Gunplay at San Francisco

My grandfather, James A. Cowsill, Sr., was born in Cleveland, Ohio, in 1883.  A few years later, he and his family moved to Washington, DC.  Shortly after the 1906 San Francisco earthquake, he came to California to work as a bricklayer. 

My cousin came across this newspaper article from 1909, featuring some fun he had during his bachelor days.

He married my grandmother in 1913 and reformed his wild ways.

Left Too Long

Three factors have to be considered in establishing a national health care plan: (1) Who is to be covered; (2) The quality of care; (3) Cost.  Unfortunately, as (1) and (2) increase, so does (3).  The U. S. is now faced with a difficult debate about quality of health care, coverage, and cost, at a time when the percentage of seniors (who consume a majority of services) is rising.  They have left it too long.

Fortunately for Canada, some of the contentious issues were decided forty years ago.  It has universal health care coverage for illness and injury, and participation is mandatory.  It is not faced with the dilemma of having 15% of the population without coverage. The young pay premiums, thereby effectively subsidizing the more expensive costs of seniors; and issues such as pre-existing conditions don't arise.

Extending coverage to previously uninsured in the U. S. increases costs.  For those who choose not to insure until they have a medical problem, the cost can be prohibitive; and to provide them with the same cost coverage as those who have always carried insurance, unfairly increases the cost for the latter.  In an aging population, the outlook is unpleasant.  Therefore, the new health care legislation made private health insurance mandatory.

Of course, people don't like to be told what to do, particularly when it means higher costs.  But you can't have your cake and eat it, too.

It's possible that health care costs might be reduced.  Many of the tasks performed by doctors; e. g., vaccinations, prescription renewals, review of routine medical tests, and physical exams, might be conducted by lesser trained health care practitioners.  However, the number of procedures requiring high-trained specialists will probably grow.

The best choice for the U. S. would be to have a public option to private insurance, with assistance for low-income persons.   The plan should be mandatory and tax-deductible, leveling the burden, making coverage universal, and eliminating the issue of pre-existing conditions.  Unfortunately, it looks like the disagreements will go on and on, given the number of competing interests, and the ability of these interests to promote dissent, rather than to resolve it.  
   

You Remember Some Things

To quote Forrest Gump, "It's funny how you remember some things, but some things you can't".  Some things that you do remember are assassinations of prominent persons.  I'll probably remember the shooting in Tucson this past weekend and the circumstances surrounding it.

In October 1963, U. N. Ambassador Adlai Stevenson was jeered, spit upon, and hit by a sign during  a United Nations Day speech in Dallas, Texas.  A few weeks later, President Kennedy visited Dallas in an attempt to improve his popularity in the state.

I was at UCLA at the time, and we wondered how the President would be received in Dallas.  At about 9:30 am, I was listening to a lecture in American Literature on "The Great Gatsby".  The discussion turned to the sacrifices that persons in public office sometimes make, at great cost to themselves and their families.   When I got back to my fraternity house at 10:00 am, Lowell Hahn came in and said, "Did you hear the news. Kennedy's been shot".  We didn't believe him; it was Lowell's idea of a joke.  Then Al Bock came downstairs with a radio, and said, "He's dead".  The University closed; we were left to reflect.

On the afternoon of April 4, 1968, I was working at Southern Pacific Railroad at the foot of Market Street in San Francisco.  Sometime in the early afternoon, word came that Martin Luther King had been shot in Memphis.  A little later, someone said that a riot had started up Market Street and was moving towards us.  Most of the office left.  At 5:00 pm, however, I found it normal on the street.  I wondered if there would be trouble in Oakland, a largely black neighborhood that the bus passed through on my way home to Berkeley.  Again, nothing.

When I walked into my apartment, my roommate said, "He's dead".  I took the letter that I had written to my draft board two days earlier, expressing my opinion about the war and the draft, but which I had been undecided about posting, and put it in the mailbox.  A small protest.  The next day, of course, much larger protests took place across the country.

