Sunday, November 21, 2010

Giraffe vs Coconut. You know it makes sense.

I'm covering all outlets on this one folks, because WE NEED YOU to spend a whole 5 minutes or less of your life completing a tiny survey so I can produce for the universe a hilarious tally of your responses about giraffe and coconut farming (amongst other things).  Also so as I can have a good evaluation of the back-end of the survey tool itself before I get all deadly serious with it (assuming it's as good as they say) and doing some major scientific data-collection and collation.  For a very good cause.

Here is a link:

Click here to take survey

Thank you.

Friday, November 19, 2010

Dr Weaselword will speak with you now.

The weasels deserve better.  These sleek and wondrous mustelidae have been unfairly tarred with the brush of what is sadly an increasingly common term (sad because it's needed more and more often): 'weasel words.'

They're everywhere, those words that purport to mean something that they don't exactly mean, like "Up to 50% off!" also means that there may be no discount at all, whereas the implication is that things will be half price.  Politics is especially fertile ground.  But the arena that sorely gives me the crunchy irrits the most is where people's health and wellbeing are directly affected.  The issues of dishonesty and disingenuity in medical speak.

Anyone familiar with my recent history knows I've had ample opportunity and motivation to learn lots and lots on a wide range of medically-related subjects.  This is not just on my own selfish behalf, as my journey has found me also somewhat engaged with a whole teeming subgroup of humanity who share my experience of feeding through a tube, or who care for someone who does.  And you get a tube placed for an enormous variety of reasons.  Through these folks I have learned much, and deeply.  And, you know, I care.

Even the definition of diagnosis has come in for some weaselling recently.  It used to run:

Diagnosis (n, medical):  The identification of the nature and cause of an illness; The identification of the nature and cause of something (of any nature)

but now it's been expanded in what I see as a butt-covering sort of way to:

Diagnosis (n, medical):  A label given for a medical condition or disease identified by its signs, symptoms, and from the results of various diagnostic procedures.

See what's happened there?  It used to be that for a medical professional to make a pronouncement that usefully encompassed a medical condition, thereby leading directly to a body of knowledge and experience able to be employed in the treatment of said condition, both the nature and the cause of an illness had to be clear, unquestionable, explicable. Otherwise it was just a description, not a diagnosis.  Now, just fitting some set of symptoms or descriptions agreed upon by who-knows-what process and who-knows-what panel of arbiters is enough to pronounce a diagnosis.  Which would be fine, except for one very large thing:  We, the plebs, still tend to believe - and in the throes of fear and uncertainty about our health or that of our loved ones want to believe - that a diagnosis is still somehow indicative of a cause, and thus a vital foundation of treatment and a hopeful cure.

Just found this pic - anyone know what on earth it's all about???

So let's talk about things like FTT and GERD (or if you're in the non-American anglophone world, GORD).

There's a certain certainty to an acronym, as there is to a scientific-sounding long word.  Whenever I read on a forum somewhere some mother saying how her child has been 'diagnosed with FTT (Failure To Thrive)' my heart sinks a little and I do a conscious double-check of what has been written.  My heart sinks not from sadness - compassion does not make my heart sink, it more just sort of swells a bit - but from the possibility that this person has been on the receiving end of a sale by some doctor somewhere.  Hence the double-check, I read very carefully to try and gauge the belief and feeling of the author to see if they bought the line or not.  Because FTT is not a diagnosis, it's a description.  And doctors are increasingly buying the BS of their own profession too.  (BS may be a diagnosis, I'm not sure :-).

This isn't just rogue pedantry here, because there's a serious danger to this phenomenon.  FTT is a very, very confronting thing to be presented with as a parent especially, as it all too often carries with it some direct implication that you are somehow at fault.  It also holds out a false sense of control, and thus perhaps misplaced hope.  Going back to the need for a 'probable cause' component to a diagnosis, FTT could have a whole plethora of possible contributing causes.  It's used pretty loosely too, in that it can be applied to any person who is an outlier on the 'normal' weight/age charts, and it has anecdotally been abused too - I have heard more than one story where a parent has been threatened with a "diagnosis of FTT and having child services called in" for daring to question a doctor's directions.  I should clarify that the usual first-recourse response of the medical profession with FTT is to simply 'insert more calories' and that typically means forcing in more canned formula.  Sometimes it works for a while.  Sometimes.  But it doesn't address the root cause usually, does it?

