Saturday, May 27, 2006

Streetcar Suburbs and Trolleytrack Towns

Author's Note: This is the first part of a series. The material here represents an excerpt from a longer work (in progress) to appear in print in late June. The material presented here may not appear in the final version in this form, and the formatting here has been optimised for online viewing.



Once upon a time, in a land not too far from here, the automobile was a decadent luxury item owned by a few, and most people rode streetcars. The streetcar was a piece of iconic Americana, inspiring, among other things, pop-culture references galore – from the hard-boiled gumshoe cadging a free ride on the back of a passing car, to A Streetcar Named Desire, to the Toonerville Trolley. Streetcar-centred life changed the way Americans acted, thought, and spoke. The streetcar even changed the urban American landscape.

People born in the latter half of the 20th Century, after the decline and fall of the streetcar, may have the idea that suburban development happened primarily because of the automobile. While what we stereotypically think of as "suburbia," that sprawling vista of single-family houses on neatly-manicured lots -- and other tropes from 1950s sitcoms -- did, in fact, originate with car culture, the first genuine suburbs were built because of, and adjunct to, streetcars. In fact, the modern shape of certain cities (Los Angeles, San Francisco, Baltimore and Chicago among them), are largely due to streetcars. (See a map of the LA Pacific Electric “Red Car” lines here, for example.)

A "streetcar suburb" was a planned community built around a streetcar line or a set of streetcar lines. They were often built by a single developer, and have some distinctive architectural and landscaping features that are still visible today in neighbourhoods where the original development is preserved. A streetcar suburb usually has small lots, a conspicuous absence of individual driveways (as in my neighbourhood, some houses may have no driveways at all, or may have "mutual drives" shared between two houses) with any garages present as outbuildings behind the houses. Front porches, as with most houses built between 1850 and 1920, were a prominent feature of the homes in streetcar suburbs, and were used in some areas for the dual purpose of providing outdoor social space and climate control for the house. (In my neighbourhood, one can find California-style bungalows built between 1900 and 1920, as well as typical Victorian, Queen Anne, and Regency houses of the period. Almost all of them have deep front porches to provide a windbreak and insulation in winter, and shade and cooling in summer -– very important in the extreme Southwestern Ontario climate, which features hot summers and cold winters. See www.ontarioarchitecture.com for more details and a field guide to local building styles.)

Streetcar suburbs were built with sidewalks, on a scale that was also convenient for pedestrians and cyclists. The neighbourhoods themselves feature good soil and large trees, planted to create an attractive environment for residents and passers-by. Unlike modern "transit villages," which seem to be the reincarnation of the streetcar suburb idea, streetcar suburbs were primarily residential areas, with limited integrated commercial space. The idea was less to put commercial and residential spaces into one neighbourhood (as in modern transit villages), than to separate the busy commercial district from the quieter bedroom community while still keeping shopping and amenities an easy distance (by streetcar, bicycle, or even foot) away.

It’s also important to understand that many people’s lives meshed with the streetcar lines, in terms of their patterns and rhythms of living, and also that communities’ physical geographies reflected the streetcar (and other transit) lines. (Some of these systems had different names to differentiate them –- streetcars, light rail, and so on. For example, in Southwestern Ontario, an interurban streetcar system with dedicated trackage, similar to the Pacific Electric suburban lines, was called a "radial railway," and an intraurban streetcar system that ran on rails embedded in the road was called a "street railway." For the purposes of brevity, I’m going to use "streetcar" as the generic term, and "light rail" only where contextual specificity is important.)

Our current culture privileges cars over transit, and transit over cycling and walking, but this wasn't always so. Many of the urban development and lifestyle paradigms we take for granted didn't exist in the first half of the 20th Century. That sounds self-evident, but it isn’t, exactly.

