Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

9/01/2026

Post Mortem: Pointless Practicing

Like all of the "Post-Mortem" essays, this one was intended to be auto-published after my death. I've intentionally let one of two slip past that target, but as long as I can reset the publication dates on these things I'll keep pushing them back until I can't.  Damn it, I'm still alive in 2025, so it goes back yet one more year.  

Well shit, I'm still putting up with this nonsense in 2026?  Screw it.  I'll let this one go. 

August 2, 2017 

Modern, at least American, medicine and doctors are a curious mix of uselessness and hope. The things that doctors and medicine are useless at are the important things and the things they cling to a claim of value for are hopeless. Crippling arthritis that inhibits your ability to use your hands for everyday necessities? Forget it, medicine is useless. Don’t even bother asking for help because none exists. Cancer of a vital organ or even several organs? Well, maybe, if you are willing to subject yourself to surgeries, radiation, and toxic chemicals and almost certain poverty and debt regardless of your insurance situation.

Forty years ago, I ripped out the fingernail of my left hand’s middle finger and that fingernail never grew back in any useful form. A couple of years ago, while helping my wife move a plant from a friend’s home to ours. Turns out, that plant (Snow on the Mountain) is a toxic relative of poison ivy. My wife experienced a nasty rash on her face that cortisone shot quickly stopped then cured. I am allergic to cortisone, so I tried to treat the growing, painful rash on my hands with a variety of ineffectual over-the-counter medicines, natural treatments, and a lot of whining. I went to the doctor, but was told that I was pretty much on my own since their only solution, cortisone, was not an option. The end result was that my already mostly frail and undependable fingernails began to develop a fungus that turned them into even larger handicaps. As you might suspect, there are no practical cures in modern medicine for nail fungus and I’ve been left to deal with that on my own.

And tinnitus. My constant companion for at least 20 years. Medical “science” has found absolutely nothing to combat tinnitus, but there are no shortage of non-functional tactics upon which you can pay big money for even bigger disappointments. For a long time, it was a slight background noise only in my left ear. It was enough of an irritant that when I spent time in an anechoic chamber in St. Paul several years ago I mostly thought about the first time I was in such a chamber and how, after accommodating myself to my own rushing blood and cardiac sounds, I became irritated at the asynch heart beats of the three other people in that chamber with me. No such problem 40 years later. Thanks to that constant tone, I probably couldn’t have heard someone else’s heart if it were in my hand, held next to my ear. Then, a few years ago, an inattentive evening spent in a Red Wing club and I was left with much louder and more irritating tinnitus, now in both ears. No thanks to what passes for “modern medicine,” there is nothing to be done about it.

Likewise, when my hands began to wither and twist into uselessness from arthritis a few years ago, other than pain medications, modern medicine takes an “oh well, that’s too bad” approach to my problem. I’ve had an orthopedic surgeon take x-rays and shake his head in sympathy and my regular doctor tell me “it’s just part of aging.” No comfort or relief from either of those “diagnosis,” but there is a reaffirmation that medicine is helpless to deal with problems that can be easily measured like rotting nails or disabled hands.

This week, my aging symptom is a return of my double-vision problems that first occurred last year about this time. At that time, my diagnosis was that the muscles that coordinate my eyes into a coherent single image were simply wearing out from age and over-use: my left eye has always been grossly near-sighted which exercises those muscles unusually. My diplopia was treated, at that time, by adding prisms to my glasses prescription. That worked pretty well until this last week. At least for the short term, I’m wearing an eye patch over the eye that is mostly useless for the task at hand: the right eye when I’m reading and the left eye when I’m driving. That was a “fix” that cost me $7 on Amazon.com. I’m sure Mayo Clinic’s solution will be more expensive and, possibly, less effective. I am learning how to close one eye without tensing up the muscles of that eye and causing ever more headaches than I usually experience. The end result is, so far, a diagnosis of "ocular myasthenia gravis." Still, no real solution for the double-vision but a very expensive prescription medicine.

So, as a result of my last year’s (2018) physical, my doctor noticed that my Prostate-specific antigen ( or PSA) level was around five. Supposedly, anything over four is a concern; a warning factor for cancer. I’m seventy-one now, so “concern” is a relative term. Pretty much everything about my body is turning into a warning factor of some sort. I hurt everywhere. My physical limitations abound. I am seventy-one, pretty close to, or slightly past, the terminal age for someone of my economic class and genetics.

I watched my father degenerate from an active person who regularly played tennis and golf well into his late-60s into a couch potato who was so physically limited that his only “activity” was to sit a few inches from a big screen television and try to pick out the action from various sportscasts. He hated his last two decades of life and only his fear of death—an odd characteristic for someone so religious—kept him alive for at least a decade of suffering. My father went through several surgeries for cancer, a couple for what turned out to be a misdiagnosed thyroid problem, and at least two for various cardiac problems. Not one of those surgeries or procedures extended his quality of life and I doubt that any of them did much for his longevity.

The chances that I would submit myself to any sort of elective surgery, exploratory or remedial, are tiny-to-nonexistent. Broken bones and open wounds aside, I consider almost all surgery to be “elective.” I have zero faith in an industry that can’t fix small, obvious, important patient problems but claims to have miracle cures for the big stuff; cancer and cardiovascular diseases. This is, after all, a medical industry that regularly creates complicated drug addictions by prescribing medications to offset the effects of medications. It’s almost impossible to find an addictive compound that at one time the medical industry and the people who will only “practice medicine” for their entire careers didn’t claim was not addictive: from barbiturates to stimulants to synthetic heroin to depression and anxiety medications. If you can trust the opinions of a group that is so wary of its own expertise that life-long professionals only claim to “practice medicine,” good luck with that. I have been up-close and personal with some of the richest and most incompetent physicians the country has to offer and I wouldn’t trust most of them with a sharpened pencil.