Just giving something a diagnostic name gives the impression of some power over the condition, and the cultural hangover of diagnosis=knowledge of cause too often means both medicos and caregivers backpedal or even entirely cease in their efforts to find cause - to heal, rather than treat.  The emphasis shifts not surprisingly onto getting some measurable outcomes using the 'scientific' tools available:  get that child back in the middle percentile on the weight charts, even if it's all fat and too much weight for their fragile small bones to safely bear.  Even if it means living in a world of vomit, retching and pain.  Even if it means otherwise clinical malnutrition.  At least then we've got the FTT licked, eh?

A bogus diagnosis like this too often means real healing is pushed right out of the frame, as cause is not sought, and the 'whole person' approach withers in the face of a potent-sounding acronymic lump of weasel droppings.

But wait, there's more.

GERD (GORD) stands for Gastro-Esophageal (Oesophageal) Reflux Disease.  And it's not even a disease, let alone a diagnosis.  It's been going on in humans since the dawn of time - certainly much more prevalent these days due to the whole modern diet and lifestyle catastrophe but it's only recently been given it's shiny new name.  By the pharmaceutical companies.

The described set of symptoms encompassed by the acronym GERD can be caused by any number of wildly varying factors and effects.  Including, say, standing on your head too often.

Just like with FTT, all too often seeking a root cause or addressing the real reasons for ill health get ignored when so succinctly wrapped up in four capital letters.  It gets all normalised - it's just a thing that sooooo many people have and isn't it great we have these marvellous drugs to so effectively treat it?  Except that the drugs don't.  Treat it, that is.  The main drug prescribed and marketed throughout the world is esomeprazole (Nexium, Prevacid, a hundred other commercial names) and even some doctors seem to believe it successfully treats acid reflux.  No.  It de-acidifies whatever does reflux and true, in some cases the less-acid stomach contents mean reflux happens less often or less severely but in the main it just stops it hurting and damaging the esophagus when reflux does occur.  Oh, and over time it can rather tend to destroy your stomach lining.  And other stuff.

(Disclosure: I take Nexium.  I have yet to find an alternative that works effectively.)

So whenever I hear someone talking about GERD my first instinct is to urge further questioning.  Yes, but why?  Again, too many will stop at the controllable-seeming catch-all that is a 'diagnosis' and currently-preferred treatment.

But is it any wonder?  Viewing the news media with any scope or objectivity we can quickly come to realise that we are simply being fed what it is we are most willing to believe, at least when it comes to opinion if not selection of what is 'newsworthy'.  In a scary health situation we even more want our alpha figures, our parent-types who will tell us what is wrong and what to do.  We want the comfort of a century's scientific experimentation and experience behind it, and we want most of all to believe there is a straightforward answer.  Some say this is precisely why we invented religion.  But in the end, we do ourselves a grave disservice by disempowering ourselves in the face of a profession as commercially-driven as it is driven by the best of intentions.  We must always be the final decision makers in our own health, and that of those who rely on us.

My beef is that it's just downright dishonest, and I suppose in the case of GERD (and just too many other 'diseases' to name) to big money.  Pardon the pun, but I don't buy it.

And lastly, of course I'd like a proper diagnosis for myself, not just a great antiqued funky steampunk-sounding name for a disease.  But then I know that the cause is elusive to modern science, and by now, essentially irrelevant.  Can't help a curious mind though eh?

Sunday, November 14, 2010

Things I want right now #7

In truth I've been a little remiss in not popping these up here lately - but then again, they seem to be getting fewer over time.  That said, not 2 minutes ago I read elsewhere on the webs a mention of...

A peanut butter sandwich.

Yep, that's all.  No need to go messing about with its simplicity by adding jam (that's 'jelly' in US English).

I flashed instantly to plain old soft white bread, slightly chewy crust, and smooth peanut butter.  You know I honestly can't recall how long ago it might have been since I had such a thing, because back when I was eating I'd been a multi-grain type guy for years and years, and of course for the last few years PB was just too sticky for my oral functions to handle properly.  Even all melty and oily on toast.  Oh well.

There's that weird feeling again.  I wasn't really hungry just before either but now, well.....

Honour thy peanut butter sandwiches people; one of the true culinary classics of Modern Western Civilisation.  Which, when you think about it, says quite a lot about us, doesn't it?

Friday, November 12, 2010

Hearing the dog whistle.

It's a term that seems to have made itself a regular entrant in the Australian political speech competition these days.  Most often used perjoratively, 'dog whistle politics' is a term for a type of political campaigning or speechmaking which employs coded language that appears to mean one thing to the general population but has a different or more specific meaning for a targeted subgroup of the audience.  The analogy is that the code is outside the range of the 'normal' listener's awareness, as a dog whistle is above our range of hearing.