For example, one area where the automobile has encouraged a significant and dramatic lifestyle change between the early years of the 20th Century and the mid-1950s is the way people buy food and other supplies. The change was undoubtedly helped along by other advances in technology, such as expanding refrigerators and chest freezers, but the switch from transit as a primary means of travel to the automobile provided the catalyst. In a transit-based lifestyle you are more likely to want to make more frequent trips, buying smaller amounts each time, to someplace that is convenient (ie. nearby someplace else you have to go), than to make one trip especially for the purpose, where you buy large amounts of supplies and bring them home and store them. We have an entire industry of "family packs," "club packs," Price Clubs, Costcos, and Sam's Clubs catering to this outgrowth of car culture. On the other hand, living a transit-centred lifestyle in a transit-centred environment (such as in early 20th Century US cities), encourages buying smaller quantities more frequently, at local shops, most probably near either one’s home or one’s workplace. This lifestyle is still evident today in Europe and Japan, both places where urban developments are generally amenable to pedestrian, transit, or bicycle travel.

Of course, you already know all about American streetcar culture. If you’re at all literate in 20th Century American popular culture, the iconography and landscape, the patterns of living in Streetcar America are already there, imprinted in your mind by everything from Sam Spade movies to Nick at Nite; novels, radio shows, and every other creative and popular artistic endeavour of the early 20th Century. A search of Project Gutenberg lists about 12 100 entries containing the terms "streetcar" or "trolley," which is impressive, considering that the first modern streetcar systems in the US appeared around 1850, and most of Project Gutenberg’s library predates the current copyright penumbra, which begins in 1911. Those myriad cultural references grew organically out of Americans’ experience with streetcars, and streetcar-centred urban spaces. In fact, although it seems counterintuitive, the relative unimportance of the streetcar in popular literature speaks volumes about its centrality to the American experience of the time.* The streetcar was a background fixture, something that everyone just expected to be there. The streetcar was also an integral part of the great American technological experiment. It even held a certain pride-of-place in the American self-image, as a crucial real-world demonstration of Americans’ underlying beliefs in American technological know-how, craftsmanship, and expertise, and their belief that, in America, Things Just Work.

The question is not whether the system that created this lifestyle worked; it did. The question is why it worked, especially why it worked as long and as successfully as it did.

Tune in next time for a look at one of those reasons.



_____________

* Similarly, there is a story of why there is no surviving medieval recipe for bread –- the knowledge was ubiquitous, bread recipes were learnt young and passed from parent to child (most likely mother to daughter), that nobody felt the need to commit them to print.

Thursday, May 25, 2006

The Echo of the Shot Heard Round the World

So Kenny Boy Lay and Little Jeffy Skilling got busted. It's about damn time. The Enron scandal, and all its associated scandals, were a shot heard round the world in terms of business and politics. Enron's gaming the system in California had effects even as far away as here in Ontario. I remember it vividly...

At the time when California was going through rolling blackouts and suchlike stuff as a result of Enron and friends' gaming the system to drive prices up, our dearly beloved ex-Premier, Mike Harris, was going on the media all the time broadcasting the prevailing spin that the California problems were the result of lack of generation capacity and that the ostensible stagnation in power plant construction in California (causing the shortages) was because the system was not deregulated and privatised enough to "incentivise" the private sector to build more power plants.

From there, he claimed that Ontario was likewise short of generation capacity, and that we were sure to have the same sort of problems if we didn't take immediate action. However, for the record, Ontario has a publicly-owned power utility, then called Ontario Hydro.* While he didn't manage to privatise the electrical supply, he did manage to deregulate the rates (which has never made sense to me in the context of a publicly-owned utility in the first place), and they've been rising ever since.

What's that Bartcop likes to say? If someone makes a "mistake" that puts money in their pocket, look for them to make that same "mistake" over and over again?

So Harris' logic was that if we wanted to avoid generator shortages, we should immediately sell off Ontario Hydro at fire-sale prices (he tried and failed, especially after a debacle with a British company running one of our power plants into the ground), including the transmission lines, and then the private sector would be magically willing to build more power plants and lower rates at the same time, thus sparing us from California's tragic fate.

Of course, it was obvious to anyone with half a brain who was willing to listen to more than the official line on the subject at the time (ok, friends in California didn't hurt, either) that Enron and pals were gaming the power grid for fun and profit, mostly profit, so that added another layer of absurd, greedy mendacity to Harris' little plan. We often speculated how much he stood to make from the proposal, as there was no other reason for it -- it wasn't like Ontario Hydro was particularly dysfunctional, and where I grew up, you say, "if it ain't broke, don't fix it," and he had his heart set on fixin' what wa'ant broke. Generations of Roman philosophers, Deep Throat, Bartcop, and I all came to the same conclusion in similar circumstances: Follow the money.

