AND furthermore
Patricia Schwarz
about the risk of releasing drug resistant strains of HIV.
People who barf up half of their AIDS antiviral medications can end up
producing new drug resistant strains of the virus.
Leshner fought very hard against clinical studies of the antiemetic
properties of marijuana for AIDS patients, even considering the
potential threat to the world from drug resistant HIV.
Uncle Al
What threat? POTENTIAL threat? HIV is endemic to queers (no loss;
transmission is 99.9% preventable in any case), drug addicts
(evolution in action), and genetic trash (hemophiliacs). Good
riddance one and all. The incidence of AIDS-related death in the US
is about equal to that of deaths by drownings. If you want a
"POTENTIAL threat" try tuberculosis - which is trivally communicable
to productive people.
A 30% incidence of AIDS hasn't even slowed the rate of African
population increase. What it has done is remove any need for
geriatric support and social programs. Such operating in the US would
cut the Federal budget by nearly 30%! Give it another 20 years and
Black Africa will have bred around it entirely.
A Liberal is somebody who steals from your wallet to hep another,
skimming a percentage as user fee. The Red Cross harvested over a
$(US)billion after 11 September. At least 40% has already been spent
- on the Red Cross. Hundreds of thousands of units of blood were
donated after 11 September pleas. You cannot trace more than 600 of
them.
--
Uncle Al
http://www.mazepath.com/uncleal/
(Toxic URL! Unsafe for children and most mammals)
"Quis custodiet ipsos custodes?" The Net!
Ed Green
<3BE18FC5...@superstringtheory.com>
>This man who is now the CEO of the AAAS showed not one degree of concern
>about the risk of releasing drug resistant strains of HIV.
Huh? What? Who? Why should he? Who is he?
Why do you say this?
>People who barf up half of their AIDS antiviral medications can end up
>producing new drug resistant strains of the virus.
I find something very odd about this idea, vs. the
idea of "drug-resistant TB". TB, first of all a bacterium,
not a virus, was decidely non-drug resistant, when
we first started developing effective antibiotics. TB
was very much an AIDS of its day before we had
antibiotics, in the sense that it was a wasting disease
with a long course that either could or could not be
ameliorated by various expensive therapies, and thus
was the ideal vehicle to soak up huge amounts of
cash in attempts to prolong life.
Then we had penicillin, and treatment became
trivial... at first. Then we had incompleted regimines
of penicillin, over proscribed penicillin, third world
OTC penicillin, propylactic penicillin... and inevitably,
the brief halcyon moment of cheap effective TB
treatment was treatened by drug resistant strains.
But we haven't even got to the penicillin state on
AIDS. Indeed, so far as I know, we haven't got
to the pencillin stage on any viral disease, or any
cancer for that matter (which are often intimately
related to viruses). Anti-viral agents tend to be
nasty (side effects) and incompletely effective.
Anti-viral agents may supress some stage of the
viral cycle, but seldom erradicate the virus.
Also, I believe viruses in general and aids in particular
are notorious for rapid mutation. They can also hide
out in cellular DNA, IIRC, where they are more
immune from attack than the Taliban in a cave.
Now, to set up a TB like scenario, you would
have to have a therapuetic agent which was
(1) almost 100% effective in erradicating the
microbe when used correctly (2) given to
haphazard use which would only kill off
the lest resistant genetic variants, thereby
leaving the more resistant ones to breed.
AFAIK this stage has not been reached.
Life can be prolonged, but so could the life
of syphilitics in the thirties. But it could not
be cured, so the idea of "releasing drug resistant
strains" did not mean much.
>Leshner fought very hard against clinical studies of the antiemetic
>properties of marijuana for AIDS patients, even considering the
>potential threat to the world from drug resistant HIV.
Oh. Is that what this is about? Well, I agree 100%.
Denying marijuana to patients suffering from chronic
nausea from strong chemical therapies is cruel,
inhumane, stupid, and deeply stupid. It's one of
those cases where the disease is worse than the
cure. I can't begin to express my contempt for
people who would deny any medicament to a
terminal cancer patient which that patient might
desire... even if clinically ineffective, so long as
taken with informed consent.
In other words, if somebody very sick want to smoke
pot and get high, and feels better for it, who the
hell are the healthy to say no?
But I don't think "drug resistant strains in the emesis",
however disgusting, is a particular issue. That's like
defending rivers with the snail darter... ultimately a
legal shenanigan, even if in a good cause.
''Attention, Taliban. You are condemned. Did you know that? The instant the
terrorists you support took over our planes, you sentenced yourselves to
death.''
tj Frazir
for aids , crack .
The red cross said " what billion ?" and pointed out no one looks at
thier books or there would be no red cross. Not even uncle sam gives to
the red cross, they know beter.
Send your money to Uncle AL , he neads a sence of hummer but cant
aford one.
Ed Green
<5354-3BE...@storefull-266.iap.bryant.webtv.net
>Why put money in pot research ? Just look at you ! We have a cure
>for aids , crack .
Fine. Give the very ill crack, too, if they want it.
Probably would weird out their families, though.
People prefer the lucid dying.
> The red cross said " what billion ?" and pointed out no one looks at
>thier books or there would be no red cross. Not even uncle sam gives to
>the red cross, they know beter.
> Send your money to Uncle AL , he neads a sence of hummer but cant
>aford one.
And yet you and Uncle Al are pursuing a united way
in your criticism of the Red Cross. I had not heard this
before. A simple way to assess their moral health as
a non-profit would be to look at their directors: If the
directors are in shirt sleeves, in spartan offices,
enjoying full comarderie with all levels of their staff and
drawing modest salaries, then I'm confident their
overall effect is positive. If they have succumbed to
the fiefdom syndrome, have swanky offices and high
salaries, are insultated from their low level employees
who slave away for low wages, then we can diagnose
the disease.
All successful non-profits eventually reach this second
stage.
tj Frazir
hehe this is a good one .
How Things Work
Free Electricity Information Page
I've received many comments about my discussion of the "Free
Electricity" hoax and am posting some of the most interesting
information below. I hope you find it useful and appreciate those who
sent me these tidbits. -- Lou Bloomfield
One reader sent in the following note:
"Thanks for your appropriate, well deserved response of September 25 to
the question regarding the "Free Electricity" fraud. At a neighbor's
request, and for the entertainment value (I expected, and got, a real
"hoot") I accompanied him to this dog-and-pony show in Portland last
week. This Dennis Lee is truly a snake oil salesman in every traditional
sense of the word. He builds support in his audience (applause, always
started from the same spot in the rear of the auditorium) with frequent
digressions in his victimization by the government, big power companies,
and the scientific world (David vs. Goliath). He makes several
impassioned professions of his Christianity, actually stating that God
told him to bring this invention to the people. He invokes patriotism by
espousing his deep belief in the freedom of the individual in this
country. There is no stone unturned. Unfortunately, in his hour, rather
unpolished presentation, he fails to actually explain how his device
works. He wildly mixes, interchanges, and misuses incompatible
dimensional measurements (power, torque, energy, momentum, volts, to
name a few). It was alternately hilarious, embarrassing, exasperating,
and most of all, alarming. Alarming, because it appeared many in the
audience were ready to line up as his disciples, regarding him not only
as a "scientist", but a savior. Mr. Lee even turned the fact that he has
served a jail sentence for (what else?) fraud into a plus, using his
sentence as proof that the "big powers" are out to silence him. I am
personally astounded that this man is not now in jail for what I
witnessed. His promotion is, as you said, a total fraud; worse by far
than even bad science. Unfortunately, a lot of people, based on my
assessment of this one audience, are being fleeced by Mr. Lee and his
operation. I will never understand why the attorneys general of the 47
states he appears in, or other local and federal law enforcement
agencies do not stop this scam. It is patently fraudulent from top to
bottom.
My background includes 2 years as a physics major at (a highly respected
university), taking a degree from that school in EE, followed by (36
years at nationally prominent science/engineering firms). I guess I am
just a bit stunned by the level of success I witnessed in selling this
bunk to lay people.
Thanks for your exposure of this scheme for what it clearly is."
In response to my request for more details, he added the following:
"I am very certain that shills were in the audience. I mentioned the
applause initiated from the rear of the auditorium at appropriate
places. I'll relate another little event that was just too, too
coincidental. At one point in the show, to illustrate that you CAN get
free electricity from the air, Mr. Lee attached performed a little trick
that the old GE traveling science shows used to do when I was in grade
school. It's the one where you take a fluorescent lighting tube (in this
case, a circular one) and made it light up only as far from one terminal
as you placed your hand around it. By moving your hand along the tube,
the lit area expanded or contracted with the movement of your hand.
During this demonstration, he casually mentioned that these tubes were
hard to find, and he would give anyone in the audience $100 for an old
one, working or not. WOULD YOU BELIEVE that, about a half-hour later, a
little old lady came trotting down the aisle, waving on old circular
tube in the air. You can imagine the big production made of giving her
the $100 reward, thus convincing the audience they were seeing an honest
man before them. Pardon my cynicism!
As to where the money comes from, I have wondered the same thing. An
attorney would have a field day analyzing his documents for his clients.
He does not refer to them as investors, and they are not buying
anything. Also, when you read the fine print, what you are buying is "a
chance to get your own free energy system". To get in on his energy
cooperatives, you pay $275, of which $75 is a nonrefundable fee, and
$200 is called a donation, and goes into escrow (unspecified as to who
the escrow agent is, or if it is connected to Lee's company). The $200
is refunded if the energy machines are not delivered, I think within a
year. The contract also states that the energy machines delivered must
produce "up to" 15,000 watts to the home. I believe a lemon and 2 strips
of dissimilar metal would qualify under that language. There are also
dealerships offered, although no terms were mentioned for them. I would
assume a dealership would require a lot more front money. He also
promotes his "Public Awareness Kits", consisting of video and audio
tapes and books, for a security deposit of $50. The deposit is to be
returned if the kit is returned in 2 weeks, but if not, or if you sign
up ("believe"), then they keep the $50. I frankly believe that, once you
are in for the $275, additional "contributions" will be required, but no
mention was made of this, The whole relationship between the fleecer and
the fleecies was kept pretty murky, and I did not get a clear impression
of just what it was. This, I am certain, was not accidental.
Examining the fine print of his contract, you find that what your $200
"contribution" buys is a "Certificate of Beneficial Interest" (COBI). It
"is not a guarantee or even a promise that the holder will get a free
energy machine installed on his or her property". It "is a promise that
'if' and 'when' these devices are ready and able to be supplied to
homes, the lead certificate holder ........" gets one for his home. It
then states, in ominously bold print, "Any fee charged, over the $200
contribution, to recruit and process contributors in this cooperative
effort will never be returned and are in no way secured against loss".
This tells me that more fees will be requested from contributors. The
"cooperative" referred to is a group of "50 like-minded individuals" in
a block, each of whom has kicked in the $275. Thus, you see, no one has
any expectation of getting a machine until he joins 49 other in his
neighborhood to form a cooperative. If you envision hierarchical selling
schemes and the word "pyramid" comes to mind here, we're on the same
track. Once you're into this, you need to sign up your neighbors! In
addition, having said all the above about the refundability of the $200
contributions, there is a rambling paragraph that says COBI holders
realize that the contributions were used as seed money to develop the
initial machines, it will no longer be in escrow. Any further refunds
will come from the "general income of the International Tesla Electric
Company".
I believe there are more demands for money to be made on Mr. Lee's
clients than were divulged at the demonstration. I personally believe
that one reason for the saturation blanketing of the entire country with
these shows in a very short period of time is to maximize the exposure
and income before any authorities can bring charges against him and
publicize the scam he is promoting. I believe the company will, within a
year, declare bankruptcy, go out of business, keep the money collected,
and leave all his believers standing knee-deep in disbelief and utility
bills. In short, Dennis Lee is not Mr. Wizard.
Thanks for helping counter this sort of fraud."
Another reader sent in the following newspaper advertisement:
jmfb...@aol.com
null...@aol.com (Ed Green) wrote:
>>From: Patricia Schwarz patr...@superstringtheory.com
><3BE18FC5...@superstringtheory.com>
>>Leshner fought very hard against clinical studies of the antiemetic
>>properties of marijuana for AIDS patients, even considering the
>>potential threat to the world from drug resistant HIV.
>
>Oh. Is that what this is about? Well, I agree 100%.
>Denying marijuana to patients suffering from chronic
>nausea from strong chemical therapies is cruel,
>inhumane, stupid, and deeply stupid. It's one of
>those cases where the disease is worse than the
>cure. I can't begin to express my contempt for
>people who would deny any medicament to a
>terminal cancer patient which that patient might
>desire... even if clinically ineffective, so long as
>taken with informed consent.
>
>In other words, if somebody very sick want to smoke
>pot and get high, and feels better for it, who the
>hell are the healthy to say no?