It's intention is typically that of plausible deniability.  As an example, and it's where I suspect the term originated, the Howard government's statements surrounding 'illegal immigration' in the mid-1990s were said by many to be designed to appeal to the racist elements of society, yet none of the language used was technically or overtly racist.  The racism could plausibly be denied, and thus those who were not racist but would otherwise support the Howard government could vote for them with clear(er) consciences, alongside the supposedly racist folks who heard that dog whistle.  Anyway, Australians voted for him in droves.

I'm not exactly changing the subject now, people of Australia and fellow citizens of Northam in particular, but I'd like to ask you a simple question and have your first, viscerally-determined response before your wily self-image-protective mind gets hold of it please:

Would it make a difference to you if the announced Immigration Detention Centre in Northam for up to 1500 single men was instead to be replaced by a medium security (male) prison of the same capacity for Australian criminals?

If you felt a little discomfort for a second there, or just answered a simple resounding "yes" then you might want to run a bit of internal systems check.  

To do this, we need to separate the issues out; primarily we need to separate our debate around how we manage the fact that there are asylum seekers arriving, what we do with them when they do, and how we reconcile everyone's fears and thoughts about the effects on our culture and wellbeing in the long run; from the simple issue of where we place a detention centre - as it's a given that we currently put them all (the men at least) in detention.

Northam had one of those 'town hall meetings' very recently that was supposed to be an information evening for concerned residents but which was predictably hijacked by a relative minority of louder, angrier folk (many of whom were not residents, arriving with their One Nation placards etc from Perth) whom the media naturally turned towards for good sound-bite footage as a frog naturally snaps its tongue at the tastiest-looking grasshopper it can reach.  Commercial news reality there.  So what ended up happening was that the many people who attended seeking some actual fact and information were unable to get it (what little there was to be had, that is) and just saw more piss and vinegar than they wanted to have in their lives.  And the land as a whole by and large saw another NIMBY population to feed their fears and enjoy a tiny unspoken guilty moment of "thank goodness it isn't coming HERE".

I'll just put two words in here to encapsulate where we could head if we're not careful:  

Tea Party.  

There.  I said it.

Just recognising the dog whistle doesn't make it unaffecting, you see.  Because once you identify it you have the responsibility to respond to the ugly fact of deceit - whether it was intentionally done, or just an artefact of the new reality that news must sell so what sells makes news. Even public broadcasters feel the need to compete for audience share if not market share to retain relevance so they fall increasingly under the same rules of engagement as the rest.  In a way, the increasing partisanisation (is that a word?) we see in the US where you can just choose a news channel that whistles directly to your hearing range of opinion and/or prejudice is so much more honest.  I mean, not everyone in Australia actually realises that The Australian is an anti-Labor propaganda screed as much as it is a valid news service.  And not everyone appreciates that SBS does in fact have political agendas going on intentionally or otherwise simply by selling to a particular demographic and choosing the stories and angles to support that audience's set of self-images.

So what do you do when you see the whistle being blown?

My plan is to ask my fellow townsfolk which they'd rather - immigration detention centre or prison?

(Oh, and pardon my dog whistling.  I do mean it to call out those who need to look at their issues with race and nationalism, as a priority over making decisions about the placement of detention centres.  Apparently, dog whistles can hurt dogs' ears.)

Sunday, November 7, 2010

Let's just be clear, it's not that I love the banks......

The first Tuesday in November has been famous in Australia for 150 years as the date the Melbourne Cup, that Race That Stops A Nation is run, and in recent years it's been just as in the news in Australia because First Tuesdays are when the Reserve Bank of Australia releases it's monthly pronouncement on official interest rates.

Then, as happened last Tuesday, the Big Four major banks respond publicly, typically changing or not changing their lending rates accordingly.  It's become a weird ritual.

Last Tuesday the Commonwealth Bank did something that sparked no small measure of piss and vinegar in our reportage by raising their rates well beyond the increase made by the RBA - 0.4%, as compared to 0.25%.  And yea, there was much wailing and gnashing of teeth across the land, and mortgagees were seen to lament and rend their credit card statements.  The whingefest commenced and the cries of the people for the government to "DO SOMETHING!" resounded from every second soundbite over the airwaves.

It's a business, people.  The banks are not here for you, unless you are a shareholder.  It looks to me like a sensational triumph of branding.

Where I grew up on the lovely Northern Beaches area of Sydney, there was (and probably still is) a real beach culture.  We kids were at the beach every chance we got, and being able to surf was nearly as compulsory (for a boy) as being able to swim was for everyone.  we were really used to the shark alarm going off, and having to all get out of the water until the Surf Lifesavers could confirm that Jaws was no longer lurking about.  Shark attacks happened just as regularly as they do now, but these days the consensus attitude has changed.