A little cynicism is often a good thing, and schadenfreude feels so nice. Wading around in Harris' wingnut logic years after the fact is somewhat akin to bathing in ditch liquour, though.


____________

Post-It Note: The reason I'm so emphatic above about transmission lines is that I have a deeply-held belief that one should keep one's public infrastructure under the thumb of one's Beneficent State, rather than auctioning it off to the highest private-sector bidder, where it immediately gets turned over to the profit motive. Power transmission lines (as well as generation utilities) are infrastructure.

Similarly, the value of transmission lines and other similar systemic components is becoming clearer and clearer to me as I study streetcars and light rail systems. Historically, the areas where streetcars and light rail have and had done the best were in areas where there were guaranteed rights-of-way and/or dedicated trackage, so the streetcars or light rail weren't dependent on traffic movement. More on this later, which will be the first installment of a much bigger project to appear in print shortly. Stay tuned...


* Ontario Hydro: "Hydro" is regional Canadian slang for "electricity," largely because for a long time, the largest single share of electricity generated in the areas where the slang appeared was hydroelectric.

Thursday, May 18, 2006

An Argument In A Room Full of Hungry Lawyers

Here are the Canadian government's Family-Centred Maternity and Newborn Care National Guidelines: Chapter 3, Preconception Care. Compare and contrast (see the previous post for context).

Nakedly Partisan Moment: I love my government sometimes. Let's hope the Smirking Corpse doesn't fuck it up too much.

Wednesday, May 17, 2006

Trust Your Mechanic

There's been a lot of noise in Left Blogistan lately about this scary Washington Post article on this CDC report titled "Recommendations to Improve Preconception Health and Health Care." The report itself is fairly innocuous on its face, although some of the rhetoric in it is disturbing at best. To get this out of the way briefly, I have no problems whatsoever with preventative medicine, prenatal care, regular assessments and reassessments with one's doctor about one's overall health, and/or being asked if one's birth control or lack thereof is working out well. However, I have two main objections to this report. The first, which I'm going to look at in not too much length, is the discourse used by the report, since it's also important as a lead-in to the second point. The second objection I have is to the scope and consequenses of these guidelines.

First of all, the line from the original report that jumps out at me is "all women of childbearing age in the United States [should] receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health." ("Childbearing age," defined more precisely, is between the onset of menstruation and menopause.) The recommendation in itself isn't so bad, although it's inartfully and inaccurately worded. If it said something like "all women of childbearing age in the United States should have access to preconception care services...to decrease the likelihood of adverse pregnancy outcomes if and when they become pregnant," that would be quite different. In fact, it's a completely different statement.

We don't know the intent of the CDC authors, but just in that one line we have the implication that "preconception care" must be given to all women who may be capable of becoming pregnant, regardless of whether they're single, partnered, straight, gay, celibate, or sexually active. Notice too that there is no "out" here for those women who, for whatever reason, don't want to or can't get pregnant. All women are assumed to "enter pregnancy," whatever that means -- the key there is the phrase from the above quotation "will enable," which probably more accurately should have read "would enable." See the difference? One is presuming that all women will become pregnant, the other is assuming that all women may become pregnant. Neatness counts. (According to the CDC report itself, only 85% of American women are ever pregnant, so careful writers would use the subjunctive anyhow.)

I notice that they do refer to Canada's preconception care guidelines, with which I am not overly familiar. My experience with Canadian government documents (extensive) leads me to believe they're likely clearly written and parsed better than an argument in a room full of hungry lawyers. My practical experience with Canada's preconception care guidelines so far has been to be asked "Are you happy with your birth control?" and so on, since my medical professionals already know I'm not intending on having children. One of the last times I was in to see my doctor, she asked me if I had considered having a tubal ligation. Those sorts of guidelines may be what they are going after in this document, but this is not clear from the rhetoric, which seems to imply a pregnancy-centred model of addressing women's health. They specifically and distinctly (twice, I think) separate this initiative from what they call "well-woman" programmes, which suggests to me that it is more pregnancy-focused, rather than a component of an overall programme to encourage women to be healthier.