11/04/2022

“Where Did They All Go?”

In a discussion that turned weirdly (hysterically similar to the stuff that used to go on in my parents’ home whenever they suffered any kind of cognitive dissonance sneaking inside their very conservative western Kansas news-blinders) an acquaintance shrieked “Where did they all go, then?” and “nobody wants to work anymore.” This was at the end of an interminable last-of-its-kind (I hope) dinner where pretty much everything finally went off of the rails with little hope of reconciliation. That had been a long time coming, but when it arrived it was a little startling. Still, the conversation (screaming match?) inspired some investigation into a topic I’ve wondered about.

A lot of “where did they all go” question is old news for me. Friends working in a dozen different industries have kept me sort-of-in-touch with manufacturing tech, and support work after I retired in 2013. All of them, by the way, are making more money in today’s dollar than I ever did at my peak income. Pandemic and supply lines stuff aside, people with skills are in huge demand and everyone else can, at least, find a job if they want one.

Tech and other sorts of parts in the supply lines were coming unglued in lots of manufacturing in early 2018 as Trump’s “trade” fuckups scared some of our economic partners, like Canada’s forestry production, into finding more predictable/rational trade partners. At least one guitar manufacturer in California started using “urban forestry” to supplement their diminishing access to “tone woods” like red and yellow Canadian cedar. Lots of the raw materials we used to get from South America is now going, first, to China, Japan, and the EU. Those infamous ”chip shortages” that suddenly appeared in the media as “lost in the supply chain” during 2020 and 2021, were actually vanishing about mid-2019, again thanks to Trump’s trade off-again/on-again weirdness with China, Taiwan, and India where almost all of that stuff has been made since Reagan purged the US of manufacturing investment in the 80s with his bizarre and foolish Dribble-Down Voodoo Economics. If we didn’t want it, lots of other buyers did. Now, we’re nobody’s preferred customer. When you’re building (or working in) a service economy, many of these problems appear insignificant. In manufacturing and engineering, they are show-stoppers.

As far back as mid-2018 a friend who was working for a company that supplied most of the automotive industry with design and production of high-tech headlights complained about the fact that Chinese suppliers no longer felt obligated to stick to their price quotes for manufactured parts for which they knew the US (and EU) could no longer provide alternatives. Not long after that, the company began shutting down the parts of their production that relied on semiconductor manufacturing and my friend was prewarned that he’d need to get out while the getting was good. It took him less than a week to find a better paying job in medical tech and he left Detroit in early-2019 for Minneapolis.

As for “nobody wants to work,” justifying that claim with our current 3.1% unemployment takes some hard work or simple denial. Our acquaintance chose denial, which made for an entertaining song-and-dance and an amazing display of ignorance when it comes to how employment works. It helped that neither of these folks were ever skilled labor (Unless you call being a junior college adjunct anthro “skilled?”) and neither have any sort of employment record worth talking about. If you haven’t been involved in chasing this country’s economy from one area crash to the next during the past 50 years, it’s hard to explain job hunting. I, on the other hand, have never experienced the kind of job opportunities available to today’s employment-age workers. I’m getting hit up at least a dozen times a month, through my LinkedIn page, for jobs I’m qualified for and some that aren’t even in the vicinity of my experiences.

Oddly, this Chamber of Commerce article, ”Understanding America’s Labor Shortage,” is surprisingly informative (for a group sadly known for its corporate propaganda output and disconnect from much of reality). Thanks to a variety of issues—from early retirements to Covid deaths and long-term Covid effects, to the long-standing child care problems—“in 2021, employers ended up adding an unprecedented 3.8 million jobs. But at the same time, millions of Americans have left the labor force since before the pandemic. In fact, we have more than three million fewer Americans participating in the labor force today compared to February of 2020.” That isn’t including what anyone who has followed numbers in national disasters knows will be a much larger than the reported 1,2M US citizens dead from Covid.

Speaking of killing us with Covid, thanks to the MAGAt nitwits and their “fearless leader,” almost 20% of the US healthcare workforce quit during the pandemic and another 12% were laid off, about 1.7 million professionals gone from hospitals and clinics, The people left in that overstressed, underpaid industry are considering quitting, too: 31% of them, in fact. They are not having any problems finding alternative work, either.

The Chamber’s survey found that of the many people who have yet to return to the workforce, “Twenty-seven percent indicated that the need to be home and care for children or other family members has made the return to work difficult or impossible. More than a quarter (28%) indicated that they have been ill and their health has taken priority over looking for work.” That survey found that many of those folks are not returning to the workforce because they are “concerned about COVID-19 at work, indicate that pay is too low, or are more focused on acquiring new skills and education before re-entering the job market." Some of that last group are taking advantage of the fact that many skilled labor unions are providing free and paid education for highly paid skilled in-demand jobs such as electrician and plumbers.

