MEDICAL TUESDAY . NET
Community For Better Health Care
Vol VII, No 18, Dec 23, 2008
In This Issue:
Merry Christmas 2008
Tomorrow night, December 24, 1776, marks the anniversary of George Washington leading his troops across the Delaware to attack the British the next day in New Jersey. Thus began the greatest experiment in human freedom the world has ever experienced. The history of governments for millennia has been one of oppression and servitude. Freedom of this magnitude was never previously enjoyed by a nation for 150 years. This freedom has been gradually restricting for the past 75 years. We must be forever on guard that our government does not repeat history. To that effort, MedicalTuesday is dedicated beginning with freedom in health care—the only assurance of privacy in our personal health matters.
[The Texas Federal District Court felt that the action of Presbyterian Hospital and their staff doctors against Dr. Poliner was so egregious that they awarded Dr. Poliner $366 million for having lost his practice without just cause. Dr. Huntoon has done a major service to our profession in his analysis of the Fifth Court of Appeals arguments in the unfortunate reversal of that decision. All physicians need to study this case report very carefully for the next victim may be you. And the facts of the case will make no difference. You will go to the National Data Bank, the tomb for physicians. –Editor]
Editorial: Sham Peer Review: The Fifth Circuit Poliner Decision by Lawrence R. Huntoon, M.D., Ph.D. www.jpands.org/jpands1304.htm
TO read the entire clinical story, go to www.jpands.org/vol13no4/poliner.pdf.
In a sham peer review hearing, the truth and the facts do not matter because the outcome is predetermined and the process is rigged. In a court of law, where hospitals and peer reviewers are granted absolute immunity, the truth and the facts do not matter, because the outcome is predetermined and the process is rigged.
On July 23, 2008, the U.S. Court of Appeals for the Fifth Circuit reversed the judgment of the district court in the Poliner case,  and essentially granted absolute immunity to the defendants. In so doing, the court destroyed the intent of the Health Care Quality Improvement Act (HCQIA), which was to provide qualified and limited immunity to peer reviewers, and it opened the doors wide to further abuse of peer review. Absolute immunity, like absolute power, corrupts absolutely and invites abuse.
On Aug 27, 2004, after hearing all of the evidence presented, a jury rendered a unanimous verdict in favor of Dr. Lawrence R. Poliner, finding that "…Defendants had acted maliciously and without justification or privilege."  Defendants were found to have violated medical staff bylaws, and the jury found that defendants failed to comply with the reasonableness standards of HCQIA.  In commenting on the size of the jury award ($366 million), the court stated: "The jury's attitude and award was influenced by Defendants' unwillingness to acknowledge their own wrongdoing and their callous attitude toward Dr. Poliner at the time of the abeyance/suspension and at trial." 
Although the jury made a factual determination that defendants had not complied with the reasonableness standards of HCQIA, the Fifth Circuit found that bad-faith motives of peer reviewers are irrelevant. The court stated:
Poliner's urging of purported bad motives or evil intent or that some hospital officials did not like him provides no succor…the inquiry is, as we have explained, an objective one. Our sister circuits have roundly rejected the argument that such subjective motivations overcome HCQIA immunity, as do we…[1, pp 18-19] It bears emphasizing that "the good or bad faith of the reviewers is irrelevant [internal citation omitted].…" [1, pp 16-17]
Courts that narrowly apply this "objective test" to the reasonableness standards of HCQIA fail to consider that biased peer reviewers are likely to present biased or false information and act in a biased manner in conducting a peer review against the targeted physician. Instead, courts that apply the "objective test" simply accept a hospital/peer reviewers' version of the case as truth and as objective fact—i.e. the judicial doctrine of non-review. The combination of the "objective test" and the judicial doctrine of non-review creates a steel-reinforced shield of immunity for hospitals and peer reviewers, which victims of sham peer review can never overcome.
The truth cannot be revealed and justice cannot be served when courts employ the judicial doctrine of non-review and refuse to consider the evidence. In its decision, the Fifth Circuit Court stated:
To allow an attack years later upon the ultimate "truth" of judgments made by peer reviewers supported by objective evidence would drain all meaning from the statute…as our sister circuit explains, "the intent of [the HCQIA] was not to disturb, but to reinforce, the preexisting reluctance of courts to substitute their judgment on the merits for that of health care professionals and of the governing bodies of hospitals in an area within their expertise [internal citation omitted]." [1, p 27]
If this same standard were applied in the criminal justice system, courts would automatically defer to prosecutors because they have expertise in the area of criminal law, with no need for either judge or jury to consider the actual evidence. Motives matter, and the objectivity of evidence presented by prosecutors and peer reviewers should not be assumed, but should be subject to fair and impartial consideration of the actual evidence.
Although the intent of HCQIA was to improve the quality of care by encouraging peer review, the Fifth Circuit Court stated:
"[T]he Act does not require that the professional review result in an actual improvement of the quality of health care," nor does it require that the conclusions reached by the reviewers were in fact correct [internal citation omitted]. [1, p 16]
To read the entire Editorial and the references documenting the positions taken, please go to www.jpands.org/jpands1304.htm.
In summary, the Fifth Circuit decision indicates that malice and bad-faith of peer reviewers is irrelevant, the truth does not matter, improvement of quality care does not matter, potential harm to patients does not matter, compliance with medical staff bylaws is not necessary to obtain immunity, a hospital/peer reviewers' version of the story should be accepted as objective truth and fact, and accused physicians are presumed guilty unless they can prove their innocence, which is a feat not possible under the judicial doctrine of non-review.
The Fifth Circuit has thus opened the doors wide to abusive bad-faith peer review, and the new sign over the doctors' entrance to hospitals reads, "Abandon All Hope Ye Who Enter Here."
Lawrence R. Huntoon, M.D., Ph.D., is a practicing neurologist and editor-in-chief of the Journal of American Physicians and Surgeons. Contact: firstname.lastname@example.org.
