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Health care in Canada

BoneRemake says...

I do not owe anyone 200+ grand for being able to breath and have a heart beat, My opinion is that I don't give two shits what you call it or anyone else. IT IS WORKIN FOR ME ! and it can work for you !

starrychloe said:

A single-payer system is called a monopsony. It can be as bad as a monopoly.

the myth of choice:how junk food marketers target kids

Phooz says...

While I know that parents have an enormous influence to empower their children to be able to think for themselves I always think of this, from Mr. Philip K. Dick, when I think about advertisement and the such:

"The power of spurious realities battering at us today—these deliberately manufactured fakes never penetrate to the heart of true human beings. I watch the children watching TV and at first I am afraid of what they are being taught, and then I realize, They can't be corrupted or destroyed. They watch, they listen, they understand, and, then, where and when it is necessary, they reject. There is something enormously powerful in a child's ability to withstand the fraudulent. A child has the clearest eye, the steadiest hand. The hucksters, the promoters, are appealing for the allegiance of these small people in vain. True, the cereal companies may be able to market huge quantities of junk breakfasts; the hamburger and hot dog chains may sell endless numbers of unreal fast-food items to the children, but the deep heart beats firmly, unreached and unreasoned with. A child of today can detect a lie quicker than the wisest adult of two decades ago. When I want to know what is true, I ask my children. They do not ask me; I turn to them. "

from 'How to Build a Universe That Doesn't Fall Apart In Two Days'

NASA | Earthrise: The 45th Anniversary

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Oklahoma Doctors vs. Obamacare

MrFisk says...

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
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Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

Woman 'denied a termination' dies in hospital -- TYT

harlequinn says...

Amniotic fluid does not cause septicaemia.

An alive foetus does not cause septicaemia.

A dead foetus does not cause Escherichia coli - but it can eventually cause septicaemia if it were not delivered - usually this happens by spontaneous delivery from the mothers body aborting the pregnancy. As it was they immediately delivered the baby upon cessation of its heart beat.

The septicaemia was caused by Escherichia coli - specifically a new Extended-Spectrum Beta Lactamase strain that is highly resistant to antibiotics. This bacteria is contracted in the hospital environment. This bacteria did not originate from the foetus.

So to roughly answer your question, to remove the source of the septicaemia would be to remove the source of the Escherichia coli, which is the hospital. I can't say if she would have survived outside of the hospital or not, but she probably would not have contracted the Escherichia coli and she probably would have safely delivered through spontaneous abortion.

It's sad she died, but the medical reason for her death was not a lack of abortion. It was from contracting a new deadly bacteria strain that is found in hospitals and is very hard to treat. It was probably contracted directly from either a doctor, another patient, a medical instrument, or a surface she touched within the hospital. These new antibiotic resistant bateria are a major problem worldwide killing many otherwise healthy people every year.

>> ^TheSluiceGate:

Here's a quote for you. The husband of the deceased:
“The doctor told us the cervix was fully dilated, amniotic fluid was leaking and unfortunately the baby wouldn’t survive.” The doctor, he says, said it should be over in a few hours. There followed three days, he says, of the foetal heartbeat being checked several times a day.
“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.
“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.
“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.
“The next morning I said she was so sick and asked again that they just end it, but they said they couldn’t.”
At lunchtime the foetal heart had stopped and Ms Halappanavar was brought to theatre to have the womb contents removed. “When she came out she was talking okay but she was very sick. That’s the last time I spoke to her.”
source - http://www.irishtimes.com/newspaper/frontpage/2012/1114/122432657520
3.html
The Irish Times
Now, do you think they should have removed the source of that septicaemia sooner?
(Bias declaration: I was within feet of the people pictured on the front of this video above)

Swedish Insurance Ad Introduces Skydiving Cats

PancakeMaster says...

Vi ägs av våra kunder, och den här reklamfilmen är tillägnad en av våra ägare; Eva. Hennes hjärta klappar för katten.