Retirements are kicking the workforce’s ass, too. That same article stated, “As of October 2021, the pandemic drove more than 3 million adults into early retirement.” At the other end of “ where they went,”Over the last two years, nearly 10 million new business applications were filed and in 2020 alone more than 4 million new business were started.“ This is exactly the kind of economy, except for the booming job market, where I started my Wirebender Audio Systems business after a layoff in 1980 and various good and bad times kept that going until a few months before I retired. So, good for them.

And that is where they all went. Any questions?

10/25/2022

Spreading the Word, Testing the Waters (Part 1 of 2)

“Yup, it’s true. The virus was ‘engineered.’ In an unscientific, mostly-illiterate way, you whackadoodles were right all along.” In about a dozen words, the microbiologist, who Tucker Carlson had been interviewing for the past half-hour, confirmed practically every unhinged Covid myth the Moscow Mouthpiece had made during the past four years.

All of the ridicule Tucker had received from liberals for his anti-vax position throughout the years of the pandemic was momentarily shut down. Tucker had asked, "How many Americans have died after taking the COVID vaccines?" And the experts replied with numbers and facts that had no effect on Friar Tuck’s position. Tucker had literally shrieked, "EVERYONE IN AUTHORITY WANTS YOU TO GET YOUR VACCINE" and hinted at the undisclosed deaths caused by and the ineffectiveness of vaccines. And he was right that the “authorities” he ranted against were scientists and healthcare professionals who absolutely recommended that everyone be vaccinated.

The CDC responded with "Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history," which just inflamed Tucker’s agitation further arguing that the CDC, MSNBC, NPR/PBS, and CNN, the ex-employer from whom he was “involuntarily terminated” and Fox’s arch-media-enemy, cannot be trusted. Even some of Tucker’s co-workers at Fox betrayed him. Jonah Goldberg ridiculed Tucker’s logic with, "FACT: Every single person who ever died blinked before they died. The vast majority — like 99% — blinked mere seconds before death. And yet, no one talks about this silent killer." Carlson’s hero, Donald Trump, was almost his only ally in his crusade against science and vaccinations, but when Trump “lost” the 2020 elections poor Tucker was out on a limb with only a few million (73 million in the USA, to be precise) marginally-literate supporters.

But now, Tucker’s wildest paranoid dreams were being confirmed by an epidemiologist loosely connected to the World Health Organization, Dr. Simon Turenne. Turenne had agreed to go on air, live, with Tucker Swanson McNear Carlson on the Fox News’ “Tucker Carlson Tonight” show after nearly three years of a world pandemic that had, supposedly, taken at least 20 million lives, world-wide and almost 2 million in the United States alone. Dr. Turenne was a thin, well-dressed, angular man of indeterminate ethnicity who seemed unusually comfortable in the company of a man who clearly, loudly, and often spoke of his disdain for anyone involved in science or the reality-based world. In fact, the Fox News crew had been generally hostile to the scientist from the moment of his arrival and he hardly seemed to notice, let alone be offended or nervous. When Tucker asked questions in his usual snide, smirking style the doctor smiled back at him and calmly answered each question as if the arguments were being presented by a rational, intelligent person. That act of acknowledgment seemed to push Carlson further over the edge of the cliff from which he had long since jumped; his wrath was no longer even slightly contained.

“’Yup!’ That is what you have to say for creating a disease that killed millions and has cost nations countless coin and stability?”

With that infuriating smile still plaster to his face, Dr. Turenne replied, “’Yes’ seemed a little formal, considering present company and your audience, but if ‘yes’ makes you feel better the answer is the same. The original SARS-CoV-2 and almost all of the variants that followed were man-designed or human-evolved. Actually men and women did the “designing,” since it was a cross-national and unisex effort.” That smile, again, this time a little wider bordering on outright happiness.

Tucker looked as if he’d been slapped or had seen an actual naked woman. Years of pretending to be outraged at his own conspiracy inventions had left him unprepared to be honestly outraged. You could see the steam building as he sputtered his way toward a response. But before he got there, Turenne continued, “It was an experiment. There was a lot of argument among the design community as to how a response, especially among First World countries, would play out. We were, honestly, impressed with how the USA reacted with both a collection of well-reasoned precautions and effective vaccines far sooner than we imagined. Scientists not in our loop created an assortment of vaccines and testing processes that will set the standard for however long the species continues to survive. Which, by the way, is estimated to not be much more than one hundred more years, at best, with the current climate degradation well underway.”

Tucker’s small narrow mouth and vanishing lips quivered and those strange looking puppy ears seemed to stick out even further than usual as they turned beet red. His cheeks inflated and deflated as he drew in the necessary air for a typical screaming response. “What the hell were you people thinking!” Tucker finally managed to shriek in his shrill, barely-understandable imitation of an upper-class, educated white man with little tolerance for opinions that do not mirror his own. “You intentionally murdered two million Americans [Obviously an accidental slip of the tongue, since up to this point Carlson had insisted that only a few thousand US citizens had died from the Trump Plague.] as an EXPERIMENT?” His pitch had raised nearly an octave above normal by the last word. “What kind of monsters are you?”

Despite being practically drenched with spittle from Tucker’s frothing, spluttering outburst, Dr. Turenne remained calm and looked clearly amused by Carlson’s emotional response. “A more rational and responsible question would be ‘Why would you engage in an experiment that had this radical an outcome?’ The answer is that it appears to be the only way to solve many of the problems the planet is facing, with or without humans participating in either the solutions or contributing more to the problems. It was an experiment to test the world governments’ capabilities, the individual countries’ populations, and mostly a test to see what portion of the world population a real pandemic would most affect. As a test, it succeeded beyond our wildest expectations. We have collected more data in the last four years regarding all of the issues and political systems and human responses than we expected to obtain if the pandemic had gone on in experimental form for at least another decade.”