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SEMMELWEIS SOCIETY INTERNATIONAL (SSI) APPLAUDS
THE RESIGNATION OF DR. ROBERTA KALAFUT
During her term as President, many Texas physicians experienced unnecessary, arbitrary, capricious, and punitive harassment and disciplinary actions at Dr. Roberta Kalafut's direction.
Many good, competent physicians, including the current SSI President, were needlessly targeted by Kalafut and cohorts who include past executive director Dr. Donald Patrick and general counsel Mari Robinson, who is also expected to resign.
After Texas Governor Rick Perry pushed for tort reform several years ago, the TMB turned its regulatory responsibilities agency into an untrained quasi enforcement agency, attacking many solo practitioners with destructive force and fines on issues like late paperwork, or incomplete charts while dismissing other doctors with real medical negligence issues who were either protected by the TMB or larger healthcare groups that profit from preventable injuries to patients in their care. The TMB also paid friends of Dr. Patrick to manufacture evidence and cared little that their testimony was incorrect or unfounded.
Semmelweis Society International requests that the Texas Legislature form an ad hoc committee to reopen the cases of all physicians whose medical licenses were suspended or revoked during Dr. Kalafut.s tenure to ensure that all final orders were properly investigated and heard. As champions of physicians and patient safety, Senator Jane Nelson,
Rep. Vickie Truitt and Rep. Fred Brown must take this opportunity to open hearings for physicians and nurses who were maliciously targeted by the TMB.
(Semmelweis Society International, Inc., is a registered 501c3 non-profit corporation. Comprised of physicians, nurses, attorneys and university professors, its primary mission is to promote patient safety by ending retaliation against scientists, physicians and nurses who report dangerous conditions, fraud and corruption within hospitals and the US healthcare industry.)
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Canadian Medicare: A Road To Serfdom, by William E. Goodman, MD
About the Author: William E. Goodman, MD, is a specialist in otorhinolaryngology in Toronto, Ontario, Canada. He has been on strike since 1986, when private physicians in Canada were forbidden by law to contract with their individual patients. Dr. Goodman speaks, writes, and consults extensively on the effects of government control over medicine.
This article is a slightly abridged version of a talk given by Dr. Goodman at a regional meeting of the Association of American Physicians and Surgeons, Toledo, OH, April 20, 1990. Also by Dr. Goodman: "The Canadian Model: Could It Work Here?" AAPS pamphlet number 1007, October, 1989.
The Seeds of Authoritarianism
As most of you know, the term "Road to Serfdom" was coined by the Austrian-born economist Friedrich Hayek. It was the title for his landmark book, published in wartime Britain in 1944. Some 30 years later, he won the Nobel prize in economics.
I read this work for the first time in the late 1940s. Now, it is even more apt, more mind-chilling-particularly in the light of the massive growth of post-war welfare-statism and the advent of national health insurance, the forced government takeover of medical care in many nations.
The central thesis of Hayek's book was that government planning on a major scale inevitably leads to a totalitarian approach to statehood. No matter whether the government believes itself to be socialist, corporatist, social democratic, communist, or fascist, the tendency is the same. Such a state must usurp the citizen's basic right to make his own decisions about where he will live, what sort of work he will do, what wages he will earn, what sort of food and clothing and medical care he may buy, and so on. To this end, the state must insist on total powers of compulsion.
This compulsion may take two forms. In the relatively benevolent state, the citizen either does as he's told by the government, or his ability to earn a living is threatened by that government's monopolistic financial controls. To quote the late German Chancellor Otto von Bismarck, "He who controls the purse has the power.'' In the malevolent state, exemplified by Germany and Russia in this century, the dissident individual is simply imprisoned, tortured, hanged, or shot. In other words, depending on its degree of malevolence, the state imposes its will either by financial strictures or by physical force. The protesting citizen may die by starvation or by execution, but professionally and financially if not physically, die he will. . .
Government Funds, Government Control
In Britain in the 1940s, in Canada in the 1950s and 1960s, and now in the USA, it has been claimed by national health insurance enthusiasts that the payment of medical bills by the state should not and would not affect the freedom of physicians and patients or the quality of medical care. A 1950 report on Lord Beveridge's cradle-to-grave welfare plan, which led to Britain's National Health Service, said: "The necessary government controls will not be allowed to interfere with the personal freedom of patients or the professional freedom of doctors; or the confidential relationship between the two."
Politicians have repeatedly said that they weren't interested in controlling health care, only in making public safety-net funding arrangements. But common sense alone should have persuaded people of the inevitability of the US court ruling, "what the state funds it has a right to regulate." Experience has demonstrated only too well the truth of the German proverb, "Whose bread I eat, his song I must sing." In Canada, people are beginning to realize that in the long run their apparently free ride at the taxpayer's expense inevitably ends in survival only at the pleasure of the wielders of power.
A History of Canadian Medicare
There were four salient events in the development of Canadian medicare (a total, universal, compulsory, monopolistic, first-dollar-coverage system, unlike the more limited US Medicare):
1. In 1956, tax funding of all Canadian hospitals destroyed the independence of their governing boards. ["Die Kunst geht nach Brot," Martin Luther. Also see AAPS pamphlet 1002.]
2. In the late 1960s, country-wide, tax-funded, government-mandated medical care was instituted, following the lead of Saskatchewan, the only province with a socialist government at that time. . .
3. In 1984, passage of the federal Canada Health Act by the ruling so-called "Conservative" party virtually rendered medical care a legal government monopoly.
4. In 1986, in my own province of Ontario, the ruling so-called "Liberal" party pushed through Bill 94, titled "an Act regulating the amounts that persons may charge for rendering services that are insured services under the Health Insurance Act." . . . The legislation also outlawed all competition with the government by doctors, insurers, hospitals, nursing homes, and so on, and created a total bureaucratic monopoly that brooks no opposition that might interfere with central planning initiatives. Nowadays, many doctors feel that they can no longer criticize the government with impunity. They can no longer act in their traditional role as patient advocate. . .