Bolstering this point further down, we have the usage of "the interconception period," suggesting that the focus of these guidelines is to view women's health entirely through the lens of their reproductive status. (To digress a moment, a commenter on Eschaton claiming to be a CDC employee opined that, "our field is working on improving the health of women in the pre-conceptional and inter-conceptional stages of their life," to which someone replied, "I for one do not think of my life in terms of pre-conceptional, inter-conceptional, post-conceptional or any other 'conceptional' stages.") The report itself mentions that the "Guidelines for Perinatal Care, jointly issued by AAP and ACOG, has recommended that all health encounters during a woman's reproductive years, particularly those that are a part of preconception care, should include counseling on appropriate medical care and behavior to optimize pregnancy outcomes," which seems pretty unambiguous in a certain sense. Again, this may be a case of inartful and inexact wording -- do they really mean all "health encounters" (one would assume they mean medical interventions of one form or another) need to be reframed in the context of "optimiz[ing] pregnancy outcomes"? The implication here is less like, "If you're already healthy, you have a better chance of having a healthy baby," than "Be healthy because it's good for your future baby."

Incidentally, the frequent uses of the word "consumer" (twelve times) where a similar document from another country might use "patient" disturbs me slightly. While I realise this usage is a reflection of the organisation of the US healthcare system (if it can be accurately described as a "system"), it seems to me to be reflective of the apparent schism here between practical advice and sound practice.

Make no mistake, there is plenty of practical advice in this report. In general, it's a coherent, targeted strategy addressed at a pernicious problem in the US. I think, however, that it is pursuing that practical advice in completely the wrong fashion. The ends don't justify the means.

Why is this framing a problem? First of all, to get an idea of why these framings are problematic, check out the Washington Post article. The spin presented there may or may not be accurate, but that meme has definitely been injected into the noosphere now, like it or not.

I don't like it. Here's why:

The problem here is not advocating a healthier diet and exercise and the rest of the bland advice in most of the report, but rather if this "pre-pregnant" framing -- which does not appear in the CDC report, by the way -- gets into the public and/or medical community mindset, as a result of this recommendation or not, it's likely to have adverse effects on what doctors will and will not prescribe to women, on the grounds that they might become pregnant while on those drugs. The guidelines themselves, federal and applying to all public health initiatives in the US, may contribute to the mindset as well.

(The precedent for this move from rhetoric to reality might be the whole manufactured controversy about "partial-birth abortion," which is a loaded, misleading, and manufactured term used to push outlawing "dilation and extraction," a procedure performed infrequently in the later stages of pregnancy and only if the woman's life is in danger or the fetus has died, or has severe, fatal health problems.)

There is already a drug, Accutane, where the US prescribing guidelines require women have monthly pregnancy tests and be on two forms of birth control while on it, out of fear of birth defects in potential fetuses. Someone on LJ relates her problems with catastrophic weight loss (-50lbs) and ineffective seizure control due to the drugs she's on for epilepsy, but her neurologist won't prescribe better, more effective drugs with less harmful side effects. The reason? "'You're a newlywed. You'll want a baby'," and the more effective drugs cause birth defects. (Never mind that she's a nonpregnant newlywed with an eleven-year-old daughter, epilepsy, a 98-pound body, and no desire to conceive again.)

Relatedly, due to generalised and non-targeted fears of potential abuse (as opposed to an assumed generalised, non-targeted risk of unintended pregnancy), many US doctors already no longer prescribe Oxycontin, and some US pharmacies won't stock it. Former legitimate Oxycontin patients are usually put on other drugs that often are not as effective and may have worse side effects. (Full disclosure: I used to date an American who was forcibly taken off Oxycontin for precisely this reason. He was put on transdermal and oral morphine, and oral fentanyl in a sugar matrix, with devastating -- and seriously addicting -- consequenses.)

There are more than enough examples of doctors treating patients paternalistically, without having the media spin and a set of guidelines which, read the right (or wrong) way could certainly encourage the mindset.