[To be continued]

Spreading the Word, Testing the Waters (Part 2 of 2)

All Rights Reserved © 2022 Thomas W. Day

10/24/2022

Spreading the Word, Testing the Waters (Part 2 of 2)

[Continued from Part 1]

You could almost hear and see the steam escaping from somewhere under Tucker’s carefully sculpted toupee. A burst of unintelligible noise escaped that, eventually, turned into a series of insults, raving astonishment, and disconnected partially formed statements and questions. Dr. Turenne waited patiently; removing a handkerchief from his jacket with which to remove Tucker’s expelled saliva from his face and clothing. After the fake-newsman/entertainer’s expletives and hysterics wound down to sputtering and nonsense syllables, Dr. Turenne interrupted with, “Sorry. I couldn’t identify anything that I could respond to in all of that, so I’ll continue explaining the experiment’s results.

“What we learned was that in most undeveloped countries, if a vaccine was available the overwhelming majority of residents in those areas would take it immediately. In countries that most citizens in the United States might identify as ‘socialist,’ those citizens mostly trusted their governments to do a reasonable job of testing and distributing vaccines and information. Both of the first two types of societies, under-developed and ‘socialist,’ were able to vaccinate nearly 100% of their populations as soon as vaccines were available. And we worked quite hard to ensure that vaccines were made available as quickly as possible, including ignoring patent rights and corporate profits whenever possible. In the West, certain groups were also likely to obtain vaccinations immediately and those groups quickly learned the necessary skills to prevent infection.

“Other groups, your audience for example, tended to gravitate toward the worst possible information sources, like yourself, and remain unvaccinated and generally averse to taking any other precautions even four years into this experiment. First world countries in the west have done a particularly good job of segregating intellectual haves from have-nots; geographically and socio-politically. That reaction was particularly helpful for the purposes of our experiment.”

Tucker’s mouth, now wide open, failed to respond. Dr. Turenne  continued, “The kinds of people who will not make the slightest effort to protect their families and communities are also the people who will be unwilling to change their behavior regarding global warming, racial and economic inequality, ending nuclear armament and wars in general, and any number of issues that will result in the extinction of the human race and serious damage to almost all life on this planet. Their self-image and imagined self-importance is the only value they worship and that has turned out to be a spectacular advantage in ‘culling the herd.’” Turenne punctuated the end of that statement with finger quotes.

Finally, Tucker found his now hoarse and somewhat squeaky voice, “Culling the herd? What the fuck are you talking about?” At this point, Tucker was somewhere between outraged and terrified. His beady little eyes had narrowed to pinpoints and his lips had vanished entirely. There was no sign of his characteristic smirk.

Turenne’s smile returned in full force, “Thanks to influencers like you, our experiment has ended early and the conclusions are irrefutable. Our trial virus was a total and absolutely unpredictable success. I am here, primarily, to thank you and your misinformation colleagues for making it happen so quickly and moderately painlessly. Initially, there were more healthcare workers infected and even killed than we would have hoped, but for the most part they learned how to protect themselves. After the initial months if the pandemic, the few healthcare providers and first responders who were fatally infected were among your disciples. Of course, more than one million physicians and nurses left the US healthcare system in the first two years of the pandemic.

“However, the experiment is over, the data has been collected and analyzed, and the resulting actions have been taken.” Dr. Turenne’s smile dissolved into a more serious expression.

“What actions?” Tucker not only looked confused, he looked nervous and his question was barely audible.

“The last variant has been introduced and within a few hours of this broadcast, the world will begin the nasty job of cleaning up the real outcome of pandemic’s final form and getting on with the important work at hand. Depending on your perspective, and I suspect you will be around to have one since it is clear from your dissembling on the subject that you might be fully vaccinated, although I won’t be surprised if you haven’t kept up your booster regimen. If so, that will be unfortunate for you but no loss for humanity.” And the smile returned.

At the end of Dr. Turenne’s response, Tucker began to look terrified. A long pause ensued as Tucker tried to formulate a response under what had become a flood of information and an overload of doubt and suspicion. Finally, his rasping and hesitant voice returned to him and he asked, “What are you talking about? I thought the pandemic was over. Even Biden said . . . “

Now, Dr. Turenne laughed out loud. “Now, that has been your mistake from the beginning. You keep pointing your fingers at US ‘bleeding heart liberals’ and Democrats, but this ‘engineered pandemic,’ as you so cleverly deduced, is not a product of the US government; and certainly not the Chinese government or any government. This is an experiment and a world population solution that was engineered by a collection of concerned scientists and physicians across the world. The initial Covid variant and the evolutionary variants that followed were just a biological and data-collection trial balloon. Everything from the distribution and spread of the virus to the misinformation response to vaccines and preventative measures have been collected, assessed, and evaluated. Once the data and tactics were correlated, the testing phase of the experiment was complete and we are confident that the finished design will be at least 99% effective. The only undetermined variant is how quickly and efficiently the clean-up will be managed.”

Tucker’s usual quick, inaccurate, and snide response failed him and he squeaked out, “Clean-up?”