"Cost Containment," Canadian Style
Note that both the federal and provincial Canadian laws achieved their desired ends not by brute force but by financial compulsion, as befits a relatively democratic state. These are the methods:
1. Cutbacks in hospital funding, leading to chronic understaffing as well as inability of hospitals to provide the high-tech expensive machinery needed for state-of-the-art diagnosis and treatment;
2. Resultant rationing of hospital admissions and hospital procedures, leading to waits of many months or years for cardiac bypass surgery, cancer radiotherapy, intensive neonatal care, and most of all, urgent and elective surgery;
3. Government control of permitted types and frequencies of diagnostic tests, such as mammography, Pap smears, cholesterol studies, ultrasound, amniocentesis, CT and MRI scans;
4. Government-mandated drug selection;
5. Refusal to permit any Canadian to buy privately what the government has decided it cannot afford, on the egalitarian theory that if not everyone can have it at public expense, no one should be allowed to have it through private payment;
6. Indirect control of medical personnel and medical institutions, again by financial arm-twisting;
7. Stringent controls on, or outright refusal to permit privately owned alternatives to hospital ambulatory care or surgical facilities. (Bureaucrats don't like competition-it makes them look bad);
8. Compulsory "donations" by doctors to hospitals or universities-just another form of income confiscation or discriminatory taxation by what are now, in reality, government institutions. . . .
The Status of Serfs
In a previous lecture, at the 46th Annual Meeting of AAPS in Orlando, FL, I restricted myself to the problems arising from the financial absurdity of a Canadian-style system. Let's now examine some of the nonfinancial consequences of total central planning.
1. The Right to Medical Privacy. Confidentiality no longer exists in Canada. In Ontario, for example, the physician is required by law to submit the details of every medical visit, every diagnosis, every treatment, every lab test, every hospitalization, and every operation, to the government's computerized records, which are accessible to myriads of government clerks. . . .
2. The Patient-Physician Relationship. In order to persuade Canadians that universal, compulsory, comprehensive, no-limit, first-dollar-coverage, tax-paid, government-mandated and bureaucratically controlled national health insurance was the ideal, our politicians used large amounts of the taxpayers' own money to convince them that:
a) Doctors were overpaid, under disciplined, too
powerful, error prone, and out of control;
b) Only centralized supervision, payment, and fee controls could alter this situation; and
c) Only total government control and tax funding could provide the medical utopia presumably lacking in Canada.
The results, so appealing in the short term, have been nothing short of disastrous in the long run. Our socialist politicians' response, predictably, has been based on the ``hair of the dog'' hypothesis: if a little government intervention produces almost insoluble problems, then the solution is more and more government intervention.
In the preface to chapter 2 of Hayek's book is a quotation from Hoelderlin: "What has always made the state a hell on earth has been precisely that man has tried to make it his heaven." . . .
3. The Practice of Medicine as a Subspecialty of Politics. When politicians arrogated unto themselves the task of running the hospitals, direct intrusion into medical judgment was only a matter of time. First, it was justified as a means of cost control: . . . The bureaucratic establishment of mandatory norms for doctors and hospitals is rapidly leading to a government-directed, assembly-line, civil-service type of practice. The benefits, if any, are epidemiological, not individual, the direct antithesis of the Hippocratic approach to the relations between an individual doctor and his specific patients. Computers run by nonmedical, politically appointed medical administrators are progressively replacing medical judgment.
4. The Collapse of Medicine as a Profession. The emigration or early retirement of many of our best physicians have left large gaps in the medical, hospital, and university hierarchies. These have been filled, as Hayek predicted, by the rise of many (often those whose main attribute is political astuteness rather than medical excellence) who would otherwise have remained in the ranks of the mediocre. . .
5. Liberty: the Doctor's Right to Choose. At least in urban centers, Canadian physicians still have a right to choose their patients. However, they are rapidly losing their right of choice as to the location, style, and financial conditions of their practice. . . .
6. Liberty: the Patient's Right to Choose. At present, Canadian patients can choose to see any physician they wish, provided he will have them. However, equal and universal access to what doesn't exist is a mirage, a cruel hoax. If highly qualified doctors are unavailable because they have emigrated, or had their fees so reduced by government edict that they have no incentive to exert themselves beyond the minimum, the theoretical right to access to their services becomes meaningless. When urgent care must be postponed for months or years because of government underfunding, then, to paraphrase an old legal maxim, medical care delayed becomes medical care denied. . . .
The Price of the Search for Utopia
Utopia has been defined as "the best of all impossible worlds." The search for Utopia, medical and otherwise, is as old as mankind itself. Unfortunately, it often has hideous consequences:
a) At best, the politicians and bureaucrats use money made available ostensibly to implement this ideal, either to buy votes and thereby distort the normal economy of the country, or, worse, to line the pockets of themselves and their supporters;
b) The Utopian ends come to justify the often unjust, immoral, and often downright illegal means. To quote Eric Hoffer: "You cannot build Utopia without terror, and before long terror is all that is left."
c) Even in the absence of outright terror, governments have used all kinds of sticks and carrots to force both patients and physicians into the mold of politician's perceptions of the ideal citizen.
In October, 1977, Prince Philip, the husband of the Queen, made some revealing observations about the rise of welfare statism in Britain, which are now equally applicable to Canada. These are directly analogous to Hayek's arguments on serfdom. "Reduced to extremes," Philip wrote, "the choice is between a philosophy which holds that all individual citizens must serve the general public interest, which means in effect that the individual becomes a servant of the state; or alternatively, a philosophy that asserts that the individual is of paramount importance, and that therefore, the state exists to preserve and protect his human rights to liberty and integrity....Freedom is indivisible. Once the law ceases to protect the rights of the individual from the gang-any gang-freedom is lost. Once a determined government begins the process of eroding human rights and liberties, - always with the very best possible intentions, - it is very difficult for individuals or individual groups to stand against it." . . .