==

We're owned by our clients, and this commercial is dedicated to one of our owners; Eva. Her heart beats for the cat.

10 Accidental Inventions

bamdrew says...

My favorite of the list is Greatbatch, and his story really gets to the value of inspiration and curiousity as an inventor. He was just making a device to record heart beats, and put in an incorrect resistor for his circuit, resulting in a oscillating blip in his recordings. Instead of going 'fuck! I made the goddamn thing wrong! So I threw it on the grooooound!' No he said, 'Woah, thats neat, I have sort-of a built-in time guage that is very regular in my recordings, and can see how irregular the heart beat is ... wait a minute...', and then proceeded to work on the completely crazy idea of an implantable, miniature device to electrically stimulating the heart to keep it beating evenly as people just walked around.

I'd argue that its basically impossible to accidentally invent something. You have to be bright enough to recognize something interesting, and curious enough to follow it off in the direction it leads.

Jinx (Member Profile)

Mother Hears Heartbeat of Her 16-year-old Dead Son

EMPIRE says...

Although I'm sad for her, for losing her son and at such a young age at that; i fucking hate that whole "I prayed to god and he answered" stance. It's down-right stupid and egotistical and I can't stand it. She asked for a sign and god let her hear her son's heart beating. I'm sure that when she prayed for her son to be brought back to life, the prayer was also answered............

Creationism Vs Evolution - American Poll -- TYT

kceaton1 says...

>> ^Crosswords:

>> ^kceaton1:
It goes beyond evolution though, if I'm getting this right. FOR HELL'S SAKE we can use the speed of light to see things FAR, FAR, FAR, FAR, FAR^100 older than 10,000 years!!! It's a fucking joke. If you believe this you are an idiot. Period! = .
It's not just light and carbon dating, we have LOTS of ways to show this place is WAY older...

You're forgetting the Law of God Physics which clearly states God can do anything including making the universe appear much older than it actually is for the purposes of fooling his human creations so he has a way of testing their loyalty when he's not asking them to kill their first born son and saying, JUST KIDDING, at the last minute.


The funny part about this stuff is that they typically say that God "moved the photons" (atleast the semi smarter ones will) and the STILL dumb ones will say that, well light was, you see going a different speed back then so it still all adds up...YOU SEE!!!

BUT THEN!...If you understand relativity correctly like me you understand that you can change the speed of light all the time you want. In fact make it go 1 ft/second! It doesn't MAKE A DAMNED difference in how we will STILL measure the time gone/go/will go by! People never get this at all and it really is the sort of thing were someone mumbles under their breath when they finally understand what I'm saying/going to say: "Is that not amazing!!!". You see mass and energy are the same thing and light is special, it goes the same speed EVERYWHERE, EVERY-TIME, ALL THE TIME--and this thing called "light" are these little tiny particles/waves called photons that as I said before, but not quite as directly, they literally ARE mass and energy, so the relationship between us and light is so fundamental it SHOULD blow your mind. But, so many people went through school and listen to their preachers and have no idea how vitally important that "little" discovery that Einstein made was!!! So, even we at 1 ft/s light speed STILL notice everything moving and everyone we know moving at that same "time" measurement of one second (funny isn't it; but, light is traveling at one second as well, how can this make any sense..!?!?! Well here it comes, it is called relativity and the fact that light is a constant and the other very important fact that our measurement of one second really measures...what?) as we are literally stuck in a cage (this "cage" is called The Universe) that cannot be tampered with. This is all due to that little fact that our perception of time IS relative and our view of one second can be EXTREMELY messed with, but to us it will always seem to be one second--even if 1 Billion years went by. The age of the Universe comes from the SHIFT of energy in the photons present that we can see coming from other places in any direction around us; so God would need to put THAT hologram there nothing else, BUT there is a giant problem in doing this (because due to our friends that want God to actively fuck us over for some reason--the hologram only extends technically 10,000 years out and "hides" the rest--if God put everything the way we see it and it isn't even an illusion--what can I say at that point if God was real I would join the Devil in less than a heart beat to overthrow his LYING, SADIST, and moreover EVIL ass!) If the hologram WAS there then: the hologram, it would need to be different in EVERY single direction you look; every time you move one Planck length (I might be wrong, maybe just the length of a photon) further out into space God would need to fix the energy distribution to make his illusion look correct... YOU HAVE no idea how absurd to the absurd degree this sounds, even GOD would spend his entire existence doing this because the job would require this long to do it: forever (until the UNIVERSE STOPS!). I'm not kidding it would be utterly ridiculous (from Earth his "image" would look right, on Mt. Everest, it would look wrong,; in space it would look wrong--in fact if you have sensitive enough equipment every square foot you took would somehow end up looking incorrect--we're talking about the cosmic background radiation, the little thing that lets us know how old our Universe is and that everything around us is moving away from us...