There are side effects. I'm very glad that pot wasn't a pain
alternative when JMF was dying because I would not have denied
him the pain relief. But, if he had been toking a joint anywhere
near me, I'd have been buzzed myself. I did not need to smoke
to get higher than a kite; that second hand smoke was sufficient.
There were studies getting done by some of the drug companies
that were putting the pain relief parts of pot into little pills.
I haven't heard about any outcomes from that, though. What's
really interesting about these people who promote the pot
legalization is that they're against the equivalent
pills being available.
/BAH
Subtract a hundred and four for e-mail.
tj Frazir
to sell opeum . Thats how they got HK. Hitler was a junkie . So was
most of the japanees big wigs. Drugs started ww2 . Bin Laden looks
strung out .
Callffffff calllffff , Im sick , some one role me a joint ! Yea
right.
Mark Fergerson
<snip>
> There are side effects. I'm very glad that pot wasn't a pain
> alternative when JMF was dying because I would not have denied
> him the pain relief. But, if he had been toking a joint anywhere
> near me, I'd have been buzzed myself. I did not need to smoke
> to get higher than a kite; that second hand smoke was sufficient.
> There were studies getting done by some of the drug companies
> that were putting the pain relief parts of pot into little pills.
> I haven't heard about any outcomes from that, though. What's
> really interesting about these people who promote the pot
> legalization is that they're against the equivalent
> pills being available.
Uh, JMF passed? Sorry, I didn't know.
Anyway, yes, there are side effects, but the
problem with the pills is that those who'd benefit
from the pain relief without the disorientation
(the buzz) generally have an exaggerated gag
reflex from the other treatments (rad, chemo,
etc.) and degraded stomach linings as well (rad in
particular makes you shed your epithelium), so
they either can't swallow the pills in the first
place, or can't keep them down long enough for the
active agent to be absorbed, or they just pass
right through undigested.
Generally, their lungs are adequate (except in
lung cancer cases, obviously) so the common
"delivery system" of inhaling smoke or vapor
(there are such things as THC vaporizers that
don't break the stuff down) is the most effective.
AFAIK nobody's bothered to investigate the
vaporization points of the many compounds in pot
to see if the pain-releiving bits come out at a
lower temperature than the buzz-inducing ones. Now
that'd be a breakthrough.
I see this as partly the Mother Teresa (she of
"no pain meds for the terminal cases, suffering is
good for the soul" fame) syndrome in the medical
community; if the cure is arbitrarily immoral then
the agony must be uniformly tolerated. Damn,
cruel, foolishness IMNSHO. The other part (I wax
cynical here) is that those in power just can't
stand the idea that there exists a natural
medicament that _needs no pharmacization_ to be
effective. You can use it raw, right out of the
ground. Hell, you can eat the leaves and buds off
the plant without even killing it.
And while I'm being cynical: on a political
note, anybody remember Clinton's "I didn't inhale"
defense? I believe you when you say second-hand
pot smoke gave you a buzz. Now, if second-hand
tobacco smoke is as lethal as first-hand, why did
_anyone_ believe Clinton?
Mark L. Fergerson
jmfb...@aol.com
Mark Fergerson <mferg...@home.com> wrote:
>jmfb...@aol.com wrote:
>
><snip>
>
>> There are side effects. I'm very glad that pot wasn't a pain
>> alternative when JMF was dying because I would not have denied
>> him the pain relief. But, if he had been toking a joint anywhere
>> near me, I'd have been buzzed myself. I did not need to smoke
>> to get higher than a kite; that second hand smoke was sufficient.
>> There were studies getting done by some of the drug companies
>> that were putting the pain relief parts of pot into little pills.
>> I haven't heard about any outcomes from that, though. What's
>> really interesting about these people who promote the pot
>> legalization is that they're against the equivalent
>> pills being available.
>
> Uh, JMF passed? Sorry, I didn't know.
S'ok. I survived it.
>
> Anyway, yes, there are side effects, but the
>problem with the pills is that those who'd benefit
>from the pain relief without the disorientation
>(the buzz) generally have an exaggerated gag
>reflex from the other treatments (rad, chemo,
>etc.) and degraded stomach linings as well (rad in
>particular makes you shed your epithelium), so
>they either can't swallow the pills in the first
>place, or can't keep them down long enough for the
>active agent to be absorbed, or they just pass
>right through undigested.
>
> Generally, their lungs are adequate (except in
>lung cancer cases, obviously) so the common
>"delivery system" of inhaling smoke or vapor
>(there are such things as THC vaporizers that
>don't break the stuff down) is the most effective.
>
> AFAIK nobody's bothered to investigate the
>vaporization points of the many compounds in pot
>to see if the pain-releiving bits come out at a
>lower temperature than the buzz-inducing ones. Now
>that'd be a breakthrough.
There's also a delivery system that JMF had where they
stuck a needle into his body cavity and delivered morphine
that way.
>
> I see this as partly the Mother Teresa (she of
>"no pain meds for the terminal cases, suffering is
>good for the soul" fame) syndrome in the medical
>community; if the cure is arbitrarily immoral then
>the agony must be uniformly tolerated. Damn,
>cruel, foolishness IMNSHO.
Heh. That's not what I encountered. The nursing home
doctor didn't want JMF to get addicted...this was two
weeks before he died. I had to fight like mad just to
get his morphine dosage to 50% of what he had been on.
> ...The other part (I wax
>cynical here) is that those in power just can't
>stand the idea that there exists a natural
>medicament that _needs no pharmacization_ to be
>effective. You can use it raw, right out of the
>ground. Hell, you can eat the leaves and buds off
>the plant without even killing it.
>
> And while I'm being cynical: on a political
>note, anybody remember Clinton's "I didn't inhale"
>defense? I believe you when you say second-hand
>pot smoke gave you a buzz.
Oh, it didn't buzz me; it knocked me right out.
> ... Now, if second-hand
>tobacco smoke is as lethal as first-hand, why did
>_anyone_ believe Clinton?
Did anybody believe him?
Ed Green
>Date: 11/3/01 12:08 PM Eastern Standard Time
>Message-id: <3BE432A9...@home.com>
> I see this as partly the Mother Teresa (she of
>"no pain meds for the terminal cases, suffering is
>good for the soul" fame) syndrome in the medical
>community; if the cure is arbitrarily immoral then
>the agony must be uniformly tolerated. Damn,
>cruel, foolishness IMNSHO.
Mother Teresa thought that?
I didn't know that of the sainted... er, saint.
I wonder... this is really a stretch... but my ex-wife
got angry with me when I had a painful eye-injury
and I swallowed (perscription) codeine. And she
was Catholic. Is it something about Catholic
theology and narcotic pain-relief?
As far as I was concerned, the codeine was an
unalloyed blessing... I was freed from several days
of nagging pain, I had no trouble getting adequate
rest, and as a result, I'm convinced that I heeled
faster. On the third day I woke up, realized my
eye felt much better, took off the patch, blinked,
and stopped taking the codeine.
And somehow I avoided becoming a dope feind.
Drug control is for people who can't handle drugs.
So the rest of us are invited to suffer. Even a
Marine Corp. Colonel was once quoted as saying
'there is no point practicing being miserable".
Ed Green
>Date: 11/4/01 4:48 AM Eastern Standard Time
>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>In article <3BE432A9...@home.com>,
> Mark Fergerson <mferg...@home.com> wrote:
> I see this as partly the Mother Teresa (she of
>>"no pain meds for the terminal cases, suffering is
>>good for the soul" fame) syndrome in the medical
>>community; if the cure is arbitrarily immoral then
>>the agony must be uniformly tolerated. Damn,
>>cruel, foolishness IMNSHO.
>Heh. That's not what I encountered. The nursing home
>doctor didn't want JMF to get addicted...this was two
>weeks before he died. I had to fight like mad just to
>get his morphine dosage to 50% of what he had been on.
Huh? I think you read Mark's comment backwards.
You are reporting the same mindset.
I've thought about the reasons not to give powerful
drugs... fear of addiction... and wondered what this
has to do with the terminally ill. Your experience
would seem to be a hideous example of this
"thinking". How can a doctor "think" that it is better
to avoid addiction in a terminally ill patient than alleviate
suffering? For that matter, if there is acute suffering,
what would be the horrible drawback of having a
recovered but addicted patient who now must be
medically weaned off the drugs... but who was
spared agony? Even if "mere" pain alleviation were
not morally sufficient justification, the medical point
might be taken that suffering inteferes with rest and
recuperation.
This was my very minor experience with narcotics...
that they not only alleviated pain but presumably
shortened healing... since I assume it is better
to sleep rather than lie awake painfully.
If you have read James Herriot, "the Yorkshire Vet",
you may recall a story of a sheep in agony, which
he went to put down. He gave it a massive dose of
sedative and the animal promptly fell over; however
it didn't stop breathing, and they didn't bury it,
and it merely slept for about three days. When it
woke up, weak and dehydrated, it was nonetheless
free of pain, and able to recuperate. I thought of
this story when I had to have a cat in kidney failure
put down, and the first dose just put him to sleep.
I wonder based on my personal experience if some
of this "suffer lucidly" ideal isn't related to discomfort
in the presence of somebody who seems drugged.
It's embarrassing for must people to visit a relative
in a nursing home who doesn't know where he or
she is, or who you are, whether or not they are on
drugs. But this is ultimately a selfish reason to
without pain relief.
I have the feeling there is a lingering tradition
of pain in the American medical system as a manly
thing: from civil war operations biting the bullet, to
"agressive" surgery, the the pschological torture of
interns through sleep deprivation. Someone who has
been through this style of medical training may
unconsciously feel that since his suffering was
irrelevant, then his patients can just put up and
shut up too... it is a common result of abuse.
Finally I think there was the incidence of narcotic
addiction following WWI pain treatment. Given a
pre-association of addicts with low-lifes this seems
to have been a shameful secret, rather than simply
a medical problem... an attitude which has also
persisted... doubly ridiculous in people who became
addicted through pain relief, rather than voluntary use.
So, we are never going to make _that_ mistake again,
are we: even if it means denying the dying; at least
they won't die addicted, heaven forbid.
BAH, if you are still there: why do people oppose
putting the anti-nausea agents in pot in pill form?
Mark Fergerson
>
> >From: Mark Fergerson mferg...@home.com
> >Date: 11/3/01 12:08 PM Eastern Standard Time
> >Message-id: <3BE432A9...@home.com>
>
> > I see this as partly the Mother Teresa (she of
> >"no pain meds for the terminal cases, suffering is
> >good for the soul" fame) syndrome in the medical
> >community; if the cure is arbitrarily immoral then
> >the agony must be uniformly tolerated. Damn,
> >cruel, foolishness IMNSHO.
>
> Mother Teresa thought that?
>
> I didn't know that of the sainted... er, saint.
Yup. Some claimed at the time it's because the
(donated) money could be better spent on rawer
essentials like food and water, but there's a
direct quote somewhere; Uncle Al probably has a
link to it on his site.
> I wonder... this is really a stretch... but my ex-wife
> got angry with me when I had a painful eye-injury
> and I swallowed (perscription) codeine. And she
> was Catholic. Is it something about Catholic
> theology and narcotic pain-relief?
Well, if you want a good idea of the Xtian
association of suffering with spirituality, read
Dante's _Inferno_. Also, why did the Catholics
have to invent Purgatory? I don't see anything
about it in any Bible I've ever read.
> As far as I was concerned, the codeine was an
> unalloyed blessing... I was freed from several days
> of nagging pain, I had no trouble getting adequate
> rest, and as a result, I'm convinced that I heeled
> faster. On the third day I woke up, realized my
> eye felt much better, took off the patch, blinked,
> and stopped taking the codeine.
>
> And somehow I avoided becoming a dope feind.
>
> Drug control is for people who can't handle drugs.
Right you are. I've known people who've become
addicted on _one_ dose. Weenies all.
> So the rest of us are invited to suffer.
An unfortunate extrapolation of Democracy; the
"lowest common denominator" principle. If you
assume all people are mindless sheep, you'll get
most of them to follow you and the rest can be
written off as radicals.
> .. Even a
> Marine Corp. Colonel was once quoted as saying
> 'there is no point practicing being miserable".
The Marines are very practical people, and work
by the "highest common denominator" principle. In
the military, excellence is acheved by
disciplining people to do their best at all times.
Practice under harsh conditions ("obstacle
courses" frex) is really a "confidence" exercise
(which is why most services have renamed them
"confidence courses", it isn't really P.C.); if
you can do your job well while the feces is in the
airmover (the exception), a clear day (the rule)
gives you no excuses.
Would that somebody could figure out how to
model a political system on the military without
it becoming a Police State.
Mark L. Fergerson
tj Frazir
should we get HK back ad switch to opeum again. Hell , you dont have no
fucking buzz wihout some opeum on the green can of shit U got. EhEh.