To paraphrase American philosopher George Santayana, I hope you Americans will take the trouble to learn the cruel lessons of the history of national health insurance systems in other countries, including Canada, and not have to repeat them.
To read the entire article, go to www.aapsonline.org/brochures/goodman-serf.htm.
Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.
--Canadian Supreme Court Decision 2005 SCC 35,  1 S.C.R. 791
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4. Medicare: A Framework for Medicare Reform, by John C. Goodman, Ph.D.
The most important domestic policy problem this country faces is health care. The most important component of that problem is Medicare. Forecasts by every federal agency that produces such simulations — the Congressional Budget Office (CBO), the Social Security/Medicare Trustees, the General Accounting Office (GAO) — show that we are on a dangerous and unsustainable path. Indeed, the question is not: Will reform take place? The question is: How painful will reform have to be?
Health care is the most serious domestic policy problem we have, and Medicare is the most important component of that problem. Every federal agency that has examined the issue has affirmed that we are on a dangerous, unsustainable spending path:
There are three underlying reasons for this dilemma:
■ Since Medicare beneficiaries are participating in a use-it-or-lose-it system, patients can realize benefits only by consuming more care; they receive no personal benefit from consuming care prudently and they bear no personal cost if they are wasteful.
■ Since Medicare providers are trapped in a system in which they are paid predetermined fees for prescribed tasks, they have no financial incentives to improve outcomes, and physicians often receive less take-home pay if they provide low-cost, high-quality care.
■ Since Medicare is funded on a pay-as-you-go basis, many of today's taxpayers are not saving and investing to fund their own post-retirement care; thus, today's young workers will receive benefits only if future workers are willing to pay exorbitantly high tax rates.
About the Author
John C. Goodman, Ph.D., is the founder and president of the National Center for Policy Analysis. The National Journal recently called him the "Father of Health Savings Accounts," and he has pioneered research in consumer-driven health care.
Dr. Goodman is the author of eight books, and is author/co-author of more than 50 published studies on health care policy and other topics. He received a Ph.D. in economics from Columbia University. He has taught and done research at several colleges and universities including Columbia University, Stanford University, Dartmouth University, Southern Methodist University and the University of Dallas.
To read the entire report, go to www.ncpa.org/pub/st/st315/st315.pdf.
Government is not the solution to our problems, government is the problem.
- Ronald Reagan
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Almost all physicians are getting into the habit of giving adequate prescription refills and eliminating the need for patients to call in for prescription refills or having special lines reserved for patients to call in. They are learning that phone refills are not only hazardous, but poor business practice.
This is accomplished by the physician at the time of appointment, who, with all the information at hand, determines a safe period for the patient to take the medicine without further evaluation. Then the number of refills to that evaluation is given when another prescription will be written. Thus, if the patient should be evaluated in six months, then the total refills would equal six and the patient knows to make an appointment when the sixth refill is filled. The same for a 12-month refill.
At a recent meeting of an insurance company, a pharmacy service company was expounding on their ability to automatically send faxes to the doctor when the last prescription is picked up, which will always be one month before the required appointment. They even bragged that they could send out daily faxes until the doctor responded. We recommend that a doctor should not respond to these requests in view of the hazards involved and the costs of this practice.
They are hazardous because pharmacists assume that all that is required is a simple yes or no answer after which they can proceed with refilling a prescription that hasn't been authorized by the doctor with the patient and his/her chart in front of him/her. This will assure the pharmacist of return business without the possibility of patients having a new prescription in their hand, which could be taken to another pharmacist. But the physician had made a determination that the patient needed further evaluation when the refills are completed and thus appropriate health care is subverted. We recommend that a doctor should not respond to these requests in view of the hazards involved. Faxes can now be programmed to block such calls from repeat offenders.
Phone refills are an excessive cost to a medical practice. To refill a prescription, doctors know the risks involved if the chart is not pulled and reviewed and a new determination is made. Phone refills are basically an office visit without an exam. Therefore, the actual cost of this phone request is about half that of an office call. However, there is no payment for this half-office evaluation. If a doctor sees three patients an hour, and three refills come in during the same hour, the professional income is cut in half.
Attorneys have long known that phone calls are expensive. But they have the mechanism to charge for their time on the phone to their clients. Most law firms have a minimum time per phone call, such as one-sixth or one-fourth hour. Thus, if you have a junior attorney in a firm charging $300 an hour, the phone call is automatically billed at $75 for one to 15 minutes of time, and $150 for 16 to 30 minutes of time. The cost of a senior attorney at $400 an hour would be $100 for each quarter hour or less. Attorneys cannot take the risk of possibly giving out legal recommendations without all the facts in front of them.
The same thing applies to physicians who should not take the risk of giving out information, recommendations or refills without all the facts in front of them. Physicians need to establish a fee structure to take care of this practice much as attorneys do. If they don't, liability increases and malpractice premiums will rise to cover this liability. Meanwhile, physicians must ignore all pharmacy requests for new prescriptions or refills beyond those initially authorized.
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A patient called today to schedule an appointment. He had left the world's largest HMO and was trying private care. He was desperate, having run out of all of his medications. He had called a physician's office and was told there were no openings for six weeks. He made the appointment and showed up. He could not be seen because he did not notify the HMO of his choice of a new private physician and thus did not have a card with the physicians name on it. He became very upset and called another doctor on his list. That office told him that he had to get the HMO to issue another card with the doctor's name on it. He got upset with the second office stating, "I wish I could kill all doctors. They are so arrogant." Doctors, however, would not get paid unless they were authorized to see the patient.
There may be factors of which we are unaware, but here an HMO patient is blaming his intended doctors for arrogance and wishing them ill.