So that comes to the "putting the photons into place syndrome". For the most part I'm starting to think that these people like to abuse their brain in secret rooms with paint, huffing it until they collapse in a heap. in the morning they slowly scrub the white vinyl paint off their nose and mouth and go start with the blue. The problem with this is God had to of atleast put photons 13.5 Billion years out for this to even work--so in the end it falls so flat on it's face it makes no sense. If he was using a hologram, where is the border? Why do we detect gravitational anomalies when those have been proven to be real locally? It just goes on, and on, and on, and on.

I'd love to hear them explain why space may be full of Dark Matter or better yet why is "nothing" full of something called "The Quantum Foam"--you may have heard of "Vacuum Energy", same thing more or less--look it up it's fascinating and may even be the source OF "The Big Bang". Why can we pull photons (from "nothing") out of the Quantum Foam? According to lots of religious folks you can't create something from nothing, but WHAM, there it is! Sometimes, it just might be a bad idea to hold onto your old per-conceived precepts if they do not allow for change. BTW, the photon coming out of thin air was in a very well-known (now) experiment and is HIGHLY worth looking up; you can find details about it in my Videosift Blog (which is entirely about it).

You could disprove their crap all day. The truth is is that they did bad in their science classes, they just didn't get it and for some archaic left over juvenile resentment, they must have their righteous rite of "The Comeback Minister (or Preacher/Prophet/Father/etc...). So in revenge they are taking the easy way out and saying, "Hah, see I didn't need to learn that stuff from Mr. Scrampton in 12th grade! I'm a Minister now and I can just TELL you what is right, because I know it's right in my gut; especially after five cases of Budweiser!". Now they never tell you the truth. They lie, they tell you it "came" to them, like their a prophet now or something. ...Well if they can be prophets, why can't we? Oh wait, scientists do in fact fill this role and they do a good job at it. they constantly warn us of dangers and things the government should do. But, there are far too many damage control freaks with their own agenda running around and they seem to cling to religion as it satisfies very easily their questions, making it so they don't have to work to find the actual hard ones that exist and that we DO need.

It's not in the Bible that any of these idiots would tell us anything meaningful, nor the Koran, or any other holy book. So I find it strange that so many line up and then sit down and listen to these idiots blather on about the world and how to cure it and what it's ills are. They also as I said do a great deal of "re-education" in THEIR vision satisfying that old juvenile, washed up nothing who couldn't get over the fact that he wasn't good at science off the bat or maybe even when he tried too. This is the bane on America (and I would assume many other places, but America has a lot of this). They are teaching and re-teaching our people ridiculous notions and since they require very little work to understand, just community, people believe it--especially because it's being believed in numbers and that is the important part.