Add in "conscience clauses," the active war on birth control and abortion by the US religious right, stir in a bit of the usual moral panic, and lo and behold, it's a recipe for disaster -- and anxiety. Need anti-anxiety drugs? Sorry, we can't prescribe those because you might get addicted to them, and your future baby could be harmed by them or your withdrawl. Need painkillers? Sorry, you'll just have to tough it out, because you might be pregnant and not know it. By the way, we require you to have a negative pregnancy test before starting any drug or any form of birth control. (This is not far-fetched; I was informed by one doctor that he wouldn't put me on Depo-Provera until I had a negative pregnancy test, never mind that I wasn't sexually active at the time.)

That's the real trouble with this recommendation -- in effect, treating all women as if they are "preconceptive" (I, OTOH, will cop to being post-pissed-off) restricts women's ability to make their own decisions about their health care, by treating them as adjuncts to their hypothetical fetuses. If there are liability reasons to make sure that a woman does not become pregnant while on a medication, brief her on the dangers and options, and have her sign a waiver. Isn't that the way American culture usually handles risk?

What the question boils down to, is, do you trust women to make their own decisions about their health care? If not, why not? And why would anyone put the health of a potential, unconceived fetus ahead of the health of an actual, living woman? (That's a rhetorical question.) In short, the CDC either needs to change its discourse habits, or agitate actively for a better healthcare system (single-payer?), which would reduce or eliminate many of the class and race disparities (not all, but a significant percentage) that are driving up the US' maternal and infant mortality rate, if indeed this "for your own good" stuff is actually a reaction to the infant mortality rate at all.

Tuesday, May 09, 2006

Philosophers With Bad Backs, Aching Teeth, and Nasty Rashes

I've been reading a lot of stuff, particularly on "Alas, a Blog," about body issues, and the general consensus seems to be that a lot of people don't understand why a lot of other people find certain natural bodily functions if not disgusting, then at least somewhat distasteful. The latest example of same is breastfeeding, and a lot of people have been jerking their knees saying it has entirely to do with sex, and I don't think that's the case. Either that or it's the general patriarchal revulsion for anything and everything biologically female. Oh, no, I think it goes much, much deeper than that.

My radical hypothesis is that the culture in general, despite loads of objectification of same, still basically hates bodies -- all bodies. Anybody saying differently is probably in a position where they're fairly comfortable in their own skin, and so don't really notice the counterpropaganda. That would be everything from mouthwash ads to hair dye to disposeable razors, to Jenny Craig to Viagra to most of the garment industry. Actively getting people to hate their own bodies for reasons superficial and not is a big, big business in this culture, but I also don't think they invented the concept; they're just exploiting it for all (the trillions of dollars) it's worth... Personally, I think this is dualism hangover, particularly that peculiar sort of Pauline dualism where everything to do with the soul (or mind) is pure and sacred, and everything to do with the body is defiled and profane. It's not hard to get from "defiled and profane" to "vaguely disgusting" in several thousand years...

Speaking as someone who legitimately does hate her own body, which forces me into a de facto uneasy dualism (man, do I ever like those "externalisations of the senses" -- thank you Marsh McLuhan -- I have access to) -- I'm pretty happy most of the time with my state of mind, but I generally despise what my body's up to. Not, of course, that I think there's really any difference, knowing as I do that I'm pretty much ruled by my mental biochemistry, but the English language still basically operates on the premise that dualism is real and so there really isn't another way of talking about it that wouldn't take this entry into the "lengthy philosophical tractate" category, which is not where I want to go with it.

My further elaboration is that the more you hate your body in general, the more you'll be likely to extend that out into generally disliking almost everything in the physical realm. As in the title, I'm picturing ancient philosophers with aching teeth, bad backs, nasty rashes, and one with a bum knee who limps a lot and spends a fair amount of time inventing new maledictions when called upon to walk any significant distance.

A lot of you are probably thinking I'm just having a fit of culturally motivated "image issues"; naah, those are just the icing on this particular strychnine-laced cake. No. I have genuine reasons to really despise my body. It, unlike most of yours, really doesn't do anything like what I want it to do, and so most of the time I exist in a state of uneasy armed physical detente. Right now, I've got a bit of a skirmish going on.