This seems to be an attitude with much of the public blaming doctors for what's wrong with healthcare. I was unable to bend a hospital rule for the benefit of one of my patients, who wanted to use his own medications instead of the expensive hospital medications, and got blamed by the patient who stated rather loudly, "I know doctors run the hospital and your word is the law. So you could do this if only you wanted to save me money." What I didn't have the heart to tell him was the charge would be the same whether the nurse gave him his own medication or the hospital supply. The cost is the RN administrating the medication.
The same attitude is frequently seen whether doing Social Security exams, Veteran's exams or employment exams. The doctor is always at fault if benefits are not received.
The lay people are increasingly blaming physicians for all the ills of health care. However, the box we're in does not allow much latitude for appropriate care and patient relationships. Unless doctors assume charge for private health care, we will go down the route of used car salesmen and attorneys in the ranking of the respected professions. Some doctors favor this practice of being simple civil service employees with fixed hours, ten holidays off and vacations guaranteed. The patients complain whenever their doctor is not available. When doctors are employees negotiating more and more time off, patients will be increasingly unhappy due to the loss of continuity of care. This translates into a lower quality of care.
A Foretaste of Things to Come with Government Medicine
The critical answer is for doctors to lower their exposures to third-party medicine, whether Medicare, Medicaid, any government program and FP-HMOs whenever they can.
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Nobel Laureate Dr. Muhammad Yunus
has spoken to the World Health Care Congress several times over the years,
telling the world health care leaders about micro credit bringing people of
Bangladesh out of poverty into entrepreneurship. Headlines surfaced this past
year of his bringing his micro credit plans to New York and the United States
to help poor people become self-
- sustaining. His Grameen Bank has
done remarkable things in this country during its first year. We have just
received this Holiday Message, which we would like to share with you and your
friends. Your contributions here will do far more than either your federal or
state taxes to reduce poverty in America. To learn more, please go to their
website below. Dr. Yunus is speaking at the sixth WHCC on April 14-16, 2009.
Don't miss hearing a Nobel Laureate speak on reducing poverty through free
enterprise. See special offer below the following holiday message.
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Please help us reach out to those who will be inspired by the possibilities of microfinance in the United States and can work with us to spread the word until every American has access to income producing loans and savings.
Launched approximately one year ago with an initial focus on immigrant women in Queens, New York, Grameen America is a unique microfinance organization dedicated to serving low-income communities in the United States. Grameen America is managed by a 27-year veteran of the Grameen Bank in Bangladesh. Grameen America is committed to building a self-sustaining organization that will build upon a culture of individual responsibility, savings and prudent use of credit for income producing activities throughout the U.S. Our overarching goal is to assist ALL low-income people in building better lives for themselves.
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Grameen America and the participating women of Queens, New York are building better lives and futures, responding to the Grameen belief that every person has within them the skills and energy to take care of themselves. Grameen America's initial target customers are mothers working for a better world for their children, and there is no stronger motivation or more reliable and productive investment. They are the foundation on which a prosperous future is being built.
The average year-long loan is currently about $2,000. Please give $20, $200, or $2,000 or more in the name of five of your most inspiring friends, Grameen Leaders, who you know will want to pass this on to five other Grameen Leaders.
To invest in a better future and an America without poverty, please follow the link at DONATE, or go to www.grameenamerica.com/Get-Involved/Contribute.html. . .
Best wishes to you and your family during this holiday season and in the New Year.
Vidar Jorgensen, President
Stephen Vogel, CEO
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SONOMA MEDICINE, the Magazine of the Sonoma County Medical Association, Fall 2008
Reflections from the History of Medicine, By James K. Gude, MD
I love the history of medicine! I enjoy rolling among its pages like my trusty Airedale, Oliver, relishes rolling in new-mown hay. I cherish what is oldest and distant best. Although I have enjoyed Sonoma County medicine since I came to Santa Rosa in 1971 to join Dr. George Firestone in his office (now a parking lot) and teach at the family practice residency at Community Hospital (now Sutter Medical Center of Santa Rosa), I prefer ancient Egypt, China, Greece, India, Rome, and the Arabic world. I enjoy talking to Imhotep, Charaka, Huangdi, Aretaeus and Rhazes. When I pick up a book, it's usually not on the New York Times bestseller list. Instead, it's by Rabelais, Locke, Goldsmith, Keats, Schiller, Doyle, Chekhov, Maugham, Joyce, Cronin, Williams, Percy or Thomas—all of whom were physicians or at least attended medical school.
When I'm asked for advice, I prefer quoting my physician mentors. I'll share with you the richest, most memorable nuggets I know from the history of medicine. My appreciation for 150 years of Sonoma County medicine begins with my delight in the first named physician, Imhotep, circa 2700 bce, and what has happened in medicine since then. Here goes:
Imhotep is credited with writing an ancient papyrus scroll that contains the following clinical presentation: "Should thou find his countenance is clammy with sweat, the ligaments of his neck are tense, his face is ruddy, his mouth is bound, and both his eyebrows are drawn, while his face is as if he wept." This is the first description of risus sardonicus diagnostic of tetanus, and Imhotep's conclusion is, "An ailment not to be treated." This wise clinician recognized the ethical principle of not treating a fatal illness. Here was one of the first No Code orders based on the concept of futility.
Hippocrates (ca. 400 BCE) wrote, "Life is short, and the Art is long: the occasion fleeting, experience fallacious, and judgment difficult." There is no better summary of a physician's fate.
Charaka (ca. 300 BCE), a Hindu physician, wrote, "Those who for the sake of a living, make merchandise of medicine, bargain for a dust-heap, letting go a heap of gold." This aphorism sets a high moral tone for medical practice. . .
Rhazes (ca. 900 CE), a Persian physician, advised, "Practice what I have preached, and if there be in what I practiced some deficiency, yet thou canst profit of my theory, and my shortcomings will not injure thee." Rhazes practiced in Baghdad and wrote prolifically. He was the most original practitioner of the art of physical diagnosis during the Islamic Golden Age. . .