Hay lets, lets, let production role stoned . We can build ezzyroller
mini vans and paint them all pink ! Dig Up Jimmy Hendrix and trip !
prop him up and watch him melt. Go to the greatfull dead and have 30000
people put names on an old chevy van. Sit and be lost . Die early ,
live with a stupid addiction at 300 a pop .
ORRRRR Put your head between and up right and live the dream. Find
out how easy rich healthy and wise is. Do what they allways did you get
what they allways got.
Those that dont studdy history are doomed to repeat it.
tj Frazir
"" Drug controle is for people that can"t handle drugs.""
1 , so you dont have a drug problem , you nevr run out .
2 , addicts and drunks are all people that can handle their drugs .
3 , So you have a drug problem .
Ed Green
<7729-3BE...@storefull-263.iap.bryant.webtv.net>
>Some one just said ...
>"" Drug controle is for people that can"t handle drugs.""
Actually, that wasn't my partiuclar typo, but close enough.
> 1 , so you dont have a drug problem , you nevr run out .
> 2 , addicts and drunks are all people that can handle their drugs .
> 3 , So you have a drug problem .
Huh? You read me completely backwards. Ok.
Addicts and drunks are people who can't handle
alcohol and drugs, not the other way around.
Handle as in take them or put them aside.
Of course, I have heard that some people can
become addicts on one dose... I don't know that
I actually believe this. Your neuro-chemistry can't
change _that_ quickly. But on whatever psychological
or physiological level, I don't think everybody is
potentiated to become an addict, unless you force
feed them narcotics. The drug addicted vet was a
cliche after Vietnam, but supposedly some guys
just did drugs when they were in 'Nam, and stopped
when they came home.
I happen to think that it would be far less costly to
society to allow those who decide to opt out into
a drug infused poverty to do so, and support them
at some subsistence level if necessary, than to
accept the hugely corrupting and violent influence
of drug money and drug enforcement.
I would just make walk-in help available to anyone
at anytime who comes in and says "I'm addicted to
X and I want to stop". And maybe I would have a
few Marine DI's come and beat the shit out of
stupid HS kids who want to start. ;) But other
than that, I'm in favor of a free market.
tj Frazir
Its nothing new , I would not outlaw it , but I would not say where
the addiction begins. Its " I can handle it " then its : I nead a break
for hard work . A few brews wil the games on no big deal hu . Wrong .
Then its a feal good once in a wile HABIT . Now do what you were doing
without it. Now its I could if I wanted too but this is silly I dont
have a problem , Its not costing shit . Wrong again . Recreational
buzz is your not going to have fun without it . Sit on yer but and
smoke and drink then . I'm living the dream wile you sleep.
jmfb...@aol.com
null...@aol.com (Ed Green) wrote:
>>From: jmfb...@aol.com
>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>
>>In article <3BE432A9...@home.com>,
>> Mark Fergerson <mferg...@home.com> wrote:
>
>> I see this as partly the Mother Teresa (she of
>>>"no pain meds for the terminal cases, suffering is
>>>good for the soul" fame) syndrome in the medical
>>>community; if the cure is arbitrarily immoral then
>>>the agony must be uniformly tolerated. Damn,
>>>cruel, foolishness IMNSHO.
>
>>Heh. That's not what I encountered. The nursing home
>>doctor didn't want JMF to get addicted...this was two
>>weeks before he died. I had to fight like mad just to
>>get his morphine dosage to 50% of what he had been on.
>
>Huh? I think you read Mark's comment backwards.
>You are reporting the same mindset.
But different rationalizations. I also encountered medical
types who had the attitude that it was good for dying people
to be aware at all times.
>
>I've thought about the reasons not to give powerful
>drugs... fear of addiction... and wondered what this
>has to do with the terminally ill. Your experience
>would seem to be a hideous example of this
>"thinking". How can a doctor "think" that it is better
>to avoid addiction in a terminally ill patient than alleviate
>suffering? For that matter, if there is acute suffering,
>what would be the horrible drawback of having a
>recovered but addicted patient who now must be
>medically weaned off the drugs... but who was
>spared agony?
For some strange reason (that I haven't figured out yet),
the weaning is left as an exercise to the user. I was the
one who had to help him get off the drugs with his first
bout of cancer. MDs don't seem to like to deal with this
aspect of therapy. The only thing I can think of is that
the connotations of being addicted are so non-PC that it's
just easier to ignore the whole problem. I consider it
a fallout of this foolish war on drugs business.
>Even if "mere" pain alleviation were
>not morally sufficient justification, the medical point
>might be taken that suffering inteferes with rest and
>recuperation.
Exactly. There's another stupidity in the way those
drugs are dispensed. You want to keep the pain in
a dull background state rather than an hour of coma followed
by increasing discomfort. Since every person is different,
one flavor of treatment doesn't apply to everybody. It's
a side of effect of this damned statistical study business.
When they cut JMF's throat out, what he needed was 1/3 of
the morphine dosage but every two hours rather than every three
hours. I did manage to convince a nurse to change the protocol.
I got him out of bed and exercising faster than anybody else
who had gone through that ward with a similar malady. When
he finally was able to eat, I got him onto real food by using
<gasp!> hard-boiled eggs. I had to fight for that one because
eggs cause colesterol.
>This was my very minor experience with narcotics...
>that they not only alleviated pain but presumably
>shortened healing... since I assume it is better
>to sleep rather than lie awake painfully.
Yup. Good sleep heals all. It allows the body to
redirect most available energy towards the immune system
and healing. If you're dealing with pain, you waste that
precious healing energy on pain reaction.
>
>If you have read James Herriot, "the Yorkshire Vet",
>you may recall a story of a sheep in agony, which
>he went to put down. He gave it a massive dose of
>sedative and the animal promptly fell over; however
>it didn't stop breathing, and they didn't bury it,
>and it merely slept for about three days. When it
>woke up, weak and dehydrated, it was nonetheless
>free of pain, and able to recuperate. I thought of
>this story when I had to have a cat in kidney failure
>put down, and the first dose just put him to sleep.
>
>I wonder based on my personal experience if some
>of this "suffer lucidly" ideal isn't related to discomfort
>in the presence of somebody who seems drugged.
>It's embarrassing for most people to visit a relative
>in a nursing home who doesn't know where he or
>she is, or who you are, whether or not they are on
>drugs. But this is ultimately a selfish reason to
>without pain relief.
I don't know. All I know is that, if I had allowed a
dog to suffer like JMF did, I'd be in jail today.
>I have the feeling there is a lingering tradition
>of pain in the American medical system as a manly
>thing: from civil war operations biting the bullet, to
>"agressive" surgery, the the pschological torture of
>interns through sleep deprivation. Someone who has
>been through this style of medical training may
>unconsciously feel that since his suffering was
>irrelevant, then his patients can just put up and
>shut up too... it is a common result of abuse.
I hadn't tied the two together. There may be something to
it. That training system is definitely of that mindset.
The trainers think that if it was good for them, it would
be good for the young things. If the process gets changed,
there has to be another way to figure out how to winnow out
those not cut out for that kind of profession. Although,
JMF's surgeons had him in the OR for 20 hours. Maybe it
is a good training technique.
>
>Finally I think there was the incidence of narcotic
>addiction following WWI pain treatment. Given a
>pre-association of addicts with low-lifes this seems
>to have been a shameful secret, rather than simply
>a medical problem... an attitude which has also
>persisted... doubly ridiculous in people who became
>addicted through pain relief, rather than voluntary use.
>
>So, we are never going to make _that_ mistake again,
>are we: even if it means denying the dying; at least
>they won't die addicted, heaven forbid.
>
>BAH, if you are still there: why do people oppose
>putting the anti-nausea agents in pot in pill form?
I don't know. I had heard about studies that got started
around the time of this latest push of legislation. I don't
know what stage those studies are at. I've been out of
the medical study loop since Jim died.
JosephShore23
>Subject: Re: AND furthermore
>From: jmfb...@aol.com
>Date: Mon, 05 Nov 01 12:17:32 GMT
>
>In article <20011104100958...@mb-bj.aol.com>,
> null...@aol.com (Ed Green) wrote:
>>>From: jmfb...@aol.com
>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>>
>>>In article <3BE432A9...@home.com>,
>>> Mark Fergerson <mferg...@home.com> wrote:
>>
>>> I see this as partly the Mother Teresa (she of
>>>>"no pain meds for the terminal cases, suffering is
>>>>good for the soul" fame) syndrome in the medical
>>>>community; if the cure is arbitrarily immoral then
>>>>the agony must be uniformly tolerated. Damn,
>>>>cruel, foolishness IMNSHO.
>>
>>>Heh. That's not what I encountered. The nursing home
>>>doctor didn't want JMF to get addicted...this was two
>>>weeks before he died. I had to fight like mad just to
>>>get his morphine dosage to 50% of what he had been on.
>>
When the end seems to be coming on, get back home fast, before they kill you
with
medical school "wisdom;" at least you will be able to tell the Gate Keeper that
you got there your way! A lot of medics point left with their right hand and
sometimes confuse the Hell out of many people including themselves.
JS
Mark Fergerson
>
> In article <20011104100958...@mb-bj.aol.com>,
> null...@aol.com (Ed Green) wrote:
> >>From: jmfb...@aol.com
> >>Date: 11/4/01 4:48 AM Eastern Standard Time
> >>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
> >
> >>In article <3BE432A9...@home.com>,
> >> Mark Fergerson <mferg...@home.com> wrote:
> >
> >> I see this as partly the Mother Teresa (she of
> >>>"no pain meds for the terminal cases, suffering is
> >>>good for the soul" fame) syndrome in the medical
> >>>community; if the cure is arbitrarily immoral then
> >>>the agony must be uniformly tolerated. Damn,
> >>>cruel, foolishness IMNSHO.
> >
> >>Heh. That's not what I encountered. The nursing home
> >>doctor didn't want JMF to get addicted...this was two
> >>weeks before he died. I had to fight like mad just to
> >>get his morphine dosage to 50% of what he had been on.
> >
> >Huh? I think you read Mark's comment backwards.
> >You are reporting the same mindset.
>
> But different rationalizations. I also encountered medical
> types who had the attitude that it was good for dying people
> to be aware at all times.
No, that's for the doctor's convenience; he
wants his questions answered.
> >I've thought about the reasons not to give powerful
> >drugs... fear of addiction... and wondered what this
> >has to do with the terminally ill. Your experience
> >would seem to be a hideous example of this
> >"thinking". How can a doctor "think" that it is better
> >to avoid addiction in a terminally ill patient than alleviate
> >suffering? For that matter, if there is acute suffering,
> >what would be the horrible drawback of having a
> >recovered but addicted patient who now must be
> >medically weaned off the drugs... but who was
> >spared agony?
>
> For some strange reason (that I haven't figured out yet),
> the weaning is left as an exercise to the user. I was the
> one who had to help him get off the drugs with his first
> bout of cancer. MDs don't seem to like to deal with this
> aspect of therapy. The only thing I can think of is that
> the connotations of being addicted are so non-PC that it's
> just easier to ignore the whole problem. I consider it
> a fallout of this foolish war on drugs business.
There are still doctors who think addiction to
pain medication is evidence of their incompetence.
Look up "Iatrogenic".
> >Even if "mere" pain alleviation were
> >not morally sufficient justification, the medical point
> >might be taken that suffering inteferes with rest and
> >recuperation.
>
> Exactly. There's another stupidity in the way those
> drugs are dispensed. You want to keep the pain in
> a dull background state rather than an hour of coma followed
> by increasing discomfort. Since every person is different,
> one flavor of treatment doesn't apply to everybody. It's
> a side of effect of this damned statistical study business.
> When they cut JMF's throat out, what he needed was 1/3 of
> the morphine dosage but every two hours rather than every three
> hours. I did manage to convince a nurse to change the protocol.
> I got him out of bed and exercising faster than anybody else
> who had gone through that ward with a similar malady. When
> he finally was able to eat, I got him onto real food by using
> <gasp!> hard-boiled eggs. I had to fight for that one because
> eggs cause colesterol.
Cholesterol? Don't get me started. It's fine to
put _men_ on soy derivatives that are _loaded_
with estrogen analogs, but don't give them
cholesterol. Grrrrr.
<snip>
I haven't been in a hospital for more than
twelve years (some of the healthiest in my life)
and I'm staying the hell out of them. The only
doctors I'll go anywhere near anymore are
Optometrists (and the odd Opthalmologist) and
dentists.
Mark L. Fergerson
Steve Harris
>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>>>Heh. That's not what I encountered. The nursing home
>>>doctor didn't want JMF to get addicted...this was two
>>>weeks before he died.
And his doctor was supposed to know he was 2 weeks away from death...how?
If he was terminally ill, had a recurrent cancer, was bedbound and losing
weight and clearly the battle, why didn't you get him signed into hospice,
where they are so liberal with the morphine you need to watch carefully to
see that they don't gently euthanize the patients (by giving them so much
juice that they don't eat, drink, move, etc, until they just get infected
and die).