I've got cerebral palsy, spastic quadriplegia, which means in practice that my muscles are too tight (think like guitar strings tuned a couple tones too tight, and yes they behave about the same way), and that I twitch uncontrollably at times, I have crappy hand-eye coordination, and erratic fine- and gross-motor control, and that I'm sarcomere-deficient, and that the tension from some of my muscles pulling against some of the others can pull large portions of my skeletal system out of position, plus a raft of other things. I've had four surgeries to correct CP-related things, and one to remove my gallbladder. I have astigmatism and strabismus (hello, no binocular vision), and I'm slightly hyperopic in my left eye. (That used to be worse, but I hit a postadolescent nearsighted phase and my vision corrected itself.) I can't either stand or sit for very long without something hurting, no matter how good my physical condition is. I fell back in December and damaged the anterior ligaments in my shoulder, which caused the ball of the joint to move too far forward in the socket and start pinching muscles and nerves, and that's not completely healed yet. My kneecaps sit too high on the joints, and are prone to dislocating. My calves are atrophied, and between the way I walk and the sarcomere deficiency, there's not much I can do about it. I have gastric reflux (another symptom of the CP syndrome). I've already had to have my gallbladder out, despite being 15 years, a couple children, and many pounds outside the usual "fat, 40, and fertile" profile for gallstones. Besides having to watch my fat intake, because it still gives me indigestion, I am lactose intolerant and allergic to casein, plus there's something about eggs I can't tolerate really well, and I also have to watch things like bananas and potatoes that can contain lactose-like compounds. I get tension migranes. I have chronic sinus problems aggravated by a very severe mould allergy that manifest usually as six of my top teeth aching, three on either side. I have dysmenhorroea, and have ever since I started menstruating. I have (or had) toenail fungus, which again, is very common in people with CP. I went on a systemic antifungal, which is interfering with the hepatic metabolism of the hormonal contraceptive I use to control the dysmenhorroea, so I've had either menstruation or heavy spotting for most of the last month. (A total hysterectomy never looked so appealing.)

Those are just the chronic conditions. I get colds, flu and other illnesses the same as everyone else. I've had mononucleosis (which gave me splenomegaly and liver dysfunction). I get pneumonia on a scarily regular basis. I'm prone to yeast and urinary tract infections. (You know you're in bad shape when you pretty much know the location of your internal organs by mapping out what hurts.) There are probably other things, but I can't think of any off the top at the moment. You will note that none of those things is a superficial aesthetic consideration. Bite me. My body doesn't work right, and I want a new one. If I'm getting a replacement, I'll redesign the exterior, as well (why not?) but I'm not so unhappy with the superstructure as to find it anywhere near the source of my problems.

That kind of thing does tend to turn one into a quivering bundle of physical neuroses. The acculturated ones tend to centre around eating, excreting, and reproducing -- I'd wager that breastfeeding trips two of those subconscious squicks for a lot of people, and probably all three, since we all know what comes out the other end of an infant (Reason #20478 I Am Never Having Children).

This of course is not to excuse the particular philosophic paradox, because it's still bullshit, but I certainly do understand it. Those ancient dudes probably only ever felt like they were in their own when they were writing or arguing (I empathise), and the rest of the time they were probably annoyed about their aches and pains and whatever else. I feel your pain, brothers...literally.

Saturday, May 06, 2006

The Unbearable Lightness of Conspiracy Theories

So this shows up in my inbox tonight, sent by my dad, who has the worst scientistic bent I've ever seen:

