Begging for Respect

In a recent Atlantic Magazine video-article, titled “Why Don't Democrats Take Religion Seriously?” Emma Green asks, "Why haven’t liberals tried harder to reach the broad percentage of Americans who identify as religious?' Democrats in Washington often have trouble speaking in religious terms, and they reflect a broader liberal culture that doesn’t take religion seriously.'" The answer lies in reality. Liberals/educated people don’t take all sorts of silly shit seriously. We argue about exposing our children to Santa Claus, the Easter Bunny, ghosts, vampires, zombies, talking animals and inanimate objects, along with various gods and semi-gods like Jesus and Mohammed. We worry about the slippery slope of letting kids believe in “harmless nonsense” when they are young enough to imprint on that crap. The upside to believing in nonsense is so small it appears to be immeasurable. The downside is immense.

It is absolutely true that the Civil Rights Movement was driven, mostly, by religious conservatives like Martin Luther King. That was then, this is now. Today, religion has joined forces with the opposite view. Evangelicals and other so-called Christian groups have thrown their hat in the ring with Trump and the Republicans who are trying to turn the US into an oligarchy. Not that this is news, but from the Catholic Church to evangelicals to more traditional Protestant churches, sex scandals, financial scandals, and political wingnutery abounds. For the most part, the practitioners of religion have abandoned any pretense of moral character and its priests have turned religion into a poorly-disguised money machine; just like Republicans.

There is a reason liberals don’t take religion seriously, it is not a serious thing. It’s dangerous, it holds the whole society back, but it is not a subject for serious philosophical consideration.

Just to sum up the argument, you believe that there is a just, kind, jealous, vengeful god who randomly punishes little kids and other innocents with disease, starvation, war, and general mayhem for “mysterious reasons.” You believe that when Jebus comes back you will rise up from the grave (in prime condition, not the rotting mess your physical body became in the grave or the pile of ashes your kids were supposed to preserve) and go to a heaven that is designed to be ideal for every person (with a god who looks exactly like you). Belief is a funny thing. However, no matter what you believe the universe operates on the laws of physics and could not care less about your faith.  

It’s not the delusions or the superstition or even the arrogance that puts off many liberals, intellectuals, and generally sentient humans, it’s the celebration of death. Not just of death of the self but of the whole world. All of the Abrahamic religions have cults that believe the end of the world will be the beginning of Nirvana or whatever they’ve named their Big Rock Candy Mountain.  Christianity, as it is practiced in the US, is particularly driven to end life on this planet in the hope that the “faithful” will drift up to the sky and sit at “the right hand side” of their god for eternity. With the usual poor math skills exhibited by conservatives everywhere, I suspect they haven’t bothered to visualize how remote a position they are likely to have with the billions of believers stacked up on that side of the god’s throne.

If Christians were able to settle on eliminating themselves, leaving the rest of the planet to get along without them, the aversion to their belief wouldn’t be nearly as strong. Fundamentalist Christians appear to have a weak grip on their “faith” so, in case they are wrong and the whole Rapture thing doesn’t happen, they seem to be convinced it is important to turn the planet into a smoking husk before they drift off to where ever they will be going. That is the reason liberals and other rational thinkers are hostile to religion. If you want to Jim Jones yourself into oblivion, please be our guest. If you want to take the rest of us with you, get ready for a fight.

Double-Down or Half-Down?

A well-known local American motorcycle gear company is, like everyone in that industry, experiencing a severe down-turn in the business. Motorcycles are not looking like the wave of the future right now. In fact, if I were forced to bet one way or the other I’d have to bet that motorcycles will be solely for recreational use by 2030 with no or limited access to public roads and with almost no affordable options for liability insurance. It’s that serious. Many of the companies that have wallowed in easy money for the last 30 years are now struggling to maintain any sort of visibility or customer base. As the last of the Boomers moves from a Harley or BMW to electric wheelchairs, motorcycle sales is drawing down fast; especially in the high end market. In my Geezer with a Grudge column and blog, I’ve been predicting this decline for at least a decade and if I weren’t a motorcyclist I’d be happily saying, “I told you so.” I did (tell you so), but I’m not happy about it.