>> I had to fight like mad just to
>>>get his morphine dosage to 50% of what he had been on.
Again, you fought with the hospice people for this? I don't believe it.
>>I've thought about the reasons not to give powerful
>>drugs... fear of addiction... and wondered what this
>>has to do with the terminally ill. Your experience
>>would seem to be a hideous example of this
>>"thinking". How can a doctor "think" that it is better
>>to avoid addiction in a terminally ill patient than alleviate
>>suffering?
Doctors don't think that way, and haven't for 20 years, now. Not in the US.
>For some strange reason (that I haven't figured out yet),
>the weaning is left as an exercise to the user. I was the
>one who had to help him get off the drugs with his first
>bout of cancer. MDs don't seem to like to deal with this
>aspect of therapy. The only thing I can think of is that
>the connotations of being addicted are so non-PC that it's
>just easier to ignore the whole problem. I consider it
>a fallout of this foolish war on drugs business.
No, the fallout from the war on drugs is how closely they watch prescription
records to see which doctors are too free with the narcotics. That certainly
doesn't help, though they do give carte blanche for "pain clinic" and
"hospice" so it's merely a matter of having a patient consult with a doctor
who bears the proper label. Stupid, but that's the system.
>Exactly. There's another stupidity in the way those
>drugs are dispensed. You want to keep the pain in
>a dull background state rather than an hour of coma followed
>by increasing discomfort. Since every person is different,
>one flavor of treatment doesn't apply to everybody. It's
>a side of effect of this damned statistical study business.
>When they cut JMF's throat out, what he needed was 1/3 of
>the morphine dosage but every two hours rather than every three
>hours.
Been there, done that. However, that's mostly a nursing problem and occurs
mostly in institutions. Again, hospice, either at home or in the SNF, is
the answer. For that, you get morphine solution at the bedside, with a
dropper.
> I did manage to convince a nurse to change the protocol.
>I got him out of bed and exercising faster than anybody else
>who had gone through that ward with a similar malady. When
>he finally was able to eat, I got him onto real food by using
><gasp!> hard-boiled eggs. I had to fight for that one because
>eggs cause colesterol.
Or maybe not. They also cause choking. I once knew an on call intern who
grew so tired of a patient's demand for boiled eggs that he actually wrote
late one night in the chart "Administer 2 boiled eggs PO PRN." Two hours
later the patient had a respiratory arrest, and they had to intubate her by
poking through (you guessed it) remnants of hardboiled egg. A photocopy of
the orders containing the egg order followed by the code blue arrest orders
adorned the call room bulletin board for awhile. This is medical humor. No,
it wasn't me. And no, the patient actually survived. But the lesson is that
a boiled egg isn't always all it's cracked up to be.
>>I have the feeling there is a lingering tradition
>>of pain in the American medical system as a manly
>>thing: from civil war operations biting the bullet, to
>>"agressive" surgery, the the pschological torture of
>>interns through sleep deprivation. Someone who has
>>been through this style of medical training may
>>unconsciously feel that since his suffering was
>>irrelevant, then his patients can just put up and
>>shut up too... it is a common result of abuse.
Nah, doesn't translate to care of the patient. However the abuse during
training may well contribute to how doctors feel about other doctors. Which
is that they assume they can take care of themselves and don't need any
coddling. Which means a doctor in trouble in his or her mental or physical
well-being doesn't get much professional help and still less professional
sympathy from his or her colleagues.
SBH
--
I welcome email from any being clever enough to fix my address. It's open
book. A prize to the first spambot that passes my Turing test.
jmfb...@aol.com wrote in message <9s66t0$9bv$1...@bob.news.rcn.net>...
jmfb...@aol.com
"Steve Harris" <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
>>>>From: jmfb...@aol.com
>>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>
>>>>Heh. That's not what I encountered. The nursing home
>>>>doctor didn't want JMF to get addicted...this was two
>>>>weeks before he died.
>
>And his doctor was supposed to know he was 2 weeks away from death...how?
>If he was terminally ill, had a recurrent cancer, was bedbound and losing
>weight and clearly the battle, why didn't you get him signed into hospice,
There aren't any. I had hospice nurses visiting once/week.
Unfortunately, I was also dying and couldn't take care of him
by myself. That's how he ended up in a nursing home.
>where they are so liberal with the morphine you need to watch carefully to
>see that they don't gently euthanize the patients (by giving them so much
>juice that they don't eat, drink, move, etc, until they just get infected
>and die).
>
>
>>> I had to fight like mad just to
>>>>get his morphine dosage to 50% of what he had been on.
>
>Again, you fought with the hospice people for this? I don't believe it.
I ended up calling at 3 AM each morning to make sure that he
had his other meds like co-tylenol and another kind that takes
is an aspirin derivative that eliminates the bone pain.
<snip>
<snip>
>> I did manage to convince a nurse to change the protocol.
>>I got him out of bed and exercising faster than anybody else
>>who had gone through that ward with a similar malady. When
>>he finally was able to eat, I got him onto real food by using
>><gasp!> hard-boiled eggs. I had to fight for that one because
>>eggs cause colesterol.
>
>
>Or maybe not. They also cause choking.
He had his throat cut out. The one good thing about that is that
I never had to prevent choking ever again.
> .. I once knew an on call intern who
>grew so tired of a patient's demand for boiled eggs that he actually wrote
>late one night in the chart "Administer 2 boiled eggs PO PRN." Two hours
>later the patient had a respiratory arrest, and they had to intubate her
by
>poking through (you guessed it) remnants of hardboiled egg. A photocopy of
>the orders containing the egg order followed by the code blue arrest
orders
>adorned the call room bulletin board for awhile. This is medical humor.
No,
>it wasn't me. And no, the patient actually survived. But the lesson is
that
>a boiled egg isn't always all it's cracked up to be.
<groan> However, eggs are the best transition I knew to get him from
off a liquid diet to normal food.
<snip>
Dirk Bruere
"Ed Green" <null...@aol.com> wrote in message
news:20011104164558...@mb-fp.aol.com...
>
> Of course, I have heard that some people can
> become addicts on one dose... I don't know that
What that means is that they decide after one dose that they like it and
want to do it again.
> I actually believe this. Your neuro-chemistry can't
> change _that_ quickly. But on whatever psychological
> or physiological level, I don't think everybody is
> potentiated to become an addict, unless you force
> feed them narcotics. The drug addicted vet was a
> cliche after Vietnam, but supposedly some guys
> just did drugs when they were in 'Nam, and stopped
> when they came home.
The figure for non recidivist drug addicts from Nam was about 95%. Change
the environment, change the behaviour.
> I would just make walk-in help available to anyone
> at anytime who comes in and says "I'm addicted to
> X and I want to stop". And maybe I would have a
> few Marine DI's come and beat the shit out of
> stupid HS kids who want to start. ;) But other
> than that, I'm in favor of a free market.
People become drug addicts (mainly) because they have nothing better or more
interesting to do. Yesterday I was suffering from a kidney stone. Went to
the local hospital and got a shot of some opiate. Killed the pain almost
instantly. However, rating it as a drug of pleasure I'd say it's not worth
the pain of injection.
Dirk
Dirk Bruere
<jmfb...@aol.com> wrote in message news:9s66t0$9bv$1...@bob.news.rcn.net...
>
> Exactly. There's another stupidity in the way those
> drugs are dispensed. You want to keep the pain in
> a dull background state rather than an hour of coma followed
> by increasing discomfort. Since every person is different,
> one flavor of treatment doesn't apply to everybody. It's
> a side of effect of this damned statistical study business.
> When they cut JMF's throat out, what he needed was 1/3 of
> the morphine dosage but every two hours rather than every three
> hours. I did manage to convince a nurse to change the protocol.
Over here they have machines that administer morphine/heroin (diamorphine)
when the patient presses a button. IIRC the actual dosages tend to go down
simply because the patient knows that they can get relief whenever they
want, so they tend to put up with more pain as well as spread the same dose
over a longer period.
Dirk
Ed Green
>Message-id: <9s66t0$9bv$1...@bob.news.rcn.net>
>For some strange reason (that I haven't figured out yet),
>the weaning is left as an exercise to the user. I was the
>one who had to help him get off the drugs with his first
>bout of cancer. MDs don't seem to like to deal with this
>aspect of therapy. The only thing I can think of is that
>the connotations of being addicted are so non-PC that it's
>just easier to ignore the whole problem. I consider it
>a fallout of this foolish war on drugs business.
That's very interesting, and you are undoubtly right
about the last thing. As I said, I think already following
WWI vets who became addicted to pain-killers in
the hospital were regarded as shameful rather than
merely suffering from a side-effect of their treatment.
Taboo thinking seems to be very persistent... we
weed it out in one area... or at least try to... it's
ok to be gay, its ok to be depressed... but it's
apparently not "ok" to be addicted to narcotics,
even as a byproduct of medical treatment.
And the mindset you report is among MD's,
presumably very well educated and familiar with
the human condition. The thing seems hopeless.
>I don't know. All I know is that, if I had allowed a
>dog to suffer like JMF did, I'd be in jail today.
Your sentiment is similar to Mark Twains... though
he took a cosmic view: if a man treated his children
the way God treated his human children, that man
would be jailed for child abuse.
>Although,
>JMF's surgeons had him in the OR for 20 hours. Maybe it
>is a good training technique.
Ok. This is similar to the military thing. I'm not
sure it's possible to "train" to operate sleep deprived.
Though I suppose it is at least possible to select
those who perform better under sleep deprivation.
The British, who by all accounts have a rather
repsectable naval tradition, are reputed to think
the US Navy is nuts because it makes a cult
of sleep deprivation. I can testify to this personally.
Like our attitudes to narcotics, this seems to have
been formed by some historical events which live
in institutional memory, unexamined. In particular,
during the Navy's darkest and finest hour, in the
war in the Pacific, ships may have been at battle
stations almost non-stop for days. Crews were
exhausted. Therefore (?) it's good to train at
being exhausted.
Relative to the healing power of sleep, I think this
confuses the necesssity of occasionally testing
your limits in a contest of will, and "training to
be miserable". Misery breaks down the organism.
Sorry to revive some painful memories for you.
Ed Green
>Date: 11/5/01 8:06 PM Eastern Standard Time
>Message-id: <3BE744E0...@home.com>
> There are still doctors who think addiction to
>pain medication is evidence of their incompetence.
>Look up "Iatrogenic".
Not in my unabridged.
Tending to produce what? Pay? Worship?
Ed Green
<9s7jcq$d4n$1...@nntp9.atl.mindspring.net>
>>>>Heh. That's not what I encountered. The nursing home
>>>>doctor didn't want JMF to get addicted...this was two
>>>>weeks before he died.
>
>And his doctor was supposed to know he was 2 weeks away from death...how?
Well, suppose there were a 50% chance of recovery,
based on best informed medical opinion.
Does it _increase_ the chances of recovery to allow
chronic discomfort and pain? I would think this
would further wear what reserves of strength the
body had.
His doctors may not have been able to prognosticate
the hour of his death, but they could see he was
gravely ill. What is to be gained by witholding
effective pain relief from a gravely ill patient?
My admittedly limited and anecdotal evidence suggests
that adequate pain relief speeds and increases the
chances of healing. Which doesn't mean that...
>hospice,
>where they are so liberal with the morphine you need to watch carefully to
>see that they don't gently euthanize the patients (by giving them so much
>juice that they don't eat, drink, move, etc, until they just get infected
>and die).
that you couldn't go too far the other way.
So the idea seems to be; once a patient is written
off as the still-breathing dead, drug him or her to the
max, but God forbid we ever allow a patient who
recovers to become chemcially habituated.
When you write...
>If he was terminally ill, had a recurrent cancer, was bedbound and losing
>weight and clearly the battle, why didn't you get him signed into hospice,
The "you" is a bit jarring. It may be the decision of the
patient and his family, but you seem to impose the
entire burden of medical and moral judgement on
them...
EG> How can a doctor "think" that it is better
>>>to avoid addiction in a terminally ill patient than alleviate
>>>suffering?
>
>Doctors don't think that way, and haven't for 20 years, now. Not in the US.
Ok. Twenty years is not outside of living memory.
If doctors "thought" this way twenty years ago, it's
a good bet some of them still think that way today.
At least your remark confirms that my generalization
identified a real phenomena although my data may
be out of date, and there in fact may be a reaction
to this mindset in place today.
Fashion.
EG>I have the feeling there is a lingering tradition
>>>of pain in the American medical system as a manly
>>>thing: from civil war operations biting the bullet, to
>>>"agressive" surgery, the the pschological torture of
>>>interns through sleep deprivation. Someone who has
>>>been through this style of medical training may
>>>unconsciously feel that since his suffering was
>>>irrelevant, then his patients can just put up and
>>>shut up too... it is a common result of abuse.