John Locke (1632-1704), an English philosopher and physician, wrote his own epitaph: "Stay, wayfarer, near here lies John Locke. If you ask what sort of man he was, his answer is that he lived content with his modest lot. Educated in letters, he accomplished as much as satisfied the demands solely of truth." Thomas Jefferson borrowed freely from Locke in writing our Constitution.
Oliver Goldsmith (1728-1774) was an English writer and physician about whom Samuel Johnson observed, "No man was more foolish when he had not a pen in his hand—or more wise when he had." Goldsmith's play "She Stoops to Conquer" shows his strength of loving his fellow man with a kind acceptance of man's comical situation.
Friedrich Schiller (1759-1805), who began his career as a physician, is second only to Goethe in German literature. In his plays "The Robbers" and "Wallenstein," he explores the dimensions of rebellion and freedom.
John Keats (1795-1821) attended medical school in England but became a poet. His "Ode on a Grecian Urn" contains the famous lines: "Beauty is truth, truth beauty,—that is all / Ye know on earth, and all ye need to know."
Arthur Conan Doyle (1859-1930) fashioned his fictional detective Sherlock Holmes after Dr. Joseph Bell, Doyle's own professor of medicine at the University of Edinburgh. Doyle wrote that Bell "would sit in his receiving room and diagnose people as they came in. He would tell them their symptoms, and even give them the details of their past life, and hardly ever would he make a mistake."
Anton Chekhov (1860-1904) worked tirelessly as a physician, short-story writer and playwright in his native Russia. In his play "Uncle Vanya," the character Dr. Astrov declares, "I am overworked, nurse. From morning till night I am always on my legs, not a moment of rest, and at night one lies under the bedclothes in continual terror of being dragged out to a patient. All these years that you have known me I have not had one free day. I may well look old! This life swallows one up completely."
Somerset Maugham (1874-1965) was an English physician and writer whose novel Of Human Bondage is a thinly disguised autobiography that portrays the coming-of-age of a doctor named Philip Carey. Maugham writes, "He had lived always in the future, and the present always, always had slipped through his fingers. His ideals? He thought of his desire to make a design, intricate and beautiful, out of the myriad, meaningless facts of life; had he not seen also that the simplest pattern, that in which a man was born, worked, married, had children, and died, was likewise the most perfect?"
James Joyce (1882-1941) studied medicine briefly in Paris after graduating from University College Dublin. His epic novel Ulysses contains many references to medicine. Of his famous book, Joyce wrote, "I've put in so many enigmas and puzzles that it will keep the professors busy for centuries arguing over what I meant, and that's the only way of ensuring one's immortality."
A.J. Cronin (1896-1981) was a Scottish physician and writer. In his novel The Citadel, the main character, Dr. Andrew Manson, seeks the truth despite the medical establishment's repressive actions. Cronin vividly outlines the ethical problems in medicine brought about by greed, power and ignorance. . .
Walker Percy (1916-1990), a physician who wrote The Moviegoer and other novels about the American South, noted, "If the first intellectual discovery of my life was the beauty of the scientific method, surely the second was the discovery of the singular predicament of man in the very world which has been transformed by this science. An extraordinary paradox became clear: that the more science progressed and even as it benefited man, the less it said about what it is like to be a man living in the world."
Lewis Thomas (1913-1993), medical-school dean at Yale and NYU, was a superb essayist. In "The Youngest Science," he wrote about women: "I am, in short, swept off my feet by women, and I do not think they have yet been assigned the place in the world's affairs that they are biologically made for. Somewhere in that other X chromosome are coils of nucleic acid containing information for a qualitatively different sort of behavior from the instructions in the average Y chromosome. The difference is there, I think, for the long-term needs of the species, and it has something to do with spotting things of great importance."
I have shared with you the richness of our medical heritage as represented by these physician writers. There were not a fair share of women, but if you believe Lewis Thomas, that is now changing for the better.
To read Dr. Gude's entire article, go to www.scma.org/magazine/articles/?articleid=53.
Dr. Gude, a specialist in critical care medicine and pulmonary disease,
lives in Santa Rosa.
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The Prince, The Spy, and The Biker who Came in from the Cold. By James J. Murtagh, M.D.
Biker drama echoes both Shakespeare and John Le Carré.
Warning: spoiler alert. If you have not seen the final episode of Sons of Anarchy, do not read further. The episode contains a major plot twist which is discussed in this Op-Ed.
The season finale of Sons of Anarchy, the brash new biker-gangster drama, ended this week in the funeral of an innocent woman mistakenly gunned down in a blood feud. This is not just another crime story- Sons is even more ambitious than The Shield, The Wire or The Sopranos. Sons of Anarchy is one of the best counter-espionage stories in recent memory- worthy of John le Carré, even of Shakespeare.
Sons borrows from the two best spy stories of
all time- The Spy Who Came in from the Cold, and Hamlet. The
Prince, the Spy and the Biker are all totally disillusioned anti-heroes,
acutely aware of gross rottenness. Ghosts haunt all three. His dead father
haunts hamlet the Prince.
The Prince, the Spy and the Biker all use expendable double agents and triple agents. Do Rosencrantz and Guildenstern even really know who they work for as they blunder into execution? Does the British Spy's girl have any idea why she is gunned down on the Berlin wall?
Anarchy explicitly rules all three stories. How can the body politic be cured of rank and rampant corruption? When Kings are criminals, no one is safe.
In Sons, bikers are in a kind of cold war with the FBI. Just as le Carré's spy masters set up their own agents to deliver lies, the FBI frames a biker to falsely appear as an informant. Sons baits their dirty lie with detailed artistry to trap their man behind enemy lines.
The Prince, the spy and the biker all both contemplate and wreck horrific collateral damage. Hamlet sacrifices a dozen innocents to bring down Claudius. British Control sacrifices dozens of their own agents. The Bikers sacrifice their own to protect "The Brotherhood."