Two months later, June 4, 1968, I voted in the California Democratic primary between Eugene McCarthy and Robert Kennedy.  I had voted for McCarthy, but also supported Kennedy.  A year earlier, I had shook Kennedy's hand during a rally, but had been a little disappointed with his speech, in which he only promised "to do better" in Vietnam.  Gene McCarthy seemed  less equivocal.  I watched Kennedy give his victory speech in Los Angeles around midnight, got ready for bed, when shouting broke out, "The Senator has been shot".  For a few moments, it wasn't clear which Senator they meant.  Two days later, Robert Kennedy died in hospital.

As with the assassination attempt in Tucson, political feelings were running high in the 1960's.  Issues of civil rights, war, free speech, and role of government divided the U. S. left and right. These events tend to leave their marks on the public psyche.  In most instances, these and those which followed, the perpetrator was a young male, alienated, angry, confused, lashing out against his circumstances. Unfortunately, he may sometimes have been set off by the rhetoric and bombast of others.  You wonder if we ever move forward.  

New Year's Day

We all had a very enjoyable New Year's Day with four generations.  Vera said she liked the time with her great grandchildren as much as or more than Christmas.

Given that the children are young, they are very well-behaved.  The parents do an excellent job with them; much more patient than my own upbringing.  I have a pretty strong sense of right and wrong, so the possibility of my correcting them always looms.

Christmas Dinner at Grandma's 1948

The four-year-old climbed on the sofa and knocked a picture off the wall.  I told him firmly to get down, and he went off and pouted with hurt feelings for a time.  Fortunately, his parents didn't rescue him, and after awhile he returned to the group and we reconciled.

Sometimes I ignore boorish behaviour; sometimes not.  A few years ago, I told the grandson not to suck his food off the plate and to use a knife and fork.  He was surprised, but did what I asked.  He still wears his cap in the house, even to the dinner table.  I just absorb this, since no one else seems to notice.

On some occasions, such as Christmas, I also absorb cigarette smoking in the house.  The offenders know well my attitude, but apparently assume that they are safe in the circumstances.

The grandson's girlfriend didn't appear for either Christmas or New Year's Day.  This is sad, because she misses sharing the occasion with her son, but all we can do is invite her and see what happens.    

The holidays were a big success.  We escaped healthy, a few pounds heavier, and resolved to accomplish a few things in the new year that we put off in the old.

Size is Relative

CNN ran a story on Christmas featuring a 98-year-old woman who had 100 grandchildren (actually 24 grandchildren, 57 great grandchildren, and 19 great great grandchildren).  Someone thought this was news.

My 4X great grandmother, Jael Kavanaugh Woods, doubled this.  Interviewed at age eighty (1845), she noted that she had 16 children (all living to be adults), 104 grandchildren, and 91 great grandchildren.  By the time of her death in 1848, a few more had been added.

Jael was born in Culpeper County, Virginia, in 1765, and moved with her parents to Greenbrier County, Virginia (now West Virginia) at a young age.  At seventeen, she married Peter Woods, an itinerant Babtist minister, and started a family (2).  At twenty-five (1790), she moved to Madison County, Kentucky, where her remaining 14 children were born.  At forty-five (1810), she and her husband moved the entire family (children ranging in age from one to twenty-five) to Franklin County, Tennessee; and from there (1819) to Cooper County, Missouri.

The children were born in largely unsettled territory, without doctors or hospitals.  These families travelled by wagon;  built their own homes (including their roads and churches); sewed their own clothes; grew or hunted for their food; cooked on wood stoves; dug wells for water.  No malls; no McDonald's.  Of course, this was before the age of entitlement.

You frequently hear that the United States is a nation of immigrants.  After the Civil War, as the country industrialized and the cities grew, this may have become true.  The reality is that although everyone descends from original immigrants, most of the early population growth came from settlers (or slaves) having generations of large families.  Seldom do you see pioneer families marrying recent immigrants. More likely they marry members of their own community (frequently second or third cousins).

Jael Woods' daughter Mary Woods Dallas also had 16 children; and her daughter-in-law Susan Jennings Woods (my 3X great grandmother and wife of  Charles Woods) had 12.  Only in the 20th century did the size of the families decline.