“Of course, here in the United States we anticipate approximately 140 million deaths in the next 24 hours. That will create approximate 10.4 million metric tonnes of human waste that will have to be disposed of quickly. Countries like Russia, England, Ireland, and Australia will have relatively similar clean-up problems to contend with, since those countries have comparable ‘conservative’ unvaccinated populations. ‘Vaccinated,’ by the way means having the initial vaccination and all boosters as of at least 30 days ago when vaccinations had been available across the world for at least 120 days. If you have the usual Covid early symptoms, you might want to get your affairs in order quickly. As Edward R. Murrow used to say, ‘Good night and good luck.’”

While Turenne beamed that irritating smile at the camera, Tucker coughed and began to look frantically around him at the Fox News familiar faces all breaking out in a sweat, many heading for the exits. 

[The End, Literally?]

All Rights Reserved © 2022 Thomas W. Day

 

5/31/2021

If You Build It . . . You’re A Fool

Like a lot of small rural villages, Red Wing, MN has visions of grandeur that may be reflections of the town’s past or, more likely, are evidence that down-breeding has consequences. The current city bureaucracy and mismanagement have been hustling growth bullshit since the momentary burst in the area’s economy in the 70’s when Xcel’s Prairie Island Nuclear plant generated a substantial increase in the city and county population and tax base.Since the 70s, Red Wing has clearly suffered from a Field of Dreams syndrome, believing that if the city builds enough expensive crap people will finally be attracted to moving here and creating jobs and businesses that will make the dreamers look like actual planners. So far, if anyone is coming they must be the ghosts that populated that corn field baseball game in Costner's movie. They are very much invisible.

The city “planners” have been hacking away at a weird idea to convert the only significant riverside area of the city into some sort of “shopping district" and a misbegotten concert venue. The project name is the "Old West Main & Upper Harbor Renewal Project." The picture above is what the area looks like now and it is obvious that this is a grossly underused and somewhat unsightly waste of a prime Mississippi River location. The two videos below are concept renderings of the anticipated outcome of this multi-million dollar project in an economically disadvantaged area that has a mostly-abandoned downtown and a rapidly vanishing retail economic segment (like almost every small town in the country).

It’s a dream, obviously, and one based on a gross over-estimate of the city’s planning and development skills that could only be sustained if one were to ignore the long, expensive, and sad history of the city’s weird attempts to encourage growth, population-wise and economically. Currently, what businesses exist in the area are a couple of biker bars, some tiny and insignificant consumer retail businesses, a fair amount of small manufacturing, and some of the city’s scabbier housing units. Odds are, when the $3.5-5M are spent, if the city is lucky a few of those businesses will survive the customer and access problems caused by the grossly optimistic time schedule for the project. My bet is that there will be no more than one more restaurant in the area and several of the small manufacturing companies will either be forced out or will leave, probably Red Wing altogether, “willingly.” And the local citizens will be stuck with another large cost overrun bill, higher taxes, an enlarged and even more inefficient Public Works department that will do at least as poor a job of maintaining both the “pedestrian bridge” and the additional sidewalks as they do with the existing paths, sidewalks, and city parking areas. All of this as Xcel is likely to continue to decommission the property tax cash cow that has, in the past, funded every City Council pipedream and city planner's vanity “legacy” project since 1970.

In case you think I’m overstating Red Wing’s development past, here are a few examples of the city’s development track record. #1 the most recent (2017 through 2019) Spring Creek Road Project was promoted as being a business “starter” that would free up anticipated commercial real estate and increase business to existing businesses and to “to reduce traffic deaths along Highway 61.” That last bit was a pretty tough sell, since the next major intersection, which has all of the “features” the Spring Creek Road Project would bring to the Spring Creek/HW61 intersection is one of the city’s highest “impact points” for crashes and traffic deaths. 
This foolish project was, unbelievably, “20 years in the making.” Instead of accomplishing any useful goals, the city removed 3 supposedly desperately needed lower income duplexes and created two large, toxic-material-leaking and highly illegal junk yards and there have been some spectacular crashes at the new traffic light intersection.I’ve witnessed two of of those crashes while sitting on my bicycle at the intersection waiting for the “walk” light. Not to mention driving one of the city's grocery stores (Econofoods) out of business during the long project delays and due to the difficult access to the

 

This isn't the first time Red Wing has tried to "develop" Spring Creek Road along Highway 61. More than a decade ago, the city removed three houses from the southwest side of the street in a strange attempt to create a commercial section where there had been homes on a street that has about as much commercial appeal as a back alley in an abandoned mining town. Obviously, this was another waste of local taxpayer money and one from which the city learned nothing.

This might be my favorite Red Wing "development" failure. Anderson Park was obviously someone's pipedream of a recreational attraction to the city and for the half-dozen people who use the lower park it really can be a special place to hide out, walk the dog, experience a little mildly natural Minnesota flora and fauna, or start a ride on the Cannon River bicycle trail. Clearly, someone thought that would be a big draw because a buttload of money was spent on this park. 

Just as clearly, that someone had no idea that regular maintenance would be an issue in an area and facilities that would see the kind of use the design implied. Maintenance is not a Red Wing city skill. City sidewalks go the entire winter without seeing a single attempt at snow removal. Water faucets in the few areas where there is some tourist and local traffic almost always remain "out of order" all summer. And this bathroom was massively outside of the city Public Works' capabilities. The city can't even manage placing and maintaining trash cans at the more obvious tourist attractions. A public bathroom on a bicycle trail? What a pipedream. This building has been closed and a public reminder of city incompetence for more than a decade.