I’ve been buying expensive commuting and touring gear from my friend’s company since the early 1980’s and, mostly, I’ve been a huge fan of the gear this company makes; even though they are almost always the most expensive equipment in their market. Today, with all of the Chinese-made ROW-marketed similar-to-equal motorcycle equipment available it is getting harder to justify spending the extra money for made-in-USA gear, simply because it is made in the USA. There is only one thing that can make a company stand out from the pack when the pack is large, well-funded, and quickly becoming a commodity. That thing is customer service.

Unfortunately, mismanagement often takes their eye off of the customer service ball too early in the competition game. Like quality, customer service shouldn’t be a profit center subject to simple accounting measurements. Quality and customer service are items that are as hard to quantify and appraise as design and originality. Unlike labor, materials, manufacturing equipment and facilities, the sales force, marketing costs, and management structure and personnel, customer service is one of the intangible things that customers use to assign added value to the products they purchase. Many of the once-great companies in recent history have risen and fallen with their commitment to customer service. People will pay a premium for a product they can assume the manufacturer and dealers will stand behind and they will expect extreme discounts on products without that support.

While company executives often whine that customer loyalty no longer exists, the evidence that it does is overwhelming. The problem is that corporate loyalty is even more rare. The key to loyalty is that the people who most benefit from it have to give the most of it. What a company gets from customer loyalty is the ability to price goods and services at a price that provides a decent profit. What they have to give to get that privilege is beyond-the-expected customer service. Without that expectation, customers view practically every purchase they make as a commodity: a good or service that has many equivalents and deserves no regard to who produced it. Once you are in that bracket, the only thing you have to offer is low cost. Getting back out of the commodity market is thousands of times harder once you’ve dropped into that category.

I created this illustration in a lame attempt to get across this point. The basic concept ought to be pretty obvious, but it isn’t to most executives. A zillion years ago, I taught quality courses for the Phil Crosby Quality is Free–based “Quality College” training program. One of the examples we used that I’m going to have to make up the numbers for (because I can’t find this reference anywhere today) related to the restaurant business. The rule is something along the line of “it takes $5 worth of advertising to attract a new customer, 5 seconds of poor service to send them away, and $5,000 in advertising to get them to try you again.” If you look at my illustration, you’ll see there are several nodes where that “5 seconds” thing can happen and what happens next is that your customers will try everyone else before they give you another shot.

For example, I recently paid as much to have some of my gear repaired by the local company as I would have spent on a new Chinese-made equivalent. When the repaired gear arrived, I discovered a good bit of the equipment was in worse shape than it was when I dropped it off for repair. I spent a couple hours  repairing the repair. If I have to buy similar equipment again, I won’t be able to forget that experience. That’s 40 years of customer loyalty possibly blown up with a single half-hearted repair job.

What American Medicine Does and Doesn’t Do

A recent article in a terrific reoccurring physician’s column in the Duluth Reader titled, “14 Lies that Big Pharma and Their Academic Psychiatrists Teach Medical Students” that details the many fables and fairy tales Americans believe about what the FDA does and doesn’t do. (Hint: What it doesn’t do is insure drugs and devices are safe for use.) This particular article is about the delusions Americans regarding the safety and effectiveness of the drugs and devices approved by the FDA. Americans are weird in that they distrust their government for the easy stuff and are as gullible as newborn babies about the hard stuff. Dr. Gary Kohls article in the Duluth Reader bursts some bubbles about the FDA’s part in the mental health drug business and that is a pretty important story. He describes the lack of sophistication in the actual drug development, testing, and application while pointing out how much better Big Pharma’s marketing and politics are than their science. "The so-called Selective Serotonin Reuptake Inhibitors have been deceptively mis-named by Big Pharma because those amphetamine molecule-based SSRI drugs do NOT mess only with serotonin neurotransmitter systems! In fact, they do not actually raise total brain serotonin levels as advertised. Actually, SSRI drugs deplete serotonin long-term while only “goosing” the release of serotonin at the synapse level while at the same time interfering with the storage, reuse and re-cycling functions of the serotonin synapses that, by the way, are far more abundant in the human intestinal tract than in the central nervous system." You wouldn’t get that from any of their ads, would you?