Back then, when a large shark attacked someone in the area, or any other popular swimming areas about the coast, there was a hue and cry and a hunting party was raised to rid ourselves of the brute.  The voices against this knee-jerk ridiculousness were there, but small, and drowned out by those who preferred to see us as masters of our domain, who sought perhaps some vengeance and balm for their fearful souls.  Over time though, we know this has completely turned around.

Now when someone is taken, we keep a better eye out for a while, but what we mainly hear in response are things like how the person involved always respected that this is the shark's home, and we are the visitors.  That sharks are carnivorous hunters, and that we might just be tasty.  That this is the natural order and we are rightly humbled in our place in it.  This is a good thing, that we have come to respect the shark's right to behave like a shark and do what we can to protect ourselves - we've grown out of our childish anger and punitive tantrum-throwing destructiveness.

Why is it then that we expect a business, whose reason for existing is by definition to make profits for its stakeholders - in the banks' cases their shareholders - to behave in any other fashion than that which it is designed or born to do?

It's 'reporting season' now too, and yep, the Big Four are all showing us their record profits.  They are also telling us that they have done a poor job getting their customers to understand that their 'cost of funding' has risen due to other factors.  We dummies out here just see more bank profit + higher interest rates = cause and effect.

OK, sure, there are all sorts of ameliorating arguments; for example it's an unfortunately perpetuated myth that the RBA cash rate is the main determinant of the banks' lending rates.  It's a major factor of course, and the banks' habit of using the RBA rate rises as cover for raising their own rates has not helped the public decouple a cause-and-effect theme in their minds.  Lots of thing affect a bank's ability to make a profit.  they are very complex businesses.  Well, it's true that most of us shall never understand fully the labyrinthine machinations of the globalised finance sector and precisely how it impacts our home loans but it doesn't have to be that hard.  They make more money, and we are paying more.  Looks simple enough from out here, yes?

Yet here in the modern commercial world we have chosen to accept a bizarre situation - that corporations are somehow a part of society; that they are essentially citizens like us with social responsibilities.  The banks do a super job of telling us in their marketing that this is *exactly* who they are, because the choices we make (or at least, the choices many of us make, to date) about who we do our banking business with - who we trust with that most crucial element of our self-value, our money - are not based solely or even mainly on hard-headed maths or pecuniary self-interest, but on *feel*.  We want our financial affairs to feel, above all, safe.

Banks are NOT people.  The profit motive will only be subservient to other social motivations insofar as it can be seen to support profit.  It's a circle.  Money spent on environmental programs, charity, all that - recouped in the power of their image and the continued success of their branding - their branding that makes us think that they do in fact support us.  Banks support business, of course they do - like bison support the great plains.  They must have a rich environment in which to feed, yes?

So there's a mighty disconnect here.  The larger and more successful a bank is the more likely we are to see it as a worthy entity to do our business with, but of course they got there by making more profits than their competition.  And apparently we don't like that.  Because we think they've done it by taking money from us.

And oddly, there are so many better options than the big players out there for home lending (just as an example) yet very few take up these different opportunities.  Doing so is not only the best, it is perhaps the *only* way to change the ways the banks operate in their treatment of customers.  We all know that in the Australian environment that the small-pond syndrome of having only four major players leads to price collusion (go ahead, sue me) as surely as we know we're being ripped off mercilessly by encouraging the situation where 75% of our grocery market is owned by just two players.

Democracy has been just a little bit crippled here, but we've let it happen.  We've bought the fallacies we're sold ($10 Coles meal anyone?) and dimly lie down to let them have their way.  We can't see a way to smash the status quo so we have our whinge, blame the government if at all possible, and bend over for some more.

What if, instead, we just used the system as it is?  Bank with an institution that behaved a little better, or at least gave us a better deal?  Grew a few more veges rather than buying lemons imported from the USA?  Used the local shop - paid a little more for the local milk from the corner store to support local jobs and the industry outside of the monopolistic players?  And on the larger scale, engaged with politics is a way that made our concerns about the government's useful roles in changing all this actually heard by both those who represent us, and by our wider community?

If we pressure the system to make it more competitive - to act 'rationally' as the free marketeers say we apparently do - and the institutions thus drive their rates down to win or win back our borrowing business, then that is where we are successfully engaged in the ecosystem of finance, as symbionts.  Right now most of us are just behaving like prey or worse; like a domesticated herd.

No use railing against the banks, really.  They're just doing what they're designed to do, and they're doing it very, very well.  Let's look more closely at this cause and effect stuff before we waste all that energy we could use for useful change on railing against something that is how we made it in the first place.  Let's not be those folks who buy a house at the end of the airport runway and then complain about the noise.