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Archive for May, 2014

Does this bother you?

GSK

 

It obviously bothers the investors who wiped $1 billion off the share value of GSK after this story appeared.

Dr Peter Gøtzsche, the founder of the Nordic Cochrane Centre, recently described drug companies of behaviours which we would normally attribute to organised crime. He strikingly said

The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs.

A post I wrote a couple of years back about GSK being fined $3 billion mentioned that between 2009 and 2012 drug companies had paid $11 billion in fines. ProPublica summaries some of the biggest fines from 2009 to 2014 here.

An analysis by Dr Syndey Wolfe at the end of 2013 showed Big Pharma had paid $30 billion in fines from 1991 to 2012. He concluded

“There is a pathological lack of corporate integrity in many drug companies.”

Well fines like these, large as they seem to be, aren’t stopping these behaviours and why is that?

Over the past decade, the 11 largest global drug companies reaped about $711 billion in profits, according to a new analysis from the Health Care for America Now (HCAN) advocacy group. In 2012 alone, the drug companies’ annual profits totaled nearly $84 billion.

No wonder there are profits like this. A recent report titled “Health, United States, 2013” — found

the percentage of Americans taking prescription drugs has increased dramatically. During the most recent period, from 2007 to 2010, about 48 percent of people said they were taking a prescription medication, compared with 39 percent in 1988-1994.

and

One in 10 Americans said he or she had taken five or more prescription drugs in the previous month.

and, shockingly,

About one in four children took one or more prescription drugs in the past month, compared to nine in 10 adults 65 and older, according to the study.

Don’t you think we have a problem here?

Are prescription drugs the best way to increase the health of human beings? And if it is, why are more and more people needing more and more drugs? Or are more and more drugs being prescribed because of the way drug companies behave?

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Maya Angelou was wonderful with words. You’re probably coming across some of them just now as the internet spills over with memories and thoughts about her provoked by the news of her death.

Here is one of my favourites

My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.

I especially like this one because I just don’t accept the sole point of living is to make it to the end. Is a Life survived for a number of years something you’d aspire to? Isn’t the sole goal of survival ultimately 100% doomed? (Nobody makes it out of here alive!). You can spend a life like a robot, or, in terms of this blog, like a zombie, on some kind of autopilot, surviving, but there’s something else you can do. You can thrive. You can flourish. You can express the uniqueness you are in this universe, and become what only you could become. You can live with passion, fully engaged with the wonder of the everyday (l’émerveillement du quotidien), you can connect, feel, respond, use your imagination to put yourself in the shoes of others, you can laugh, live with a twinkle in your eye, and you can do it with beauty, grace and, yes, style.

 

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Here’s a page from today’s “i” newspaper –

indy

There are three interesting stories here about inequality and the global financial system which probably have some bearing on the voting patterns of the people of Europe in this last week. (Just to remind you, a lot of voters in Europe have turned away from the “mainstream” parties to vote for “extreme right” or “extreme left” in a way which many interpret as a protest against the current powers that be)

Down on the bottom left of the page is a quote from Christine Lagarde, the chief of the IMF. She says

The behaviour of the financial sector has not changed fundamentally in a number of dimensions since the financial crisis

Not exactly a snappy or readily comprehensible quote, but what is she referring to?

Against the backdrop of several leading banks caught in scandals over the fixing of Libor rates, foreign-exchange rigging and money laundering, Lagarde said: “Although some changes in behaviour are taking place, these are not deep or broad enough. The industry still prizes short-term profit over long-term prudence, today’s bonus over tomorrow’s relationship.”

Well, that’s a bit clearer. She’s saying bonuses are too high and are given for high risk, short term gain behaviour, and that banks are still “too big to fail” ie that they can still expect the rest of us to bail them out when their gambles don’t pay off. (as an aside, look at that wee list of “issues” highlighted by the i – “the fixing of Libor rates, foreign-exchange rigging and money laundering” – who’s been found guilty and jailed for these crimes?