I have a mixed history with the FDA; the old and the current. When I worked for a pacemaker/implantable cardio-defibrillator (ICD) company in Colorado, Telectronics Pacing Systems, that was eventually closed down by the FDA and bad publicity for a variety of awful Class 1 recalls. While all that was going on, with FDA inspectors and manufacturing experts roaming the halls of our company, many of the company’s engineers were saying, “Thank God there is an FDA,” because the British Pacific Dunlop executives would have been willing to carve the company’s patients up for meals if it meant they’d get a bigger quarterly bonus. As it was, Telectronics had pacemakers and ICDs with defective connector block seals that leaded body fluids into the electronics and caused sudden and unpredictable device failures and leads that included a “forming wire” that would poke through the leads’ insulation and carve chunks out of patients’ atrium walls. Yes, that would often kill them.

Telectronics’ product failures were eventually exposed when an autopsy of a young woman who died from the atrial carving revealed a piece of wire sticking out of the atrial “J” wire’s insulation. The pathologist, a friend of the cardiologist who performed the pacemaker implant, described the wire to the cardiologist; assuming his friend had accidentally left a guiding stylet in the atrial wire. The cardiologist was absolutely certain that wasn’t the case and asked for further investigation, risking his own reputation in the process. The resulting investigation eventually involved the FDA investigators and the discovery that several similar incidents had occurred in the past, with no certain knowledge of how many such failures had resulted in patient mortality and morbidity. That knowledge and the discovery that the company had covered up the knowledge of both types of failure brought the full attention of the FDA. At that time, Dr. David Kessler was the commissioner of the FDA and he took the job very seriously. Appointed by Bush I and replaced in 1997 by Clinton, with practically nothing of substance from then on, Dr. Kessler ran an FDA that was both active and patient-oriented. After Kessler’s FDA, American patients have been pretty much on their own as far as anything resembling federal regulation of food and drugs.

One of the experiences I had with Telectronics was in a team of folks who were writing the clinical trial plan for the company’s ICD products. I got to study chemotherapy and cardiac therapy drug trials and their methods and results. The results were every bit as interesting as the methods, since the results were so ambiguous that I don’t know how anyone could conclude either of those drugs worked worth a damn. Statistically, every clinical trial we looked at demonstrated that the state-of-the-art drugs were inconsistently the equivalent of placebos. Sometimes, the drugs were slightly worse. As Dr. Kohls explained with his, “Myth # 3: ‘FDA approval means that a psychotropic drug is safe long-term’” In fact, FDA approval means nothing. Drugs and devices "are usually only tested in human clinical trials for a couple of months before being granted marketing approval by the Big Pharma-conflicted FDA. " FDA approval is just a stamp applied to practically anything the medical industry wants to foist off on patients and medical providers.

The next train wreck, I mean medical devices company, was CPI/Guidant. When I first applied, it was still CPI, the company that invented the ICD. CPI had a reputation for being “conservative,” in the real definition of that word. Their devices (pacemakers and ICDs) weren’t tricky, but they were reliable, had long battery lives, and had only the features necessary to do the job well. CPI was acquired by Eli Lilly corporation in 1978 and Lilly added a pile of medical devices company to its portfolio until 1994 when it spun those companies off into Guidant/CRM and the rest of the mess that became Guidant. I interviewed  in 1995 and early 1996 and by the time I started work in March of 1996, Lilly had separated itself from Guidant and the retirement and pension package I’d been promised vanished without anyone bothering to tell me about it. Since Telectronics was being pulled to pieces for the patents and valuable employees, it probably wouldn’t have made a difference, but it would have been nice to know what I was getting into.