The Old Main Street and Harbor area where all of the upcoming and ongoing development disaster is just beginning is a reminder of the city's maintenance lethargy, too. Believe it or not, there is a sidewalk buried under the snow in this picture and that sidewalk remained buried from January to April in 2021, while the city was convincing taxpayers to add even more maintenance to ignore with the newest development disaster. There is almost a mile of this expensive sidewalk that gets ignored by the city all winter, every winter.

Even the newest addition to the upcoming project, the traffic circle and harbor trail, that hasn't been in place for five years and, as you can see by the footprints in the snow, gets used in spite of the city's inability to make even the slightest effort to keep the sidewalks safe to use. You know that giant footbridge is going to be everything from an accidental deathtrap to a suicide launching pad and I'm sure the city will act surprised when the first city budget-crushing liability lawsuit is filed.

And my all-time favorite Red Wing boondoggle happened long before I arrived in Red Wing and, maybe, before we moved to Minnesota in '96. This retaining wall must have cost the city a half-million dollars or more and if it had a development purpose, it failed miserably. My picture doesn't convey how massive this retaining wall is. There are thousands of large retaining wall blocks in this thing and the lot it "protects" is idiotically small and impractical for any serious development. It is for sale, if you are interested, though. Beyond that, there is about 1/2 mile of marginal "condos" and apartments along this frontage road. The development cost to local taxpayers will take a couple centuries to recover. The city owns acres of undeveloped land and various abandoned "business" and industrial properties repossessed over the years due to unpaid taxes. In the right light, Red Wing could become the next great place for apocalypse or zombie movies: just add dead people and/or zombies.

In another burst of irrational optimism, in 2019 the city spontaneously decided to blow $3,655,200 (estimated cost and probably a fraction of the final bill) on a 2nd fire station on the sparsely populated west end of the village. The idea was that adding a dozen fire fighters and a multi-million dollar fire station would shorten the response time by about 5 minutes, at best. Curiously, there was a west end fire station that closed in the 1970s. That must have been a brief burst of actual conservative financial planning for the city that has since been solidly squashed by the "if you build it" nonsense. In a few years, this building will be one more monument to unrestrained municipal spending,
"irrational exuberance," and apathetic and uneducated taxpayers. Whoopee!

If this story and series of pictures does not make you want to hire Red Wing's City Council and the City "Engineer" for your next development project . . . good for you. Personally, with my money I wouldn't employ anyone associated with Red Wing's city government to run a kids' lemonade stand

So, with all of this insanity, why would anyone consider living in Red Wing, let alone moving there. There is one gigantic, overwhelming, massively impressive feature of Red Wing, Minnesota: the Red Wing branch of the Mayo Clinic. The majority of Red Wing's incoming citizens (and out-going, for that matter) are healthcare workers and the senior citizens and retirees they are here to serve. We come to Red Wing because of the incredibly high quality healthcare the Mayo Clinic provides to an otherwise very isolated and under-served area. Lose the Mayo and I'd bet half of us would have our houses and condos up for sale by the end of the first year. There are at least 100 places my wife and I would rather live, but none of them have anything near the quality of healthcare services of the Mayo Clinic. I know of at least another dozen couples, our age, in town who are here for exactly the same reason. Yeah, the Mississippi River valley is picturesque, but the weather sucks 10 months out of every year, and the working-age population are unskilled and uneducated and as racist and foolish as the January 6th Goober Rioters. A substantial portion, the overwhelming majority, of the new construction in town are apartments near the Mayo Clinic.  If that isn't a scary fact for the future of the village, you are either a fool (and highly qualified to serve on Red Wing's City Council) or someone who doesn't care what happens to the town in a decade or two when that big rat passing through the bull snake economy (aka "Boomers") dies off and the places is left with hundreds of expensive and empty condos and apartments and dozens of over-priced/over-sized housing units. It's going to be scary for someone, but not us. We'll be dead. I've been in the situation that the two or three generations behind us will be in before. In the 1970s, I bought a large, older home in Fremont, Nebraska in 1976. By 1978, the Nebraska farm economy had been crushed by Vietnam War-caused inflation and the town's major employers, ag-based manufacturing (like my employer), died like they had been shot in the heart. When we moved to Fremont, there were no more than a total of a half-dozen houses for sale in a 20,000 population town. When we were forced to sell after I was laid-off, there were hundreds of houses desperately up for sale. Not having any real attachment to the area was a big advantage for us. I sold the house for a substantial (for us, at the time) loss, but I got out without having to declare bankruptcy, suffer foreclosure, or being stuck with a house payment without employment for an extended period. So many people we knew went the other route, because Fremont was "home" to them and they didn't feel they had the luxury to abandon the place while the ship-jumping was good; or as good as it would get for the next 20 years or more. I have a strong sense of déjà vu these days in Red Wing. This time, however, I don't have my life savings tied up in a house. I don't have a young career and a young family to manage, but for those who do these should be very nervous times.

11/26/2018

Men’s Lives Matter?

stop-male-suicide-International-Mens-day-Nov-19-2017tI’m on a mail list with a few local guys. Mostly, the point of the mail list is about motorcycles, but one of the guys is growing some kind of facial hair for the Movember organization. Supposedly, this organization is looking for the magic bullet to slow up the rate of deaths by male suicides (white men are 70% of the 35,000 suicides in the US) and prostate and testicular cancer. I can only say, “Good luck.”