At the top of page is a piece on the Bank of England governor, Mark Carney, who says

financial sector excesses and “market fundamentalism” in the build-up to the global crisis were breaking down the “social contract” of equality of outcomes, opportunity and fairness across generations. [He] warned of “disturbing evidence” of declining social mobility in the US as well as widening inequalities “virtually without exception” at a time of soaring executive pay. “Returns in a globalised world are amplifying the rewards of the superstar and, though few of them would be inclined to admit it, the lucky. Now is the time to be famous or fortunate,”

So as well as referring to the “excesses” (that would include some of the things they’ve fined, but not jailed, for?) he says why he thinks it is important for capitalism to deal with the issue of inequality. I think he highlights an interesting aspect of this issue – how in our present time, being “famous or fortunate” is what brings the greatest rewards. In other words, it’s not about effort, contribution, talent, work etc….its about being famous (read anything about a wedding in Florence in this week?), or fortunate (who your dad was, who your spouse was, what lottery you won?)

Finally, the third piece on this page is an expansion of Mark Carney’s reference to CEO pay.

The median annual pay package of chief executives rose above $10m (£6m) for the first time last year

This gives them “roughly 257 times the average worker’s salary, according to the research, which is up sharply from 181 times in 2009.”

Two questions here – is any boss worth 257 times the average worker’s salary? And, what have these bosses done to merit such a substantial relative increase in the last five years? They’ve gotten THAT much better/more valuable??

Is it any wonder that people are losing faith in the current economic-political system?

Is it not clear we are not on a sustainable path? (see here or here for more, and if you’d like to explore the potential impact of inequality, read this)

 

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Ben Ledi Summer Sunset

From my home I look out to Ben Ledi and in the summer months in particular the sunsets are frequently stunning. I probably have hundreds of photos of Ben Ledi taken over the last few years.

It just never ceases to amaze me. Changes ALL the time.

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DSCN0338

There is an astonishing amount of information from the environment flooding into your brain every single second. Think just about the information picked up by your sensory organs. All the sounds your ears can hear, all the light, colours and shapes your eyes can see, all the scents your nose can smell, all the textures your body can feel, all the flavours your tongue can taste. All of these, plus all the information being sent to the brain from within your body, plus all the information generated by your brain itself (your thoughts, memories, imaginings), are continuously flooding through the billions of neurones in your brain.

Why doesn’t that overwhelm us?

I’m nor sure anyone can fully answer that question, but at least we do know we have two ways of dealing with all these continuously changing information flows.

One way handle it is to use our brains as filters or valves.

William James, the psychologist said

one function of consciousness is to carve out of the vast sensory environment—what he called the “blooming, buzzing confusion”—a manageable, edited-down version. Only a limited amount of information reaches our conscious awareness, and for the very good reason that the majority of it is irrelevant.

The “blooming, buzzing confusion”….nice phrase!

He thought that

consciousness selects from the world at large elements that are of particular value and interest to it

In other words, consciousness enables us to “edit” the information flows, to focus on what is of “value and interest” – that, of course, opens up a whole other can of worms about how we decide what is of “value and interest”, but let’s leave that for another day.

Henri Bergson, the philosopher, argued that the brain’s function

was to act as a kind of “reducing valve,” limiting the amount of “reality” entering consciousness.

He said

“The brain is the organ of attention to life,” and the part it plays is that of “shutting out from consciousness all that is of no practical interest to us

Same idea as James…..the brain, or consciousness at least, as an editor, or a valve. In both cases the idea is that we reduce the full flow of information and pay attention to only part of it.

Iain McGilchrist argues that this is primarily the function of the left hemisphere – which “re-presents” the information flows to the brain.

There are great benefits to be had from being able to abstract information from the vast rivers washing through our brains, to be able to focus, and to concentrate on, just a subset, or a part of the world. We use this ability to both “grasp” and manipulate the world…..to exert our will on it, to exert control.