What I was getting into was a carbon copy of the situation I’d just left. Guidant eventually collapsed under its own avarice and incompetence. To make a long, painful story short, one “Quality Committee” meeting illustrated the company’s philosophy perfectly. When a team of quality assurance engineers presented their analysis of a defective device that needed to be notified on, the executives in the committee asked, “How will that affect our bonuses this quarter?” Since the device failure was a life-threatening malfunction, no one had done the necessary research to determine how that would affect executive compensation. Imagine that.

Eventually, and after hundreds of patient injuries and a few deaths, a few doctors began to suspect their corporate beneficiary was less than benevolent. Even weirder, a couple of those doctors did the minimal research necessary to discover that even their own small group of patients had been affected multiple times by Guidant product failures. I had collected more than 600 such failures for one of the products I monitored and I waited for more than a year for one patient-oriented cardiologist to ask me, “Have you ever seen this before.” Never happened.

When Guidant died, 95% of the company’s products were under FDA Class 1 recall, but the FDA deserves little-to-no credit for uncovering the company’s many problems. Like the physicians profiting from selling these defective products, the FDA’s attitude was summed up by something an “investigator” said to me not long before I quit medical devices, “We don’t care what kind of product problems you have or how many patients you kill as long as we don’t read about it in the paper first.” As long as the FDA wasn’t embarrassed by being shown up by a media investigation, they will let Pharma and Devices do whatever the hell they want with patient safety and therapy effectiveness. To them, patients are nothing more than “lab rats who clean their own cages.”

Parents or Not Parents?

June 3, 2014

It’s summer 2014 and I’m getting Facebook, Twitter, and email bombed with “we’re having a kid” notices from ex-students and friends. I guess I’m supposed to be happy for them, but if that’s what they expect they don’t know me very well. Do they?

I’d offer a general rule of thumb (with the original definition of that rule intact) for prospective parents: If you would have hated to be your own parent (think during ages 13-25) you will be a lousy parent and will raise a terrible kid. Sure, there are a tiny number of exceptions to that rule, but they mostly prove the rule.

Remember, even alligators care for their babies as does about every species on the planet, but humans need care, feeding, nurturing, patience, investment (emotional and financial), training, and protection well into young adulthood. Babies are the easy part and if you have never cared for a baby I recommend you put in some time doing that before you consider reproducing. Of course most people aren’t considering reproducing at the time of conception, anyway. They are just fucking. After they discover what fucking leads to, they pretend they wanted to be a parent all along because they’re too lazy and cowardly to hunt down an abortion clinic. Not long after that, a kid is born and lousy parenting ensues.

Still, it’s all easy and somewhat fun and games until the little brat turns into a teenager. Then it all goes downhill fast. The kid turns into a fair reproduction of the parent at that age. The “parent” loses patience with the mirror reflection of him/herself and the kid continues the cycle with another kid; or ten.

And don’t forget, if you reproduce you have to pretend to care about your kid’s future. You can fake-pretend by joining a religious cult (all religions are cults) that absolves you of responsibility for the environmental, economic, and social disasters you’ve left for your kid to suffer and clean up, but that’s just avoidance. Every generation in front of us did the same damn thing and that’s why much of the ocean’s surface and bottom are covered in plastic and human waste. It’s why we stumble from one war to the next, each one driving society closer to total war and global annihilation. It’s why our species and culture gets dumber and dumber, because smart people do not reproduce (or do in small numbers; ie. less than 2).

Of course, you could actually care about the next generations’ futures and try to do something right for your children and your children’s children. But if that’s the kind of person you are you probably didn’t meet the criteria I started out with in the beginning of this essay.