Humorously, the organization claims to "know what works for men" and somehow they expect to reduce male suicides by 25% in 2030. I prowled the organization's website following all of the "how we're going to win the fight" links to the expected proclamations of doing something and I didn't see any evidence that Movember knows more about what they are doing than do the so-called healthcare and mental health "professionals." In fact, as WebMD reports "One doctor commits suicide in the U.S. every day -- the highest suicide rate of any profession. And the number of doctor suicides -- 28 to 40 per 100,000 -- is more than twice that of the general population . . ." And, as you’d expect, for every female doctor who commits suicide there are seven men offing themselves. "Male anesthesiologists are at highest risk," for some reason. If doctors don’t have access to solutions to depression mental healthcare, how will Movember manage to reach everyone else? They won’t. As for Movember, H.L. Menken once said something like “For every complex problem there is a simple solution . . . that won’t work.” I didn’t see anything on the Movember website that looked like they even had a simple solution to propose.

The problem is not just a US-thing, either. Men and doctors and male doctors kill themselves at a higher-than-average rate all over the world. If there isn’t a solution, at least there ought to be some attempt to find the reasons for suicides. One of the most interesting insights I heard recently, when a European psychologist was responding to an American right wing pundit crowing about how societies with the highest quality of life and general satisfaction are also among the countries with the highest suicide rate; again, particularly high among men. The response was that there seems to be some connection to the fact that, in a generally happy society, people who are depressed feel particularly miserable about not being part of all that joy. The distance between the average person living their lives and someone with mental illness may feel exaggerated in a country where the average person is more-than-typically happy.

lucy-van-pelt-psychiatristIn the US, mental “healthcare” is pretty much getting a drug prescription for anxiety, depression, or “tiredness” from your doctor. All of the available health insurance plans pay more for pills than for therapy; if they pay for therapy at all. For starters, there is a severe shortage of mental health professionals in the US. The reason is that insurance companies don’t cover that kind of “healthcare.” For example, in my home area, Goodhue County, Minnesota, there is one psychiatrist for every 15,000 residents. Since estimates of the country’s mental health assume about 7% of US citizens have suffered depression at some time and 3-4% suffer long term depression and another 18% suffer from some form of anxiety, that leaves a lot of people out in the cold; even if they were inclined to put themselves on a decades-long waiting list to see a mental health professional. So, the answer is “take a pill” and call me in a year or two if you aren’t feeling better about yourself; if you are still alive.”

Men and boys are in heavy denial, insisting that the problem with us isn't from the outside. Wrong. It's us and our cultural training. There is a video on YouTube from a trans-guy who commented on how he hadn't realized how inhumane male culture is until he became one. There wasn’t much information in his speech, but the comments were informative. There was a crowd of guys pretending “inhumane” means “inhuman” and lots of nitwits imagining that being a macho bully has a place in normal, rational society. My takeaway from the comments was that the people who comment on YouTube videos are not very insightful.  

40 years ago, a friend and I were swimming out to scuba dive on San Clemente reef on a stormy day with 8' waves and 2' visibility and he wondered what we'd be doing with our lives; since we'd clearly outlived our design parameters. His thought was that guys like us were evolved to die with an axe in our skulls or a sword in our guts at about 22. At that moment, we were both in our early 30’s. Since we’d failed in our evolutionary purpose, his question was “What the hell are we supposed to do with the 30-50 years evolution has unprepared us for?” Obviously suicide is the answer about 30,000 US men pick. It is pretty obvious that there is an oversupply of men on the planet and war just isn't doing the job it used to do with rectifying that imbalance. The overwhelming majority of terrrorists and suicide bombers are men and they are just following nature’s coding to try to take themselves out of the gene pool.

Society provides plenty of cues, too. There wouldn't be OSHA labor laws if those rules were only intended to protect men from work injury and death. The whole concept began when women ended up in factories during WWII. As part of researching noise-induced hearing damage for material in one of my Acoustics classes, I found more information about how quickly work noise rule enforcement vanished once women were back out of the munitions factories. The whining from companies about OSHA's rarely-enforced or obeyed hearing protection rules is pretty hilarious when you learn that those guidelines came from 1944 and they are so obsolete (useless when it comes to protecting your hearing for a lifetime) that the rest of the industrialized world (outside of China) has a whole different set of standards and objectives. Again, if the point is in protecting men, it’s pointless to worry about it.

Likewise, a big reason men die from prostate cancer is men don't see doctors nearly as often as women. When we do we just want to get the hell out of there as fast as possible. I know I do. Many men (and women ) live those lives of "quiet desperation" and just want to get it over with as soon as possible.

nra_protectionAs for men and mental health, forget about it. This country decided long ago that the wealth of a few is far more important than the health and quality of life of the many. It's one of the many awful things we adopted from the UK. I don't see that ever changing. It was something Alexis de Tocqueville commented on in "Democracy in America" in 1835. The rich will have all the healthcare they can choke down and everyone else will be victims of our "wealth extraction" healthcare practical joke. All of that adds up to the obvious fact that we don’t care about any of this, as a nation. The only time mental health gets into the national conversation is after some idiot has shot up a school, church, restaurant, or some other public place. Then, it's just to distract us from wondering why gun manufacturers are so well-insulated from product liability. And we are one really easily distracted public. The NRA and their gangster-owned politicians and pundits quickly go into a “don’t regulate guns, regulate crazy people” song-and-dance that is increasingly ineffective at distracting the majority of Americans. So far, it’s working well enough, though. It will always be true that “you can fool some of the people all of the time.”