Now this was a longer post than what I wanted it to be and it also went past the scope of my original intentions. BUT, the reason why those statistics exist is due to the nature, the epidemic of how people are being re-taught forcibly (you think like us or you are no longer with us--it can have shocking community affects, especially when it becomes a inter-family problem...I know this EXTREMELY well due to my Mormon upbringing; when I became an atheist I was shunned and cut-off from the community, at first. they slowly let me back in when they realized I was an extremely good person, usually a better person than many of the people in the Church and so my neighbors finally no longer cared--cared what the churches stance was either--who or what I was, they took me for what I was--IT TOOK 20 years to happen!). So many people are started and taught young this is a HUGE problem, I know it's a major one with the Mormon church. You are baptized into the church at eight. You should hear the things they ask you to accept and agree to--they are things that only and adult with experience could properly answer (more like someone that is 25) yet an eight year old surrounded by their family and peers of course can give only ONE answer.

After that, you being to be taught all the incorrect things you could possibly think of. If you are even semi-devout like me (and this goes for many other religions as well) going to public school in Utah, the church has LITERALLY built seminary schools next to every High School and Junior High (and this is true outside of Utah too, as I'm SURE Idaho, Arizona, Colorado, Wyoming, and Nevada--maybe more too, I'm sure they have them locally to attend--I'm sure many of these states have these institutions built right next door or somewhere for kids to attend) you will attend seminary due to the wishes of your parents (my parental situation was beginning to change--and for the better).

Still I attended seminary through grades 7-12 and could have continued in College, but I was agnostic by then...if not basically atheist, just not strong enough to say it. Seminary had it's wonderful parts, but the mis-information was a joke. luckily I was smart, very smart. So I was able to separate the information apart from each other and it allowed me to ask STRONG questions about my one time faith. These questions and their mis-information EASILY killed that religion for eternity, for me--for A LOT of reasons. Many of which, many of you know...easily. It came to ME slow. SO when i talk about helping other people you need to realize what we are up against. facts that do come to us easily usually don't to them and it typically has to do with their past. but, it is HARD to get them to talk about their past openly. For one thing there is no possibility of them being wrong or in danger of it. Somehow we MUST change this.

/Like I said longer, but I hope it was worth it.
/edited for more clarity and a few additions

Sylvester_Ink (Member Profile)

BoneRemake says...

Dont be sorry, I'd dupe you in a heart beat.

In reply to this comment by Sylvester_Ink:
Technically not a dupe, (different by 3 minutes or so ) but yeah, I'll go ahead and call a *dupe out of the interest of keeping VS less cluttered. Sorry man. :*(

In reply to this comment by BoneRemake:
Now that I look at it I have more or less the same tags as you. SIftbot let us down, and I let myself down.

*bang*


Edit-" goes the bell" for our sensitive viewers.


Spider's heart beating

Seric says...

>> ^dapper:

Thanks for the clarification. i love that people on here know about this stuff....
>> ^oritteropo:
Spider respiration isn't like ours, it's based on diffusion rather than forcing the air through like we do.... or, in other words, no.
I felt quite sorry for the poor little fellow.
>> ^dapper:
Is it possible that the movement is a consequence of it breathing rather than the heart beat?




I know some insects (and spiders) pulse their abdomen to force air through their spiracles (little breathing holes on their underside), similarly to the way we use our diaphragm and intercostal muscles to draw air in and force it out again. Reading about it, it seems spiders tend to mix and match their breathing systems, depending on the species - but only "more advanced species" use spiracles"

Spiders hearts are located on the back of the abdomen. See this picture of a tarantula for example: http://i.imgur.com/7kexx.jpg (elongated yellow thing). So it could be it's heartbeat.

TL;DR - It could be breathing or a heartbeat. But due to spider anatomy, heartbeat would appear more likely.

dapper (Member Profile)

oritteropo says...

I'm afraid that "knowing about this stuff" rather overstates my position! Half remembers stuff from a lifetime ago and can kinda confirm with google is more like me.
In reply to this comment by dapper:
Thanks for the clarification. i love that people on here know about this stuff....
>> ^oritteropo:

Spider respiration isn't like ours, it's based on diffusion rather than forcing the air through like we do.... or, in other words, no.
I felt quite sorry for the poor little fellow.
>> ^dapper:
Is it possible that the movement is a consequence of it breathing rather than the heart beat?





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