>Nah, doesn't translate to care of the patient. However the abuse during
>training may well contribute to how doctors feel about other doctors. Which
>is that they assume they can take care of themselves and don't need any
>coddling. Which means a doctor in trouble in his or her mental or physical
>well-being doesn't get much professional help and still less professional
>sympathy from his or her colleagues.
Well, thanks for your frank reply. It's hard to believe
a little of that doesn't translate into care of the patient...
particularly if the patient is perceived as a "peer"
somehow. I'm not a hypochondriac, but whenever
I have merely broached the idea that I _might_ have
one of those chronic exhaustion/infection diseases,
because I sometimes become exhausted performing
daily tasks... although other times I am full of animal
energy... it has essentially been immediately dismissed
as "in my mind", or a failure of will, etc.
I can imagine a doctor not feeling like himself meeting
just the same attitude following your report...
Richard Herring
> >From: Mark Fergerson mferg...@home.com
> >Date: 11/5/01 8:06 PM Eastern Standard Time
> >Message-id: <3BE744E0...@home.com>
> > There are still doctors who think addiction to
> >pain medication is evidence of their incompetence.
> >Look up "Iatrogenic".
> Not in my unabridged.
> Tending to produce what? Pay? Worship?
Not tending to produce, but produced, by the doctor (Gr. iatros)
--
Richard Herring | <richard...@baesystems.com>
Steve Harris
--
I welcome email from any being clever enough to fix my address. It's open
book. A prize to the first spambot that passes my Turing test.
Ed Green wrote in message <20011106091701...@mb-fp.aol.com>...
>>From: Mark Fergerson mferg...@home.com
>>Date: 11/5/01 8:06 PM Eastern Standard Time
>>Message-id: <3BE744E0...@home.com>
>
>> There are still doctors who think addiction to
>>pain medication is evidence of their incompetence.
>>Look up "Iatrogenic".
>
>Not in my unabridged.
Means a problem caused by the doctor or the treatment. "Iatros" = doctor in
Greek.
Steve Harris
--
I welcome email from any being clever enough to fix my address. It's open
book. A prize to the first spambot that passes my Turing test.
jmfb...@aol.com wrote in message <9s8ie8$ptd$1...@bob.news.rcn.net>...
>In article <9s7jcq$d4n$1...@nntp9.atl.mindspring.net>,
> "Steve Harris" <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
>>>>>From: jmfb...@aol.com
>>>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>>
>>>>>Heh. That's not what I encountered. The nursing home
>>>>>doctor didn't want JMF to get addicted...this was two
>>>>>weeks before he died.
>>
>>And his doctor was supposed to know he was 2 weeks away from death...how?
>>If he was terminally ill, had a recurrent cancer, was bedbound and losing
>>weight and clearly the battle, why didn't you get him signed into hospice,
>
>There aren't any. I had hospice nurses visiting once/week.
>Unfortunately, I was also dying and couldn't take care of him
>by myself. That's how he ended up in a nursing home.
Babs, "hospice" isn't a place, it's program. It's everywhere, and was
everywhere a decade ago (AIDS basically got it universally available). What
place and what year are you talking about? Hospice can be done at home (so
long as the patient doens't live alone), in the hospital, in assisted
residential living, or in a skilled care facility. If you had hospice nurses
visiting, he should have been able to get all the narcotics he wanted, just
by asking. In fact, I cannot imagine how you got hospice nurses without a
hospice program. Your story is extremely confused. The hospice doc, not the
facility doc, controls the pain med orders, and in effect it is actually the
hospice nurses who do it, since they have very wide latitude.
Hospice is also a state of mind. It switches labels on a patient and says
"Okay, our primary goal now is comfort for this person, NOT long term
recovery." So narcotics and also antianxiety drugs run like water. If you
can get the primary care doc to agree that the patient even reasonably MIGHT
have less than 6 months to live, you can get a hospice program anywhere in
the country, and medicare/medicaid will pay for it. I've seen these patients
go for 2 or three repeat signups, too-- there is no demand that you die on
schedule. And it's no problem for a guy who's had a laryngectomy for throat
cancer (see what smoking does to you?) and is in a nursing home, failing.
There's no penalty if the patient outlives the 6 months.
You might have thought you were dying. But if you had enough presense of
mind and knowledge to think he wasn't getting good pain control, you also
had enough to get him signed up for hospice. Perhaps you didn't know enough
to do so. However, the resources are out there. I'm surprised the attending
at the nursing home didn't suggest it.
SBH
Steve Harris
>jmfb...@aol.com wrote in message <9s8ie8$ptd$1...@bob.news.rcn.net>...
>In article <9s7jcq$d4n$1...@nntp9.atl.mindspring.net>,
> "Steve Harris" <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
>>>>>From: jmfb...@aol.com
>>>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>>
>>>>>Heh. That's not what I encountered. The nursing home
>>>>>doctor didn't want JMF to get addicted...this was two
>>>>>weeks before he died.
>>
>>And his doctor was supposed to know he was 2 weeks away from death...how?
>>If he was terminally ill, had a recurrent cancer, was bedbound and losing
>>weight and clearly the battle, why didn't you get him signed into hospice,
>
>There aren't any. I had hospice nurses visiting once/week.
>Unfortunately, I was also dying and couldn't take care of him
>by myself. That's how he ended up in a nursing home.
COMMENT
Babs, "hospice" isn't a place, it's program. It's everywhere, and was
everywhere a decade ago (AIDS basically got it universally available). What
place and what year are you talking about? Hospice can be done at home (so
long as the patient doens't live alone), in the hospital, in assisted
residential living, or in a skilled care facility. If you had hospice nurses
visiting, he should have been able to get all the narcotics he wanted, just
by asking. In fact, I cannot imagine how you got hospice nurses without a
hospice program. Your story is extremely confused. The hospice doc, not the
facility doc, controls the pain med orders, and in effect it is actually the
hospice nurses who do it, since they have very wide latitude.
Hospice is also a state of mind. It switches labels on a patient and says
"Okay, our primary goal now is comfort for this person, NOT long term
recovery." So narcotics and also antianxiety drugs run like water. If you
can get the primary care doc to agree that the patient even reasonably MIGHT
have less than 6 months to live, you can get a hospice program anywhere in
the country, and medicare/medicaid will pay for it. I've seen these patients
go for 2 or three repeat signups, too-- there is no demand that you die on
schedule. And it's no problem for a guy who's had a laryngectomy for throat
cancer (see what smoking does to you?) and is in a nursing home, failing.
There's no penalty if the patient outlives the 6 months.
You might have thought YOU were dying. But if you had enough presense of
mind and knowledge to think he wasn't getting good pain control, you also
had enough to get him signed up for hospice. Perhaps you didn't know enough
to do so. However, the resources are out there. I'm surprised the attending
at the nursing home didn't suggest it.
SBH
--
Ed Green
<9s9blg$apn$1...@slb1.atl.mindspring.net>
>Babs,
You remind me that a fellow TA in freshman chem lab
once got in a xxxload of trouble by writing on an exam
paper "Babs, you blew it".
But since I guess there is not a TA/student relation
here, lattitude must be granted. ;)
>"hospice" isn't a place, it's program. It's everywhere, and was
>everywhere a decade ago (AIDS basically got it universally available). What
>place and what year are you talking about? Hospice can be done at home (so
>long as the patient doens't live alone), in the hospital, in assisted
>residential living, or in a skilled care facility. If you had hospice nurses
>visiting, he should have been able to get all the narcotics he wanted, just
>by asking. In fact, I cannot imagine how you got hospice nurses without a
>hospice program. Your story is extremely confused. The hospice doc, not the
>facility doc, controls the pain med orders, and in effect it is actually the
>hospice nurses who do it, since they have very wide latitude.
>
>Hospice is also a state of mind. It switches labels on a patient and says
>"Okay, our primary goal now is comfort for this person, NOT long term
>recovery." So narcotics and also antianxiety drugs run like water. If you
>can get the primary care doc to agree that the patient even reasonably MIGHT
>have less than 6 months to live, you can get a hospice program anywhere in
>the country, and medicare/medicaid will pay for it. I've seen these patients
>go for 2 or three repeat signups, too-- there is no demand that you die on
>schedule.
It's interesting/would be interesting to compare and
contrast this to nursing homes. Or are you saying
that you could be on hospice _in_ a nursing home?
But the mind set you mention also seems similar
to the nursing home/recovery option. When my
mother had here second stroke in her middle
seventies... still lucid but non-ambulatory, some
paralysis, they stopped talking "rehabilitation" and
heavily pushed "nursing home". The nursing home
gave lip service to rehabilitation, but basically was
a parking place for people too difficult to care for
at home, but not actually considerate enough to
be dying. As my wife put it, there was a distinct
feeling they had "given up" on her.
When she did die, after a third stroke in the nursing
home, it was mercifully quick. Horrible place for
a lucid person to be incarcerated, though.
> And it's no problem for a guy who's had a laryngectomy for throat
>cancer (see what smoking does to you?) and is in a nursing home, failing.
>There's no penalty if the patient outlives the 6 months.
>
>You might have thought YOU were dying. But if you had enough presense of
>mind and knowledge to think he wasn't getting good pain control, you also
>had enough to get him signed up for hospice. Perhaps you didn't know enough
>to do so. However, the resources are out there. I'm surprised the attending
>at the nursing home didn't suggest it.
Since BAH evidently didn't understand this option
(I thought it was a place also, and I would say this
is a common misconception) it was incumbent on
the nurses/doctors to educate her, so she could
make an informed decision/input to jmf's decision.
This does not seem to have occured.
Ed Green
>Date: 11/4/01 10:30 PM Eastern Standard Time
>Message-id: <7728-3BE...@storefull-263.iap.bryant.webtv.net>
More power to you... but I am neither smoking nor
drinking much of anything. If you read my little
tale "Codeine: what it means to me" you will see
that I used it medically... and in fact took about
double the recommended dose while I used it,
IIRC, then stopped when I felt better.
I hear you hearing a different idiom "handle it"';
I hear you idiom very clearly, though I think you
miss mine.
On the other hand, right about now spending the
remainder of my life in an opium den (on federal
opium den assistance) does sound rather appealing.
Where can I sign up for the benefit?
jmfb...@aol.com
<snip>
>>Although,
>>JMF's surgeons had him in the OR for 20 hours. Maybe it
>>is a good training technique.
>
>Ok. This is similar to the military thing. I'm not
>sure it's possible to "train" to operate sleep deprived.
Not train...weed out the ones who can't cope under a state
of sleep deprivation.
>Though I suppose it is at least possible to select
>those who perform better under sleep deprivation.
Yup. This is it. They also are the ones who don't
quit just because they're bone-weary.
>
>The British, who by all accounts have a rather
>repsectable naval tradition, are reputed to think
>the US Navy is nuts because it makes a cult
>of sleep deprivation. I can testify to this personally.
There was a show on TLC (I think...maybe TDC) about the
pre-Seal training. The whole point of hell week was to
get a group to automatically work together. It made
great sense to me because, if you're up to your ass in
the enemy, you don't want to have to second guess what
the guy who is covered your back is going to do..or not
do.
/BAH
<snip>
>Sorry to revive some painful memories for you.
That's OK. It was a good sanity check and you actually answered
one of my "life's mysteries" questions: "Why people need to
be aware until death".
jmfb...@aol.com
"Steve Harris" <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
>
>
>>jmfb...@aol.com wrote in message <9s8ie8$ptd$1...@bob.news.rcn.net>...
>>In article <9s7jcq$d4n$1...@nntp9.atl.mindspring.net>,
>> "Steve Harris" <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
>>>>>>From: jmfb...@aol.com
>>>>>>Date: 11/4/01 4:48 AM Eastern Standard Time
>>>>>>Message-id: <9s39ok$cqo$3...@bob.news.rcn.net>
>>>
>>>>>>Heh. That's not what I encountered. The nursing home
>>>>>>doctor didn't want JMF to get addicted...this was two
>>>>>>weeks before he died.
>>>
>>>And his doctor was supposed to know he was 2 weeks away from
death...how?
>>>If he was terminally ill, had a recurrent cancer, was bedbound and
losing
>>>weight and clearly the battle, why didn't you get him signed into
hospice,
>>
>>There aren't any. I had hospice nurses visiting once/week.
>>Unfortunately, I was also dying and couldn't take care of him
>>by myself. That's how he ended up in a nursing home.
>
>COMMENT
>
>Babs,
I prefer bitch to Babs; only one person was allowed to call me
that. Even JMF didn't dare.
> ..."hospice" isn't a place, it's program.
It can be both. I did have access to the program. However,
putting JMF into the nursing home eliminated the program.
The hopice nurses were not allowed to "interfere" with
the nursing home contingent.
Look, I don't want to get into the politics of the medical
mess we have over here.
> .. It's everywhere, and was
>everywhere a decade ago (AIDS basically got it universally available).
What
>place and what year are you talking about?
Massachusetts, 1995.