9/10/2018

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?

clip_image002I 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.”

11/29/2016

Red Wing Is Bad for My Health

My wife and I moved to Red Wing, Minnesota at the end of 2014, after almost 20 years in Little Canada, Minnesota. Little Canada is a bedroom suburb of St. Paul and while it is a an independent city with its own government, Little Canada is really just a collection of home developments with a few bars and a couple of Dollar Stores. Red Wing had been one of my favorite Minnesota destinations since I moved to the state in 1996. Since I moved to Minnesota, I’ve taken my out-of-state friends here to show them why I love Minnesota. The scenery is as good as the Lake States and Midwest gets. The Mississippi River is a national treasure. Red Wing has a lot of history to be proud of and some of it is still standing. There are proponents of the city (55% of the residents would call them “liberals”) who would like to see Red Wing survive and thrive into this century and beyond. The 21st Century infrastructure is here: from high speed, reliable fiber optic internet service to power generation to food production to traditional transportation (including a functioning railroad station and city buses). Unfortunately, there are more people who want to turn back the clock to when white people ruled and everyone else obeyed than there are people who recognize the critical value of diversity and progress.

Most of Minnesota is socially inbred and new residents often complain that, unless you are 3rd or 4th generation, you’ll always be viewed as an outsider and close friendships will be unlikely. Red Wing is no different in that aspect. The first thing I realized about moving to Red Wing was that we were leaving some precious relationships and while Red Wing is “only” 50 miles from the Twin Cities that distance is enough to terminate anything resembling regular association. Relationships are critical to mental and physical health and we’ve replaced deep friendships with casual acquaintances.

The Twin Cities are famous (in the US) for being one of the best places in the country for fitness and recreation. With its bicycle trails, water resources, and easy access to outdoor resources, you’d think Red Wing would have been a good place to be as a retiree looking to stay active. First, we left a pair of cities with a large collection of fitness centers, all actively competing for residents’ dollars and moved to a city with one option, the Red Wing Family YMCA. The Red Wing YMCA is one of two YMCA facilities (Rochester is the other) in the state that does not accept Medicare fitness plans and membership is expensive: nearly $1,000/year for two seniors (or a family of 17). That is twice what we paid for both YMCA and for-profit gym memberships in the Cities. There are a couple of much smaller gyms that do accept Medicare fitness plans, but they only offer weights and machines.

Red Wing is a tourist town and, as such, there is no shortage of restaurants and they are pretty good. Not good for you, but good as in well-designed to encourage over-eating and poor diet habits. Healthy eating is far harder than in the Cities where farmers’ markets and co-ops abound. Red Wing has a seasonal farmers’ market, but the local grocery options are very Midwestern traditional and not particularly healthy; including Wal-Mart and EconoFoods, two national chains that make no effort to stock local products.

One upside is the Mayo Clinic both in Red Wing and in nearby Rochester. After a couple of years of ignoring our healthcare, my wife and I have both found decent doctors at the Red Wing facility and we were fortunate to be here when one of us was found to have cancer. I can not fault the Mayo’s performance in any way. There is, however, no alternative to the Mayo Clinic in Red Wing: no independent physicians or clinics and no other hospital outside of 50 miles north in the Cities. While our experience with Mayo was good, we know several residents who have nothing positive to say about the local clinic and who travel long distances for healthcare.

Educational opportunities in Red Wing are sparse and disappointing. Part of my motivation for moving her was the Guitar Construction and Repair program at Southeast Community Technical College. I attended the program for one full school year, 2015-2016. The instructors are excellent and the program is a state treasure, but it is being down-scaled in favor of a two year liberal arts direction. The school recently renamed itself “Minnesota State College Southeast” in an attempt to move away from the technical school label. The school’s management is mostly absent, based in Winona and barely supervised in Red Wing. The facilities are excellent and you’d think there would be great demand for classes in both the technical programs and in 4-year school prep, but the school is a ghost town most of the day. There are no night classes and much of the program appears to be designed for right-out-of-high-school students rather than the more typical customer for community colleges: working adults. Part of this is the state’s fault, since there is a wrong-headed move to “standardize” the community colleges across the state, which will kill off most of these schools with mediocrity. There is no “community education” program like those found all over the Cities.

Possibly worst of all, in 2016 Trump got 55% of the Goodhue County vote (37% Clinton and 3 other right wing “parties” split the rest of the county). Jason Lewis—a self-declared misogynist, racist (to the point of advocating the return of slavery), homophobic, xenophobic, anti-public education, anti-science regressive—defeated another clearly superior-in-every-way Democratic candidate, Angie Craig, without a platform, without an agenda (other than being against everything), and without a clue. by an overall slim 2% margin but a considerably larger margin in Goodhue County. Lewis advocates tax policies designed to expand economic inequality, eliminating national healthcare, and a variety of failed 1980’s pro-1% policies that even the dumbest economist would stay away from. 

So, the end result of retiring from the Cities to Red Wing has been boredom, loneliness, about 30 pounds of weight gain, and a dramatic loss in social, educational, and recreational opportunities. More than half of my neighbors are regressive, racist, uneducated, and proud of their white entitlements. In all, I’d call this a failed experiment. I suspect Red Wing doesn’t want me and I’m not sure I’ll be able to look at this place the same ever again.