Hamlet a real secret agent? True, he doesn't have a James Bond car, lasers, or a decoder ring. But Hamlet claims to act for King and country, and has the code of a double 0- he has a license to kill, or be killed. He kills Polonius by mistake, then expects some lackey like Felix Lieghter to clean up.
Thinking too much only causes more carnage. Hamlet hesitates to kill his evil step-father while at prayer, contrasting the ruthless Laertes who would cut a throat in the church to end a blood feud. The Spy and the Biker also hesitate, with disastrous results, while more ruthless Laertes-figures execute without remorse.
All for the greater good. Hamlet, British control, the FBI (and the Bikers) all see the deaths of innocents as the cost of doing business. It's all part of the game, as Omar Little might say on The Wire.
The Prince agreed with Omar, when he observed that each goes to gain a little patch of ground with no profit in it.
British agent Leamas deeply understands that the secret service undermine the values of the west. Straddling the Berlin Wall, Leamas cannot distinguish West and East Leamas. How to know which way to jump?
The Biker's nemesis
To be, or not to be? Ultimately, that is the question for the Prince, the Spy and the Biker. They all end up take up arms against a sea of troubles, but ultimately, their fate is clear.
The Prince and the Spy both get their most fervent wish, and are granted the boon of release in death. Before dying, both are dipped in bloodbath.
Odds are the Biker will join Prince and Spy in a not too distant episode.
James J. Murtagh Jr.
This review can be found at www.healthcarecom.net/JM_SonsOfAnarchy.htm.
To read more book reviews, go to www.delmeyer.net/PhysicianPatientBookshelf.htm.
To read book reviews topically, go to www.healthcarecom.net/bookrevs.htm.
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Front page photo in the WSJ showing Bishop Charles H. Ellis III holding a prayer service at the Greater Grace Temple in Detroit for the auto industry (there were SUVs on the Altar platform) praying for a bailout from Washington.
What wasn't clear was whether this was a prayer to God or to Washington, DC.
Have the Liberals succeeded in making Washington their god?
The high risk of law enforcement next to Marine Airbases
A California Highway Patrol Officer was conducting speed enforcement on I-15, North of MCAS Miramar, using a handheld radar device to nab speeders cresting the hill.
The officer was dumbfounded when the radar gun issued a 400 mph reading and went dead.
Just then, a deafening roar over the treetops revealed that the radar had in fact locked onto a USMC F/A-18 Hornet engaged in a low flying exercise.
Back at CHP Headquarters, the Patrol Captain fired off a complaint to the USMC Base Commander. Back came a reply in true USMC style:
Thank you for your message as it allows us to complete the file on this incident. You may be interested to know that the Hornet's tactical computer had instantaneously locked onto your hostile radar equipment, sending a jamming signal back to it. Also, the automatic air to ground missile systems aboard the Hornet similarly locked onto your equipment, but fortunately the Marine flying the Hornet recognized the situation for what it was and quickly overrode the automated defense system before the target was vaporized.
Thank you for your concerns.
You are welcomed.
The Short History of Government Ineptitude
"The budget should be balanced, the Treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled, and the assistance to foreign lands should be curtailed lest Rome become bankrupt. People must again learn to work, instead of living on public assistance." –Cicero - 55 BC
What have we learned in two millennia about Governing?
To read more HHK, go to www.healthcarecom.net/hhk2001.htm.
To read more HMC, go to www.delmeyer.net/hmc2005.htm.
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• John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment and apart from the government. To read the rest of the story, go to www.zhcenter.org and check out their history, mission statement, newsletter, and a host of other information. For their article, "Are you really insured?," go to www.healthplanusa.net/AE-AreYouReallyInsured.htm.
• PATMOS EmergiClinic - where Robert Berry, MD, an emergency physician and internist practices. To read his story and the background for naming his clinic PATMOS EmergiClinic - the island where John was exiled and an acronym for "payment at time of service," go to www.emergiclinic.com. To read more on Dr Berry, please click on the various topics at his website.
• PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. http://home.earthlink.net/~doctorlrhuntoon/. Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. I also believe in an honest day's pay for an honest day's work. Please Note that PAYMENT IS EXPECTED AT THE TIME OF SERVICE. Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law.
• FIRM: Freedom and Individual Rights in Medicine, Lin Zinser, JD, Founder, www.westandfirm.org, researches and studies the work of scholars and policy experts in the areas of health care, law, philosophy, and economics to inform and to foster public debate on the causes and potential solutions of rising costs of health care and health insurance.
• Michael J. Harris, MD - www.northernurology.com - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis."
• Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 25–50 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to www.simplecare.com.
• Dr. David MacDonald started Liberty Health Group. To compare the traditional health insurance model with the Liberty high-deductible model, go to www.libertyhealthgroup.com/Liberty_Solutions.htm. There is extensive data available for your study. Dr. Dave is available to speak to your group on a consultative basis.
• Madeleine Pelner Cosman, JD, PhD, Esq, who has made important efforts in restoring accountability in health care, has died (1937-2006). Her obituary is at www.signonsandiego.com/news/obituaries/20060311-9999-1m11cosman.html. She will be remembered for her important work, Who Owns Your Body, which is reviewed at www.delmeyer.net/bkrev_WhoOwnsYourBody.htm. Please go to www.healthplanusa.net/MPCosman.htm to view some of her articles that highlight the government's efforts in criminalizing medicine. For other OpEd articles that are important to the practice of medicine and health care in general, click on her name at www.healthcarecom.net/OpEd.htm.
• David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at www.ssvms.org. To read his "Lessons from the Past," go to www.ssvms.org/articles/0403gibson.asp. For additional articles, such as the cost of Single Payer, go to www.healthplanusa.net/DGSinglePayer.htm; for Health Care Inflation, go to www.healthplanusa.net/DGHealthCareInflation.htm.
• Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, who would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at www.peerreview.org.
• Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848 no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see www.delmeyer.net/HMCPeerRev.htm. To see Attorney Sharon Kime's response, as well as the California Medical Board response, see www.delmeyer.net/HMCPeerRev.htm. Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD.
Semmelweis Society International is pleased to announce that the Texas Medical Board (TMB) President has resigned. To view other horror stories of atrocities against physicians and how organized medicine still treats this problem, please see section one and two this week and go to www.semmelweissociety.net.
• Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to www.sepp.net.
• The Association of American Physicians & Surgeons (www.AAPSonline.org), The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. Be sure to read News of the Day in Perspective: Massachusetts resorts to group visits with the doctor. One group appointment, featured in a Boston Globe video showed nine patients seated in folding chairs around a table with snacks. Dr. Erickson shook hands with each of them and examined them one by one, discussing their medical details aloud. The video showed him listening to and percussing chests through clothing. Don't miss the "AAPS News," written by Jane Orient, MD, and archived on this site which provides valuable information on a monthly basis. This month, be sure to read Ten Things Trial Lawyers Hope You Don't Learn by Andrew Schlafly, Esq. Browse the archives of their official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents. Don't miss the excellent article on Conviction Without a Crime: a True Story by Michael D. Jackson, M.D. There's an extensive book review section, which covers five great books this month.
* * * * *
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Del Meyer, MD, Editor & Founder
6945 Fair Oaks Blvd, Ste A-2, Carmichael, CA 95608
Words of Wisdom
Edward Langley, Artist 1928-1995: What this country needs are more unemployed politicians.
If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be. -Thomas Jefferson.
Without religion, we may possibly retain the freedom of savages, bears and wolves, but not the freedom of New England. -Timothy Dwight, president of Yale University from 1795 to 1817
Some Recent Postings
A Time For Freedom, by Lynne Cheney www.delmeyer.net/bkrev_ATimeForFreedom.htm
We The People - The Story of Our Constitution, by Lynne Cheney www.delmeyer.net/bkrev_WeThePeople.htm
"The Shield": Crime and Punishment, By James J. Murtagh, M.D. www.delmeyer.net/JM_TheShield.htm
Henry Molaison, a man without memories, died on December 2nd, aged 82
EACH time Suzanne Corkin met H.M. during one of his visits to the Massachusetts Institute of Technology, she would ask him if they had met before. He would smile and say yes, and when she asked him where he would reply, "In high school." They did not actually meet until he was in his late 30s, but they worked together for nearly five decades, and the last time they met he still failed to recognise her. The most she ever elicited in him was a sense of familiarity.
More extraordinary still, a sense of familiarity was all his own face elicited in him. People were fascinated by H.M., for whom life came to a standstill in 1953, and one of the questions they always asked about him was what happened when he looked in the mirror. Dr Corkin reports that there was no change in his facial expression, his conversation continued in a matter-of-fact tone and he did not seem upset—though this could have been because of the damage done to his amygdalas, brain structures that are important for processing emotion. Once, in the later years, when she asked him what he was thinking as he gazed at his reflection, he replied, "I'm not a boy."
H.M., or Henry M.—his family name was kept secret until he died—grew up in the countryside outside Hartford, Connecticut. He was 16 when he suffered his first grand mal epileptic seizure. The fits became more frequent, delaying his graduation from high school and, later, preventing him from holding down a job, though he tried to work on an assembly line.
By the time he was 27 he was having as many as 11 seizures a week and was on near-toxic doses of anti-convulsants. His desperate parents were referred to William Beecher Scoville, a neurosurgeon at Hartford Hospital. It was 1953 and psychosurgery—which was later to be banned, or at least restricted, in many countries—was at the height of its popularity. Scoville himself had performed frontal lobotomies, though he was dissatisfied with the way they blunted his patients' emotions.
In some ways H.M. was a product of that dissatisfaction, because Scoville had been working on a new, experimental operation, and he decided to try it on H.M. He would remove his medial temporal lobes (one on each side of the brain), the presumed origin of his seizures. Each lobe includes an amygdala and a seahorse-shaped structure called the hippocampus.
The operation was successful: H.M. experienced only two serious seizures during the subsequent year. But this happy outcome came at a terrible price. From the date of the operation he was unable to form new memories, and he also lost many of the memories he had laid down before it. Although he could recall the Wall Street crash and the second world war, he was left with no autobiographical memories at all. Having seen the effects of his handiwork, a shocked Scoville began to campaign against the operation. This meant that H.M. was the only person ever to undergo it. . .
By the time this obituary appears he will have gone under the knife again, this time for an autopsy. Before long his brain will appear in three digitised dimensions on the internet, for researchers to pore over. He never knew how much he contributed to science, says Dr Corkin, but if someone had told him it would have given him a warm, fuzzy feeling—for a few seconds, at least.
To read the entire obituary, go to
On This Date in History - December 23
On this date in 1788, Maryland gave ten miles square of land for the District of Columbia, establishing a Federal city to be the capital. Since then, the pace of government has change from leisurely to about our largest growth industry and is in large part in a process of taking things over.
On this date in 1947, John Bardeen, Walter H Brattain and William Shockley saw the fruition of their work at the Bell Telephone Laboratories in New Jersey when the first transistor came into being. The transistor not only made possible the miniaturization of all kinds of equipment, it produced a whole new world of electronic miracles. Its inventors won the Nobel Prize and great new industries grew up on the basis of their work.
After Leonard and Thelma Spinrad
MOVIE EXPLAINING SOCIALIZED MEDICINE TO COUNTER MICHAEL MOORE's SiCKO
a pro-liberty filmmaker in Los Angeles, seeks funding for a movie exposing the
truth about socialized medicine. Clements is the former publisher of
"American Venture" magazine who made news in 2005 for a property
rights project against eminent domain called the "Lost Liberty
For more information visit www.sickandsickermovie.com or email firstname.lastname@example.org.