The downside is that we can begin to forget that we’re doing the editing in the first place. We lose sight of the filters and valves and think that what we “see” is all there is.

Attend

As Gary Lachman says in his “Secret History of Consciousness”

Yet one drawback to the brain’s highly efficient ability to focus on necessities is that it “falsifies” reality, which, as Bergson earlier argued, is in truth a continuous flow of experience…….The mind constantly takes snapshots, as it were, of reality, which enables it to orient itself amidst the flux. The problem is that science, which takes the most comprehensive snapshots, makes the mistake of confusing the photographs with reality itself.
This is exactly the problem Iain McGilchrist describes in “The Master and His Emissary”.
We have another way of knowing which is different from this editing, filtering, re-presenting way. We know by seeing connections, by experiencing the whole. Bergson describes that as intuition. A good example of that is how you answer the question “How are you?” You can ask yourself, “How is my energy today?” and you will come up with an answer instantly. You don’t have to edit, filter, or quantify anything, you know it holistically, or “intuitively”.
I’ve seen the same function again and again when visiting patients. Instantly, even before anyone speaks or before any “findings” are discovered, an experienced doctor knows he or she has to act quickly. The consultant who taught me Paediatrics, said on my first day at work with him that his aim was to teach me “how to recognise an ill child”. I thought that a strange comment at the time, but that’s exactly what he did. That recognising is a holistic, intuitive function which comes with experience.
Here’s Lachman again, in reference to Bergson
Just as we have an immediate, irreducible awareness of our own inner states, through intuition we have access to the “inside” of the world. And that inside, Bergson argued, was the élan vital
The neuroscientist Wolf Singer who looks at the problem of “binding” – of how the brain puts all this information together, says
there is a process in the brain that is itself antireductionist and is concerned with creating wholes out of parts, and hence with giving meaning to our experience.
I suspect this is exactly what McGilchrist highlights as the main function of the right hemisphere.
Isn’t it amazing that our brain can enable us to know in these two amazing ways? To edit, and to bind together; to filter, and to see patterns which enable us to discern meaning?

a strange turn

Inchmahome Priory

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In the A to Z of Becoming, U is for “understand”.

morning sun

This is a verb which is close to my heart. At times I think of myself as insatiably curious, but in fact, it’s not mere knowledge I seek, it’s understanding. I don’t want to collect facts, statistics or data, I want to understand. I think that’s why I’m not impressed with the current version of “evidence based” whatever (the kind which applies the term “evidence based” as a kind of quality marker with a claim that if it has this label, then this action, or opinion, or choice, has some kind of superior status).

I often wonder what is a doctor’s job, and, at least one conclusion I reach is that it is to understand. Every patient I meet presents a story to me which I do my best to understand, and in my pursuit of understanding, I think I don’t only make a “diagnosis” or a “formulation” but I enable the person to understand themselves better. It’s a shared venture, the doctor-patient relationship, and it’s founded on the pursuit of understanding.

There is such a difference between understanding and judging. To judge, is to conclude. And that conclusion often involves approval or disapproval. The General Semanticists say “Judgement stops thought“. Also, in making these judgements there is some assumption that the one doing the judging has some superiority. To understand, on the other hand, requires a certain humility. In my opinion anyway, it does not involve leaping to conclusions. Understanding is more a never finished process. It is always possible to understand more, to understand more deeply, more fully, to understand better.

I think that to understand requires an attitude based on love. If you love and care for someone you open up the potential to understand them. If you love Nature, you are more likely to try to understand her. If you love a plant, you are more likely to understand what it needs to thrive, so you become more able to nurture it.

Understanding can create healthy bonds.

february love

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trees

Nature LOVES diversity. Monocultures just don’t occur naturally.
But do you know what I like so much about this kind of image?
It’s not only that every single tree is different and unique.
It’s that together they create the fullness of the beauty.

We are like that. We are all unique. But aren’t we so much more when we live in harmony with all the other unique lives around us?

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