> .. Hospice can be done at home (so
>long as the patient doens't live alone), in the hospital, in assisted
>residential living, or in a skilled care facility. If you had hospice
nurses
>visiting, he should have been able to get all the narcotics he wanted,
just
>by asking. In fact, I cannot imagine how you got hospice nurses without a
>hospice program.
I lost the hospice nursing when he was put into the nursing home.
The reason he was put into a nursing home was because I was
too sick to care for him 7x24. The reason I had to care for
him 7x24 is because the nursing orgs in this state had to
"listen" to the HMO that JMF had (even though he had another
kind of insurance) and the HMO wanted him in the nursing home.
I couldn't get nursing help even by paying them cash because
the HMO would bar those nurses from future assignments.
> ..Your story is extremely confused. The hospice doc,
There was no hospice doc.
> ..not the
>facility doc, controls the pain med orders,
It was the HMO doc who wrote the orders. He was more than
glad to just do all transactions over the phone because
he was afraid of JMF. He was afraid of JMF because JMF was
dying, didn't look nice, was physically a mess, and stunk.
> ...and in effect it is actually the
>hospice nurses who do it, since they have very wide latitude.
Yes. They were great at figuring out the pain meds to keep him
comfortable and functioning. It was against the rules to have
them do the same thing in the nursing home.
>
>Hospice is also a state of mind. It switches labels on a patient and says
>"Okay, our primary goal now is comfort for this person, NOT long term
>recovery." So narcotics and also antianxiety drugs run like water. If you
>can get the primary care doc to agree that the patient even reasonably
MIGHT
>have less than 6 months to live, you can get a hospice program anywhere in
>the country, and medicare/medicaid will pay for it. I've seen these
patients
>go for 2 or three repeat signups, too-- there is no demand that you die on
>schedule. And it's no problem for a guy who's had a laryngectomy for
throat
>cancer (see what smoking does to you?)
Or overzealous dentists.
> and is in a nursing home, failing.
>There's no penalty if the patient outlives the 6 months.
Sigh! The advantage of the hospice program was that we didn't
have to sit in the doctor's office to get drugs.
>
>You might have thought YOU were dying.
I knew I was dying.
> ..But if you had enough presense of
>mind and knowledge to think he wasn't getting good pain control, you also
>had enough to get him signed up for hospice.
No, you're not reading what I'm writing. The opposite happened.
He was in a hospice program. He lost that by getting put into
the nursing home.
> ...Perhaps you didn't know enough
>to do so. However, the resources are out there. I'm
>surprised the attending
>at the nursing home didn't suggest it.
The attending nursing home's nurses weren't capable. I was offered a job
because I knew how to change JMF's dressings, do minor surgery
emergency procedures and administer his meds. It was against
nursing home policy to allow the hospice nurses to step foot
into the place, let alone make drug suggestions.
jmfb...@aol.com
null...@aol.com (Ed Green) wrote:
>>From: "Steve Harris" sbha...@ix.RETICULATEDOBJECTcom.com
><9s9blg$apn$1...@slb1.atl.mindspring.net>
>
>>Babs,
>
>You remind me that a fellow TA in freshman chem lab
>once got in a xxxload of trouble by writing on an exam
>paper "Babs, you blew it".
>
>But since I guess there is not a TA/student relation
>here, lattitude must be granted. ;)
He did blow it. And I'm smart enough to catch the innuendo
he meant by it.
<snip>
>It's interesting/would be interesting to compare and
>contrast this to nursing homes. Or are you saying
>that you could be on hospice _in_ a nursing home?
That's what he's claiming but that's not how things work here.
>
>But the mind set you mention also seems similar
>to the nursing home/recovery option. When my
>mother had here second stroke in her middle
>seventies... still lucid but non-ambulatory, some
>paralysis, they stopped talking "rehabilitation" and
>heavily pushed "nursing home". The nursing home
>gave lip service to rehabilitation, but basically was
>a parking place for people too difficult to care for
>at home, but not actually considerate enough to
>be dying. As my wife put it, there was a distinct
>feeling they had "given up" on her.
I think that's an American attitude towards death.
>
>When she did die, after a third stroke in the nursing
>home, it was mercifully quick. Horrible place for
>a lucid person to be incarcerated, though.
Yes.
<snip>
>Since BAH evidently didn't understand this option
>(I thought it was a place also, and I would say this
>is a common misconception) it was incumbent on
>the nurses/doctors to educate her, so she could
>make an informed decision/input to jmf's decision.
>
>This does not seem to have occured.
Nope. Steve's got the sequence of events all screwed up.
Ed Green
<9sbdsn$p2k$3...@bob.news.rcn.net>
...
>>This does not seem to have occured.
>
>Nope. Steve's got the sequence of events all screwed up.
Well, sorry. He wrote with such easy authority that
I assumed he knew exactly what he was talking about.
But not, apparently, in Massachusetts in 1995, and
the particular collection of administrations you had to
deal with. Sounds like a power struggle between
the HMO, the nursing homes and the hospice program.
Oh... were there patients involved here? Hmmph.
My mom happened to go that year too. It was bad,
but not so horrendous as what you describe.
I hope, if I ever wind up in that situation, I have
somebody as caring and concerned as you to
look after my interests. How much more horrible
for him if he hadn't.
Ed Green
<9sbbsb$i6g$1...@bob.news.rcn.net>
> null...@aol.com (Ed Green) wrote:
>>>From: jmfb...@aol.com
>>>Message-id: <9s66t0$9bv$1...@bob.news.rcn.net>
><snip>
>
>>>Although,
>>>JMF's surgeons had him in the OR for 20 hours. Maybe it
>>>is a good training technique.
>>
>>Ok. This is similar to the military thing. I'm not
>>sure it's possible to "train" to operate sleep deprived.
>
>Not train...weed out the ones who can't cope under a state
>of sleep deprivation.
>
>>Though I suppose it is at least possible to select
>>those who perform better under sleep deprivation.
>
>Yup. This is it. They also are the ones who don't
>quit just because they're bone-weary.
BAH, I rarely must say such a thing, but how
moralistic of you. People have different tolerances
and motivations, and it is natural for those with
higher tolerance or motivation to assume that
they have greater moral fiber... which is different
from merely asserting that there may be legitmate
selection criteria, outside of any moral element.
Maybe those who don't quit because they are
"bone weary" simply have higher or lower nor-
epinephrine levels.
However, about "training"; if we agree the purpose
of various sorts of deprivation exercises... the
legitimate purpose, beyond the hazing "I went through
this, now you are going to go through this", which is
by the way how child abuse is perpetuated, the
testing need not be and is not ideally a chronic
condition. It is one thing to test limits because
we have to, it is another to wear down the efficiency
of the organism "because it's good for you".
>>The British, who by all accounts have a rather
>>repsectable naval tradition, are reputed to think
>>the US Navy is nuts because it makes a cult
>>of sleep deprivation. I can testify to this personally.
>
>There was a show on TLC (I think...maybe TDC) about the
>pre-Seal training. The whole point of hell week was to
>get a group to automatically work together.
Yes, that's the other "rational" explanation... maybe
true for all that. Testing, and building team
cohesiveness.
>It made
>great sense to me because, if you're up to your ass in
>the enemy, you don't want to have to second guess what
>the guy who is covered your back is going to do..or not
>do.
Super. Which has about zero to do with chronic
sleep deprivation as a kind of cultural norm.
Maybe it's a naval tradition because it supresses
thought. It's dangerous to have well rested, thoughtful,
and bored sailors. Much better have chronically
physically exhuasted sailors, whose only off-duty
thought is for the rack.
Steve Harris
Ed Green wrote in message <20011106094723...@mb-fp.aol.com>...
>Well, suppose there were a 50% chance of recovery,
>based on best informed medical opinion.
All it takes is the attending's certification that the patient is more
likely to die in 6 months than not. People get on hospice for congestive
heart failure and occasionally live for years. Number of times you can sign
up and receive Medicare hospice benefits, has been unlimited since around
1996.
>Does it _increase_ the chances of recovery to allow
>chronic discomfort and pain?
Hard to say, since nobody has done a randomized study, for obvious reasons.
I think that most doctors feel that you don't get a decrease in recovery
until you're giving so much drug that the patient is asleep most of the
time.
>His doctors may not have been able to prognosticate
>the hour of his death, but they could see he was
>gravely ill. What is to be gained by witholding
>effective pain relief from a gravely ill patient?
Generally, nothing.
>So the idea seems to be; once a patient is written
>off as the still-breathing dead, drug him or her to the
>max, but God forbid we ever allow a patient who
>recovers to become chemcially habituated.
How much drug a patient gets will generally be greatly influenced by whether
or not they are perceived to have pain as a direct result of their teminal
illness or not. Cancer patients with bone pain will probably get much more
drug than heart failure patients who happen to have low back pain unrelated
to anything else. Even if they're both in hospice, and even if the back
sprain patient has more pain. This is not quite fair, but pain perceived to
be related to life-threatening illness gets more treatment than incident
pain which happens at the same time as non-painful life threatening illness.
If that make sense.
People don't worry that much about habituation any more. If you have to
detox from a narcotic you're habituated to, it's not THAT bad. No worse than
the flu, if you go slowly. I'm seeing more and more of the elderly who have
chronic pain put on chronic low-dose slow release oral morphine and left
there, even if they're not terminally ill. This seems to be a good solution
for many.
>When you write...
>
>>If he was terminally ill, had a recurrent cancer, was bedbound and losing
>>weight and clearly the battle, why didn't you get him signed into hospice,
>
>The "you" is a bit jarring. It may be the decision of the
>patient and his family, but you seem to impose the
>entire burden of medical and moral judgement on
>them...
It IS on them, if they think the patient is not getting adequate pain
management. Obviously the patient is not managing to do it. Or the family
and patient disagree on how much pain there is (I've seen that many times).
If you don't like how your doctor is managing your pain, use the most
powerful words in medicine: "You're fired". But somebody has to say them.
>Ok. Twenty years is not outside of living memory.
>If doctors "thought" this way twenty years ago, it's
>a good bet some of them still think that way today.
It's at least 20 years and I used that number because that's how long I've
personally observed it. The hospice movement in the US comes in, in the late
1970's (transplanted from England in the 1960's), but that was just a little
before my own time in direct medical care. My knowledge of chronic pain
management in the dim time before that (1970's), comes mainly from the same
source yours does: a lot of grim stories I heard.
>Well, thanks for your frank reply. It's hard to believe
>a little of that doesn't translate into care of the patient...
>particularly if the patient is perceived as a "peer"
>somehow. I'm not a hypochondriac, but whenever
>I have merely broached the idea that I _might_ have
>one of those chronic exhaustion/infection diseases,
>because I sometimes become exhausted performing
>daily tasks... although other times I am full of animal
>energy... it has essentially been immediately dismissed
>as "in my mind", or a failure of will, etc.
Chronic exhaustion, vs chronic fatigue (a better defined entity) vs. chronic
pain, are completely different topics. Medical philosophy is much more
monolithic on pain treatment these days than it is for fatigue treatment.
>I can imagine a doctor not feeling like himself meeting
>just the same attitude following your report...
Yep.
Steve Harris
>It's interesting/would be interesting to compare and
>contrast this to nursing homes. Or are you saying
>that you could be on hospice _in_ a nursing home?
Yes, and about 1/3rd of hospice patients today are in fact in nursing homes.
This varies from state to state, but it's not less than 10% in any state.
Medicare pays a hospice program benefit which goes on top of Part A long
term care benefits, and this has been going on since the OBRA (Omnibus
Budget Reconciliation Act) in 1985, amended 1989. It's a Federal long term
care payment program, and the idea that news of it might not have penetrated
Massachusetts (of all places) by 1995, is pretty funny. Nursing home chains
do hear about these funding sources, trust me. If you want the stats from
1992 to 1996 for all this stuff, it's available from the kind of people who
like to do this kind of thing. See:
http://aspe.hhs.gov/daltcp/reports/nufares.htm or
http://aspe.hhs.gov/daltcp/reports/96useexp.htm
if you read into the second report you see that Massachusetts in the early
90's wasn't much different than the rest of the country so far as its use of
this program. I've also appended some info from the Massachusetts Hospice
Federation people if you have a burning desire to know more. In any case,
this is not something that happened last year.
>But the mind set you mention also seems similar
>to the nursing home/recovery option. When my
>mother had here second stroke in her middle
>seventies... still lucid but non-ambulatory, some
>paralysis, they stopped talking "rehabilitation" and
>heavily pushed "nursing home". The nursing home
>gave lip service to rehabilitation, but basically was
>a parking place for people too difficult to care for
>at home, but not actually considerate enough to
>be dying. As my wife put it, there was a distinct
>feeling they had "given up" on her.
Depends on who pays. Medicare only pays for so many rehab days, and so many
nursing home days, until you spend down to Medicaid levels. If you want more
than that, and your insurance won't cover it, you have to pay cash for extra
rehab. Caveat emptor there. If you don't like the service, fire the rehab
team (you may have to fire the nursing home also, but that also can be
done).
