesn't relate to a lot of people. It is about the central, urban heart of Mexico which is far different from other parts of the country. It centers on San Miguel de Allende and Guanajuato along with Guadalajara and Lake Atitlan. As much as I would like to see San Miguel it is too high for my heart condition and so remains a mythical place where Kerouac's pal, Neal Cassady died, run over by a train. These places and every location he writes of are those with huge English-speaking populations. Here in Quintana Roo there are already places with big foreign communities: Cancun, Playa del Carmen, Tulum, etc.

Luboff writes of prices (from 1999) that are 25-50% or the prices in the U.S. I cannot argue except to remind readers that he is writing of the most expensive neighborhoods of the most expensive towns of Mexico: San Miguel, Puerto Vallarta, Cuervevaca, Cabo San Lucas... These are places with lots of English, prices in $'s, and where the foreign and Mexican communities look fearfully or hatefully at each other from a distance. In spite of problems with individual Mexicans (and Americans), I much prefer a mixed community of cultures.

He is right about prices then and now. Here on the southern frontier the prices are far, far lower that his foreign resort towns. Here it was inexpensive and quiet until the developers and the chilangos "city people" brought their tensions and prejudices to the Mayan villages down the coast from the "international zone". He is right that there is much in Mexico that is cheaper. Medications (usually), labor, food and housing. But much is more expensive: gadgets, electronics, good medical care, cars, food beyond the Mexican staples. Some things are given up for others gained.

We have a big, lovely house on the shore of what was the most beautiful swimming hole in the hemisphere, a guard/gardener and a maid 5-6 days a week. We can hold our heads high on a budget that, in the US would be near "poverty level".

Luboff is not always right: limited to a certain part of Mexico and somewhat dated. On the other hand for those who dream of a different, slower, higher scale life than they have in the States; the more information the better. It is hard to find enough to sift through. As a result, the book is well worth the price. Just realize that there is so much to learn that a lot of research and experience will be necessary. In short, research a life change very carefully and take it slowly.

A highly respected Blogcritic asked, "With all the problems you have had (robberies and attacks); why do you stay?" That is a good question. So is the one about where one could go to find a better life. Other third world countries have similar or far worse problems. Mexico is close, relatively stable, definitely looking for its unique path to democracy and a new society.

Mexico Mike Nelson also has a book out on living in Mexico. I have not read it but have read much of his guidebook style guides to driving through Mexico when we did just that and got his material from Sanborn's Insurance in Texas. He was helpful in those guides sometimes and sometimes far off the mark. We almost missed our favorite motel in Catemaco, Veracruz since he wrote that the manager held him there an hour to check the room on checkout. But we stayed perhaps five times for a few days to a couple of weeks since it was so clean and pleasant. Mexico Mike must have given them quite an impression. There were other discrepancies and there were also incredibly fine finds from his writings.

With my website looking for its unique path, there will continue to be posts on life here, life as a stranger in a strange land. Blogcritics will be a part of My Website or the other way around. There is room for stories and advice on living as an expatriate in Mexico or another haven for the disaffected, pensioners and would-be entrepreneurs.

The site US Expatriates Abroad notes that "The Dallas Morning News highlights the growth of the population of U.S. citizens in Mexico and forecasts that it will continue to increase as baby boomers retire. "The U.S. State Department estimates that the number of Americans in Mexico has increased from about 200,000 a decade ago to between 600,000 and 1 million today," the paper reports."

They go on to report that 10 million Americans now live abroad although I have also heard the figure as 12 million.

Cozumel Tourist Display

©Beringer-Dratch, 2004. This is the tourist destination "upside". I like Cozumel but, on a big cruise ship day, 30,000 extra people hit this small town.

Sunday, August 07, 2005

Review of the book,Distant Neighbors

Mexican culture, history and politics differ amazingly from ours. It is the time to look for more understanding.

There sits America from sea to shining sea. There is a whole continent washed by both oceans carved out of the lands of native Americans, Mexicans, and anyone else who was not white enough to be coopted or Black enough to be enslaved.

To the south is Mexico. They are our closest neighbors except for Canada. Both share lengthy, contiguous borders with us. But, unlike Canada with whom we bicker now that we can no longer atttack it 18th c style, Mexico is part of a wholly alien culture. It is not America or Canada with a Spanish accent. It is a unique and sovereign country with a totally unique culture even for Central and South America.

It did not share our history of English Common Law nor the American ideal (never met) of democracy and the Rights of Man. It was at one and the same time European, Spanish colonial; multiple, mixed indigenous tribes that had shared ancient civilizations of much mystery (still) and of beautiful cities and advanced scientific and mathematical sciences. The Mayans and Aztecs are the best known although they were and are not the only indigenous groups of Mexico.

This is a complex sovereignty and a unique country that may or may not ever be understood by the English speaking countries. The USA is at the top of that list. The gap of deep understanding between the two is closer to an abyss.

As a stranger in a strange land, living here but still an American; I am not allowed to comment on Mexican politics and even writing of culture is frowned upon unless it is totally positive. Therefore I present a short review of a good, long book on the subject.

Read Alan Riding's book, Distant Neighbors. It is composed of his thoughts and observations-- and they are insightful -- from his years here as a New York Times correspondent. He wrote the book after leaving Mexico.

He wrote of history (America's Conquest that we called "Manifest Destiny" was so different from Mexico's strange domination by a small band of Spanish conquistadores. They came as gods and found a civilization that thought they were. They enslaved and burned books and knowledge and tried to destroy all the old religions. Instead they made one of the most successful societies of mixed ancestry in the western hemisphere (and perhaps the eastern).

Riding also writes of politics, into which I cannot enter, from the viewpoint of a knowledgeable foreign correspondent. He presents a complex story of interlocking parties and battles in a way that the myriad political parties can be almost understood. He presents a picture of the way the political society works that is now being changed but is an ingrained fact of the culture.

Best, I think, is that he tries to explain the culture of a complex society in a way that an American can grasp. That is not an easy chore.

Today, more than ever, America must understand the forces of nationhood, pride, honor and desires of the nations of a shrinking world and especially those of our two closest neighbors.

I leave Canada to American expatriates there and Canadians to explain. I once listened to the CBC on shortwave about a battle memorial where a great defense was made against the invaders. It took quite a time before I realized that the invaders were us.

Thursday, August 04, 2005

Blogcritics Hits 10,000,000 is celebrating nearly three years on the "air" (net, cyberspace, information superhighway...) and yesterday hit 10,000,000 visitors. Eric Olsen, who runs the show with some others I would love to meet in person rather than merely digitally, has posted his feelings on the milestone HERE.

There is also a link on the right navigation column. I have written a number of reviews, commentaries, opinions and, even, a newsy post for them and it has mostly been a good experience. I usually find something or a few somethings to read at the same time.