What am I missing?

About two weeks ago, I mentioned to Vera that I was having forebodings of misfortune about to occur.  Before Christmas.  Now that nothing has happened, I think only that I've missed something.

Our early snowstorm cleared up and the weather has been seasonal.  Of course, other parts of  North America and Europe haven't been so fortunate.

The Christmas tree is up.  Presents are bought, wrapped, and sitting under it.  The turkey is thawing. Dinner trimmings, including finger food, are bought.  Baking of cookies and tarts is done. The dog has been to the groomer for her Christmas clip.  Carpets are vacuumed; floors are washed.  It's only the 23rd and my list of Christmas tasks is completed.  So much for forebodings, although we do have a couple of family situations which concern me, (largely out of my control).

Vera's friend Harry Klassen did pass away.  We went to Harry's "Celebration" on Saturday.  The hall was packed and his family was pleased.

Maybe I should work on New Year's resolutions.   

And wish everyone peace, prosperity, and a Merry Christmas.

Treatment or Profits

Cholesterol is a waxy substance secreted by our livers and found in food that we eat.  Medical studies correlate the amount of cholesterol in our blood with the amount of plaque build-up in our arteries, leading to heart attacks and strokes.  It is believed that reducing cholesterol in the blood will reduce the risk of cardiovascular disease.

The common method for reducing cholesterol levels are drugs, both statins, which reduce the amount of cholesterol produced internally, and cholesterol absorption inhibitors, which reduce the amount received from  food.

Without drugs, I have higher than recommended levels of cholesterol.  By taking a statin, Lipitor (Pfizer), in low doses (10mg), my LDL-C  (low density lipoprotein or "bad" cholesterol) is lowered to an acceptable level for most persons (2.6 mmol/l; 100 mg/dcl;).  A few years ago, this was considered near "optimum".

Two things then happened.  First, my brother had heart surgery under age 60.  This increased my risk factors for cardiovascular disease to "high risk", because of family history.  Secondly, the guidelines for optimum  LDL-C  levels for "high risk" patients were lowered from 2.5 mmol/l to 2.0 mmol/l.

My doctor then recommended increasing the Lipitor dosage to 20 mg and added a second drug, Ezetrol (Zetia in the U. S.) (Merck), a cholesterol absorption inhibitor.  This successfully lowered my LDL-C  to 1.8.mmol/l (70 mg/dcl). 

Given the apparent success of these types of drugs and their resultant popularity, sales boomed.  Lipitor became the #1 selling prescription drug in the U. S. (peaking at revenues of  $12.7 billion annually in 2007); and Ezetrol brought in $ 5.0 billion for Merck.

Then a surprise.  Under Congressional probing, it was discovered that Merck had failed to release clinical results which showed that while Ezetrol was effective in reducing cholesterol, it apparently had no effect on reducing the amount of plaque build-up in the arteries, and that eventual outcomes for patients were not improved.  In fact, outcomes might actually be reduced.  Merck pleaded that more studies were needed.

Of course, I asked my doctor about this.  He didn't know.  He was following the guidelines and the recommendations.  He said he would ask his father-in-law, also a doctor, who knew more about these things than he did.  I've yet to get an answer from him.

I stopped taking the Ezetrol for six months, but my LDL cholesterol returned to the old (previously acceptable) level.  I've resumed taking the Ezetrol.

Now I have several concerns: (1) My drug treatment is not based on any symptoms that I have (other than higher than normal levels of cholesterol); (2) My doctor doesn't know whether a prescribed drug is effective; (3) Clinical reports cast suspicion on the drug; (4) Reasons for the guidelines to be made more stringent (availability of drugs or improved outcomes?); (5) The role of  profits to the pharmaceutical industry. 

The question of pharmaceutical profits arises particularly when I see their reps trying to get time with my doctor and wonder how successful they are in promoting their products.  Lipitor is now available in generic form in Canada, but not in the U. S., due to "negotiations" between Pfizer and the generic manufacturer.  It all makes you wonder.