>When she did die, after a third stroke in the nursing
>home, it was mercifully quick. Horrible place for
>a lucid person to be incarcerated, though.
Yep. Usually is. Many nursing homes (Skilled Nursing Facilities = SNFs)
have a separate facility for neuro-rehab (which often also includes younger
spinal cord injury patients), and it's not so mentally horrid there as in
the dementia wards. Bad idea to mix these people, on the whole, I think,
for the reasons you state. Patients need much of the same kind of care, but
in one case they're more self-aware, and need more mental stimulation.
>Since BAH evidently didn't understand this option
>(I thought it was a place also, and I would say this
>is a common misconception) it was incumbent on
>the nurses/doctors to educate her, so she could
>make an informed decision/input to jmf's decision.
Sure enough. But if the student doesn't learn, must you blame the teacher?
BAH's a big girl, and not brain damaged. If OTOH she was too ill to
participate, that would also have been true for learning about hospice.
However, what do you want me to tell you? She's refusing to learn about it
NOW. At some point, somebody has to take responsibility for ignorance.
Especially if repeated attempts at education have been made.
I can't tell you how many times I've had people complain to me that a past
doctor didn't tell them something, and they're almost always the kind of
people you can't tell anything to. Who aren't listening as I speak, either.
So what am I supposed to infer?
SBH
HOSPICE INFORMATION SHEET
Overview
- Hospice focuses on care for persons with terminal illness.
Its
services include: nursing, home health aide assistance,
social
work, pastoral care, volunteers and a 24 hour, seven day a
wee
ability to contact a nurse for advice or a visit if needed.
Additionally, bereavement services are offered for 13-18
months
after the patient’s death.
- Hospice considers the patient and family to be the unit of
care. Hospice services are a family support system, not a
substitute. If there is not caregiver in the home, the
patient
and family (or other involved party) will be asked to
participate in planning for future care.
- Hospices can, in cases of medical crisis, provide
temporary
intensive services or respite care for a limited period of
time
in order to give the caregiver a rest.
- Hospice Services can be available in a nursing home.
- Hospice services can be available in a hospital.
FINANCIAL INFORMATION
- Anyone with Medicare "A" has the Hospice Benefit.
- In most cases Medicaid covers Hospice Services. Patients
should check with the Medicaid Office.
- Most private insurers and HMOs have Hospice coverage.
- Hospices are paid a per-diem rate. This means that for a
daily
pre-set rate they provide the services named above plus all
medications, supplies, and equipment that pertains.
- Hospice benefits are available for six months and can be
renewed. Unfortunately, many persons do not become hospice
patients until shortly before death and thus do not receive
the
full benefit of the palliative care offered by the hospice
team.
HOSPICE TEAM
- Hospices operate on a true disciplinary team spirit. Hospice
professionals of all disciplines are skilled and
expert in pain control, symptom management and spiritual and
psychological aspects of death and dying.
- They have resources of a Medical Director and the ability
to
access him/her 24 hours a day, seven days a week should that
patient’s primary MD be unavailable or request that the
Hospice
MD assist with the problem. The primary MD, however, is kept
informed about progress and problems and remains involved in
the
plan of care.
- Hospice nurses pronounce death in the home, relieving the
family of all the worry and stress of ambulance, medical
examiner, equipment return, etc. Patients and family are
treated
with dignity and respect. The nurse will call the funeral
service that the family has chosen if desired.
For information about a hospice in your area:
Prepared by: Jacqueline J. Fajkowski, RN, CHPN
Hospice Federation of Massachusetts, Hospice Care Inc.,
Stoneham, MA
Steve Harris
Ed Green wrote in message <20011107101820...@mb-fj.aol.com>...
>>From: jmfb...@aol.com
><9sbdsn$p2k$3...@bob.news.rcn.net>
>
>...
>
>>>This does not seem to have occured.
>>
>>Nope. Steve's got the sequence of events all screwed up.
>
>Well, sorry. He wrote with such easy authority that
>I assumed he knew exactly what he was talking about.
>But not, apparently, in Massachusetts in 1995, and
>the particular collection of administrations you had to
>deal with.
No. Sorry to burst bubbles, but this is baloney. "Expert" is a relative
term, but I did this for a living at the time, and the only people who know
more about this kind of thing than I do, are those who write the kind of
federal-funding-use statistical articles that I've referred you to. And
perhaps the Massachusetts Hospice Federation, which I've also referred you
to. If you want to convince me, talk to them first. Or, if you prefer, give
me the name of the city in that state in 1995, and I'll give you several
nursing homes in the area running hospice programs back in 1995. You can get
that information yourself, probably, from the Hospice Federation. None of
your lip.
Unless you'd like me to entertain the idea that BAH is posting from the evil
parallel universe where everyone has beards? Some stuff does slip over into
Usenet from There, I suspect, but I think the holes are larger in
talk.politics.libertarian. I've killfiled most of the rifts in sci.physics
by just getting rid of a very few people....
> Sounds like a power struggle between
>the HMO, the nursing homes and the hospice program.
Medical power struggles in cases of people over the age of 65 generally
require only the power-words "you've fired" to fix up. You can always go
back to medicare, in the US, and you can then choose your doc (unless you
want something really fancy). If you're younger than that, you may well
have to deal with an intransigent HMO or insurance company. In these cases
the power-words are usually "I'm filing a lawsuit". If that fails, you may
actually have to retain an attorney and file. This gets you rapidly to Risk
Management, thence to a different doctor and generally better care. It
doesn't always get you the really expensive care, but hospice isn't
expensive. The Feds wouldn't have embraced it so quickly if it was.
SBH
jmfb...@aol.com
null...@aol.com (Ed Green) wrote:
>>From: jmfb...@aol.com
><9sbbsb$i6g$1...@bob.news.rcn.net>
>
>> null...@aol.com (Ed Green) wrote:
>
>>>>From: jmfb...@aol.com
>
>>>>Message-id: <9s66t0$9bv$1...@bob.news.rcn.net>
>><snip>
>>
>>>>Although,
>>>>JMF's surgeons had him in the OR for 20 hours. Maybe it
>>>>is a good training technique.
>>>
>>>Ok. This is similar to the military thing. I'm not
>>>sure it's possible to "train" to operate sleep deprived.
>>
>>Not train...weed out the ones who can't cope under a state
>>of sleep deprivation.
>>
>>>Though I suppose it is at least possible to select
>>>those who perform better under sleep deprivation.
>>
>>Yup. This is it. They also are the ones who don't
>>quit just because they're bone-weary.
>
>BAH, I rarely must say such a thing, but how
>moralistic of you.
I didn't mean it that way. :-(
>People have different tolerances
>and motivations, and it is natural for those with
>higher tolerance or motivation to assume that
>they have greater moral fiber... which is different
>from merely asserting that there may be legitmate
>selection criteria, outside of any moral element.
>
>Maybe those who don't quit because they are
>"bone weary" simply have higher or lower nor-
>epinephrine levels.
Sure. And those are the ones who should get the OK for
doing long surguries (for example).
>
>However, about "training"; if we agree the purpose
>of various sorts of deprivation exercises... the
>legitimate purpose, beyond the hazing "I went through
>this, now you are going to go through this", which is
>by the way how child abuse is perpetuated, the
>testing need not be and is not ideally a chronic
>condition. It is one thing to test limits because
>we have to, it is another to wear down the efficiency
>of the organism "because it's good for you".
Right.
>
>>>The British, who by all accounts have a rather
>>>repsectable naval tradition, are reputed to think
>>>the US Navy is nuts because it makes a cult
>>>of sleep deprivation. I can testify to this personally.
>>
>>There was a show on TLC (I think...maybe TDC) about the
>>pre-Seal training. The whole point of hell week was to
>>get a group to automatically work together.
>
>Yes, that's the other "rational" explanation... maybe
>true for all that. Testing, and building team
>cohesiveness.
It had never occured to me before watching that show, that
a single sleep deprivation exercise could produce a team.
We always had the problem of getting a group of prima donnas
to work together on one project to produce one cohesive set
of bits rather than n different sets that would undermine
all other sets of bits. JMF and TW evolved a debugging
technique such that their comversation was reduced to body
twitches, finger indications, and a form of shorthand speech
so that communication between them was at a maximum efficiency.
It had never occurred to me that sleep deprevation sessions
might do it.
>>It made
>>great sense to me because, if you're up to your ass in
>>the enemy, you don't want to have to second guess what
>>the guy who is covered your back is going to do..or not
>>do.
>
>Super. Which has about zero to do with chronic
>sleep deprivation as a kind of cultural norm.
>
>Maybe it's a naval tradition because it supresses
>thought. It's dangerous to have well rested, thoughtful,
>and bored sailors. Much better have chronically
>physically exhuasted sailors, whose only off-duty
>thought is for the rack.
I didn't intend a "This is right" stance. I'm just thinking
about establishing teams. For instance, how do you get two
people who only communicate via the net to do a job that
can't be partitioned? That is, inputs from both need to
happen at the same time. The net enforces information delays.
Dirk Bruere
<jmfb...@aol.com> wrote in message news:9sdtlc$k16$1...@bob.news.rcn.net...
>
> I didn't intend a "This is right" stance. I'm just thinking
> about establishing teams. For instance, how do you get two
> people who only communicate via the net to do a job that
> can't be partitioned? That is, inputs from both need to
> happen at the same time. The net enforces information delays.
RTFM, only more so.
Dirk
SteveHarrisMD
From: jmfb...@aol.com
Date: Wed, Nov 7, 2001 3:39 AM
Message-id: <9sbde2$p2k$1...@bob.news.rcn.net>
>>
<< It can be both. I did have access to the program. However,
putting JMF into the nursing home eliminated the program. >>
It needn't have.
<< Look, I don't want to get into the politics of the medical
mess we have over here.
>>
You're the one who brought it up. However, there is nothing special about the
"politics" of hospice in nursing homes in Massachusetts. Sorry, but you're just
plain wrong.
<<
I lost the hospice nursing when he was put into the nursing home. >>
You needen't have. If it wasn't available in the very nursing home you were in,
it was in one nearby.
<< The reason I had to care for
him 7x24 is because the nursing orgs in this state had to
"listen" to the HMO that JMF had (even though he had another
kind of insurance) and the HMO wanted him in the nursing home. >>
Name the HMO and name the nursing home. Patient names need not be involved,
since we are talking about 1995 inistitutional policy. I will personally find
out what happened and what was happening in 1995, at those institutions.
Otherwise you're blowing smoke about this ghost story/extraterrestrial landing.
I will not have you tell me that some unlikely set of medical politics
happened somewhere in a galaxy far, far away, and then get vague and
nonspecific about it. That's not the way it works. Give specifics about the HMO
and the institution.
<< And it's no problem for a guy who's had a laryngectomy for
throat
>cancer (see what smoking does to you?)
Or overzealous dentists. >>
?? He didn't smoke and you think he might have gotten throat cancer from
overzealous dentists? You ARE posting from the evil alternative universe,
aren't you?
<< >
>You might have thought YOU were dying.
I knew I was dying.
>>
Or perhaps you are posting from the Great Beyond.
<<
No, you're not reading what I'm writing. The opposite happened.
He was in a hospice program. He lost that by getting put into
the nursing home. >>
I'm reading it-- I just don't believe it. You could post on there that they
bled him and applied hot coins, and I wouldn't believe that, either. Or that he
was 10 feet tall. Or that his doctor came to see him wearing a mask with a
snout full of posies. You've simply passed beyond the bounds of credibility.
You are saying that in this HMO in Massechusets in 1995, you could not get
hospice care in a nursing home. I say you're wrong. There's an easy way to
demonstrate your case.
<< It was against
nursing home policy to allow the hospice nurses to step foot
into the place, let alone make drug suggestions.
>>
Prove it. Supply the institution name, and the HMO. That should be no problem.
This is not like an elvis sighting. Institutional policies from 6 years ago can
be checked.
SBH
Ed Green
>Message-id: <9sdtlc$k16$1...@bob.news.rcn.net>
> null...@aol.com (Ed Green) wrote:
>>Maybe those who don't quit because they are
>>"bone weary" simply have higher or lower nor-
>>epinephrine levels.
>
>Sure. And those are the ones who should get the OK for
>doing long surguries (for example).
No disagreement. Objective job-related performance
criteria fine, "fair" or not.
>It had never occured to me before watching that show, that
>a single sleep deprivation exercise could produce a team.
Now, I went through a watered down version of this
(I assume... although since I was never at Paris
island or any of the other full strength versions
I have no basis for comparison), and I must say that
while I've heard this theory, in my case at least it
didn't work. We got plenty pissed at each other,
that's sure, but we didn't experience any deep
epiphany of team building.
Whether this was my personal defect, the group,
the insufficiency of brutality... I don't know. Just
a data point. We just survived, mainly.
I recall another "toughening" exercise... the "damage
control trainer". On the surface this was to train
you to make pipe patchs under adverse conditions.
Like having the freezing cold Charles river spraying
in your face. I guess they would have opened the
door before we drowned, but before we got all the
holes covered, we were standing waist deep in
50 degree water. The result was I got strep.
This was wimpy of me, I admit, but there you have it.
Damn, that was living.
Keith F. Lynch
> Unless you'd like me to entertain the idea that BAH is posting from
> the evil parallel universe where everyone has beards?
We ARE in the evil universe.
In the good universe, Osama bin Laden is clean shaven, and the WTC is
still standing.
--
Keith F. Lynch - k...@keithlynch.net - http://keithlynch.net/
I always welcome replies to my e-mail, postings, and web pages, but
unsolicited bulk e-mail sent to thousands of randomly collected
addresses is not acceptable, and I do complain to the spammer's ISP.
SteveHarrisMD
Date: Thu, Nov 8, 2001 9:31 PM
Message-id: <9sfpns$34j$1...@saltmine.radix.net>
>>
<<
We ARE in the evil universe.
In the good universe, Osama bin Laden is clean shaven, and the WTC is
still standing.
========
Damn, never thought of that.
As for the reactance thing, yes you do have to have vectors when you add
reactances, since the capacitative and inductive components are in opposite
directions and must be subtracted directly.
But none of this *requires* complex numbers. They are just convenient ways to
represent 2-D vectors.
SBH
jmfb...@aol.com
I'm talking about work that has to occur _before_ the fucking
manual has been written.
jmfb...@aol.com
null...@aol.com (Ed Green) wrote:
>>From: jmfb...@aol.com
>>Message-id: <9sdtlc$k16$1...@bob.news.rcn.net>
>
>> null...@aol.com (Ed Green) wrote:
>
>>>Maybe those who don't quit because they are
>>>"bone weary" simply have higher or lower nor-
>>>epinephrine levels.
>>
>>Sure. And those are the ones who should get the OK for
>>doing long surguries (for example).
>
>No disagreement. Objective job-related performance
>criteria fine, "fair" or not.
>
>>It had never occured to me before watching that show, that
>>a single sleep deprivation exercise could produce a team.
>
>Now, I went through a watered down
<groan>
> .. version of this
>(I assume... although since I was never at Paris
>island or any of the other full strength versions
>I have no basis for comparison), and I must say that
>while I've heard this theory, in my case at least it
>didn't work. We got plenty pissed at each other,
>that's sure, but we didn't experience any deep
>epiphany of team building.
Aw, ratsafratz. There goes my working hypothesis. I had
envisioned one slumber party to establish the bonding, then
everybody could go back home and we'ld get a ton of work done.
>
>Whether this was my personal defect, the group,
>the insufficiency of brutality... I don't know. Just
>a data point. We just survived, mainly.
>
>I recall another "toughening" exercise... the "damage
>control trainer". On the surface this was to train
>you to make pipe patchs under adverse conditions.
>Like having the freezing cold Charles river spraying
>in your face. I guess they would have opened the
>door before we drowned, but before we got all the
>holes covered, we were standing waist deep in
>50 degree water. The result was I got strep.
>This was wimpy of me, I admit, but there you have it.
Horrors! You're lucky you didn't get anything worse. (That's
if you're talking about the Charles that flows through Mass.)
>
>Damn, that was living.
;-)
Dirk Bruere
<jmfb...@aol.com> wrote in message news:9sge0t$6kj$2...@bob.news.rcn.net...
> >> I didn't intend a "This is right" stance. I'm just thinking
> >> about establishing teams. For instance, how do you get two
> >> people who only communicate via the net to do a job that
> >> can't be partitioned? That is, inputs from both need to
> >> happen at the same time. The net enforces information delays.
> >
> >RTFM, only more so.
>
> I'm talking about work that has to occur _before_ the fucking
> manual has been written.
With the (distributed) project we are working on the manual (and spec) is
being written concurrently with the s/w.
Has its plusses and minusses.
Dirk
James Hunter
SteveHarrisMD wrote:
> << Subject: Re: Medicine and Hospice(WAS Re: AND furthermore)
> From: "Keith F. Lynch" k...@KeithLynch.net
> Date: Thu, Nov 8, 2001 9:31 PM
> Message-id: <9sfpns$34j$1...@saltmine.radix.net>
> >>
>
> As for the reactance thing, yes you do have to have vectors when you add
> reactances, since the capacitative and inductive components are in opposite
> directions and must be subtracted directly.
>
> But none of this *requires* complex numbers. They are just convenient ways to
> represent 2-D vectors.
It doesn't even require *anything* 2-dimensional,
since the really correct way to do those additions
is in the *time* domain, rather than the frequency domain.
jmfb...@aol.com
Some of our work could be done that way. We finally figured out
how to get the manuals out at the same time as the software. It
took years of errors and twiddling to accomplish that. It would
have never been done if I hadn't browbeat the writers to put
everything in bits.
>
>Has its plusses and minusses.
Sure. I also think that this approach can only be with a team
of three or less. We had a group that was rec'ed out for
12 bodies. Specs had to written first, then reviewed until
everybody's eyes were crossed. Then code got written. It
expanded the development cycle by many, many man-years.
Steve Harris
Date: Thu, Nov 8, 2001 9:31 PM
Message-id: <9sfpns$34j$1...@saltmine.radix.net>
>>
<<
We ARE in the evil universe.
In the good universe, Osama bin Laden is clean shaven, and the TC is
still standing.
========
COMMENT:
Damn, never thought of that.
As for the reactance thing, yes you do have to have vectors when you add
reactances, since the capacitative and inductive components are in opposite
directions and must be subtracted directly.
But none of this *requires* complex numbers. They are just convenient ways
to represent 2-D vectors.
SBH
--
I welcome Email from strangers with the minimal cleverness to fix my address
(it's an open-book test). I strongly recommend recipients of unsolicited
bulk Email ad spam use "http://combat.uxn.com" to get the true corporate
name of the last ISP address on the viewsource header, then forward message
& headers to "abuse@[offendingISP]."
Keith F. Lynch
> As for the reactance thing, yes you do have to have vectors when you
> add reactances, since the capacitative and inductive components are
> in opposite directions and must be subtracted directly.
> But none of this *requires* complex numbers. They are just
> convenient ways to represent 2-D vectors.
Sure. Neither do you ever need non-whole numbers for anything. You
can just use integers, and apply arbitrary rules for manipulating
pairs of them.
Actually, you never need integers either, except 0 and 1. And even
more arbitrary rules for manipulating them.
But I find it easier to use the right tools for the job. Ones that
let me think about what I'm doing conceptually, rather than mindlessly
applying senseless rules. Yes, this requires learning complex numbers,
differential equations, etc. It's not that difficult.
--
Keith F. Lynch - k...@keithlynch.net - http://keithlynch.net/
I always welcome replies to my e-mail, postings, and web pages, but
unsolicited bulk e-mail (spam) is not acceptable. Please do not send me
HTML, "rich text," or attachments, as all such email is discarded unread.
Steve Harris
news:9sml47$ieg$1...@saltmine.radix.net...
> But I find it easier to use the right tools for the job. Ones that
> let me think about what I'm doing conceptually, rather than mindlessly
> applying senseless rules. Yes, this requires learning complex numbers,
> differential equations, etc. It's not that difficult.
COMMENT:
Thanks, I can solve a differential equation using complex functions just
fine. It may not be too difficult (or then again it may be!), but I do not
agree that complex numbers, and expecially complex exponentials help the
average person "conceptually". Rather, I see them as more in the style of
"mindless" manipulation, since exponential functions work so much more
naturally and easily as solutions of differential equations, and
exponentiated complex numbers are merely ways of allowing you to more easily
manipulate functions of 2-vectors in differential equations.
But to see *conceptually* what you're doing, and what your solution function
is doing (your capacitative and inductive reactances directly subtracting,
for example), you still have to map your parametized variables out on the
complex plane-- and if you're going to have a plane, it might just as well
be the XY plane. It can be any plane. If you give me a complex number A +
iB, and I'll give you a vector [A,B] that can be used to write down the same
idea. But if you want to talk about static 3-D vector fields, now the use of
complex numbers per se doesn't help you much. You've got three variables,
and they might as well be x, y, and z. Or r, theta, and phi.
Whenever you see a complex number in physics, that simply means that
somebody has chosen to represent one of the vector dimensions (often one
dimension in 2-vector problems, and often time in time-evolving 3-D
problems) by adding it as an extra dimension in the "imaginary" direction.
But this isn't strictly required.
The reason this comes up, and why it's worth talking about, is that seeing
the "i" in a function causes many people to think that somehow nature
herself contains some things that "really" are somehow objectively complex:
such as impedances or refractive indicies or time-evolving 3-D wave
functions (which require 4 dimensions to represent). Well, these things
aren't somehow "objectively" complex. They're merely things that require a
minimum number of dimensions in any mathematical representation. They can
all be represented as real ordered tuples or triples or quadruples or
whatever of numbers. Or (yes) you can pick your favorite dimension to be the
imaginary one. If you pick it right, it may have great mathematical utility
insofar as savings in calculation (as when we use the complex conjugate with
time as the imaginified dimension, to represent a wave with time-reversed
direction). Just don't make too much of that mathematical bookkeeping
savings. It doesn't mean a thing insofar as the actual nature of what you're
talking about.
SBH
--
I welcome Email from strangers with the minimal cleverness to fix my address
(it's an open-book test). I strongly recommend recipients of unsolicited
bulk Email ad spam use "http://combat.uxn.com" to get the true corporate
name of the last ISP address on the viewsource header, then forward message
& headers to "abuse@[offendingISP]."
Keith F. Lynch
> ... exponential functions work so much more naturally and easily
> as solutions of differential equations, and exponentiated complex
> numbers are merely ways of allowing you to more easily manipulate
> functions of 2-vectors in differential equations.
I guess it's mostly a personal preference. We all see things
differently. I had a hard time understanding Laplace transforms
until I suddenly realized that they were simply Fourier transforms of
imaginary frequencies. This way of looking at things utterly baffled
my co-workers, but they conceded that I always got the right answers.
> Whenever you see a complex number in physics, that simply means that
> somebody has chosen to represent one of the vector dimensions (often
> one dimension in 2-vector problems, and often time in time-evolving
> 3-D problems) by adding it as an extra dimension in the "imaginary"
> direction.
Complex numbers are no easier or harder to add and subtract than
vectors. But they're easier to multiply. Note that complex number
multiplication is quite different from both dot product vector
multiplication and cross product vevtor multiplication.
Of course you can simply memorize that for this form of
multiplication, in polar coordinates you add angles and multiply
lengths, and that in rectangular coordinates the rule is
X' = X1*X2 - Y1*Y2
Y' = X1*Y2 + Y1*X2
But with complex numbers you don't have to remember anything, except
the rules of basic algebra and the fact that i^2 = -1. All else
follows naturally.
> ... seeing the "i" in a function causes many people to think that
> somehow nature herself contains some things that "really" are
> somehow objectively complex:
Well, yes. In exactly the same sense as nature herself contains
some things that "really" are somehow objectively real numbers. An
impedance is "really" a complex number if and only if a resistance
is "really" a real number.
If you look at actual circuits, you don't see any numbers. At least
not unless someone wrote them there. And they could just as easily
have written a lowercase letter "i" as a decimal digit. More likely
you'll just see colored stripes which encode whole numbers.
> They're merely things that require a minimum number of dimensions in
> any mathematical representation. They can all be represented as real
> ordered tuples or triples or quadruples or whatever of numbers.
Sure. And you don't need non-whole numbers, either. Who needs
fractions, when you can use an ordered pair of integers instead?
And apply the rules of fractions to that ordered pair, without ever
using the dreaded "f" word.
> Just don't make too much of that mathematical bookkeeping savings.
> It doesn't mean a thing insofar as the actual nature of what you're
> talking about.
Yes and no and wrong question. We might as well be debating whether
the middle C on a piano is really in cycles per second, radians per
second, cycles per minute, or minutes per cycle.
It's a floor wax AND a dessert topping. Unless your floors are
carpeted and you're on a diet.
And the middle C is in kiloradians per microfortnight.
--
Keith F. Lynch - k...@keithlynch.net - http://keithlynch.net/
I always welcome replies to my e-mail, postings, and web pages, but
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franz heymann
Keith F. Lynch <k...@KeithLynch.net> wrote in message
> Steve Harris <sbha...@ix.RETICULATEDOBJECTcom.com> wrote:
[Snip]
> > Whenever you see a complex number in physics, that simply means
that
> > somebody has chosen to represent one of the vector dimensions
(often
> > one dimension in 2-vector problems, and often time in
time-evolving
> > 3-D problems) by adding it as an extra dimension in the
"imaginary"
> > direction.
This is not true in the case of a quantum mechanical wave function.
That is *really* a complex function.
[Snip]
Franz Heymann