"Bird Flu"
> Do you know that 'bird flu' was discovered in Vietnam 9 years ago?
> Do you know that barely 100 people have died in the whole world in all
> that time?
> Do you know that it was the Americans who alerted us to the efficacy of
> the human antiviral TAMIFLU as a preventative.
> Do you know that TAMIFLU barely alleviates some symptoms of the common flu?
> Do you know that its efficacy against the common flu is questioned by a
> great part of the scientific community?
> Do you know that against a SUPPOSED mutant virus such as H5N1, TAMIFLU
> barely alleviates the illness?
> Do you know that to date Avian Flu affects birds only?
> Do you know who markets TAMIFLU?
> ROCHE LABORATORIES.
> Do you know who bought the patent for TAMIFLU from ROCHE LABORATORIES in
> 1996?
> GILEAD SCIENCES INC.
> Do you know who was the then president of GILEAD SCIENCES INC. and
> remains a major shareholder?
> DONALD RUMSFELD, the present Secretary of Defence of the USA.
> Do you know that the base of TAMIFLU is crushed aniseed?
> Do you know who controls 90% of the world's production of this tree?
> ROCHE.
> Do you know that sales of TAMIFLU were over $254 million in 2004 and
> more than $1000 million in 2005?
> Do you know how many more millions ROCHE can earn in the coming months
> if the business of fear continues?
>
> So the summary of the story is as follows:
> Bush's friends decide that the medicine TAMIFLU is the solution for a
> pandemic that has not yet occurred and that has caused a hundred deaths
> worldwide in 9 years.
> This medicine doesn't so much as cure the common flu.
> In normal conditions the virus does not affect humans.
> Rumsfeld sells the patent for TAMIFLU to ROCHE for which they pay him a
> fortune.
> Roche acquires 90% of the global production of crushed aniseed, the
> base for the antivirus.
> The governments of the entire world threaten a pandemic and then buy
> industrial quantities of the product from Roche.
> So we end up paying for medicine while Rumsfeld, Cheney and Bush do the
> business.


Sounds kind of good, right? Unfortunately, it's complete bullshit. Here's what I sent back:

Where to start on this...

The first place to start is Effect Measure, a public health blog written by a team of health professionals from the US. Probably the second place to go is the Flu Wiki at http://www.fluwikie.com/. Those of us who've been paying attention to H5N1 (NOT "bird flu" -- *all* influenza comes to humans through birds, so calling it that is kind of like calling the usual winter sniffles "people cold" or something) know that it really is something else. Me, I've been watching it since 1999...

First of all, the scary part about H5N1 is not how many people it has killed, it's how many people it has killed relative to the number of people it has infected. If in fact it has only killed just over 100 people, based on the actual case literature, it has *only infected* just over 200 people. (see www.cdc.gov/flu/avian/gen-info/facts.htm)

For comparison, a "normal" influenza that only infected 200 people *might* kill 3 people, maybe, in a bad year... See also this article in the Mercury News:

"Bird flu expert says H5N1 worst he's seen"

The problem with H5N1 isn't that it hasn't spread very far (yet!) or that people are worried about it spreading to humans...it's that it *isn't* yet very good at infecting humans -- but it's really, really good at killing them. (See also Flu Pandemic Morbidity / Mortality at GlobalSecurity.org) There *is* no other influenza or influenza-like virus in the world that has a mortality rate of ~50%. There is no guarantee that if it does go pandemic, the mortality rate would decline significantly, although conventional models assume so.

Again, for comparison, the 1918 "Spanish Flu" killed millions of people worldwide and caused massive social and economic disruption, with an approximately 3% mortality rate. I am going to assume that even if you're passing around things without checking them against reputable sources like Effect Measure, Helen Branswell's articles, the journal publications, or even Snopes and a quick Google search, you can do the math and figure out the difference between a 3% and a 50% mortality rate. According to new studies, H5N1 shows up in the deep lung tissue, the airways and nasal tissue, and even the intestines and the brains of its victims, which is not at all typical of influenza. (see http://www.cdc.gov/ncidod/eid/vol11no07/04-1313.htm)

Secondly, studies done have shown that Tamiflu has limited effectiveness against H5N1, if any at all, so if anyone gets rich off of selling Tamiflu to fear-panicked people, they're most likely selling snake oil.

Thirdly, H5N1 isn't a "supposed mutant virus," it's an emerging disease.

Fourthly, no, "avian flu" doesn't only affect birds. As I mentioned above, all influenza comes through birds, often by way of pigs, to humans, so that's a meaningless statement. High-pathenogenic H5N1 also doesn't only affect birds -- it kills approximately 50% of the humans it manages to infect. Some birds carry it asymptomatically. Other birds get sick from it but don't die. Still other birds die from it. It's really good at killing felines (as evidenced by the tigers in Asia who have died from it, and experiments done on domestic cats -- see http://www.cdc.gov/ncidod/EID/vol10no12/04-0759.htm, and note the abstract -- "Influenza virus is not known to affect wild felids. We demonstrate that avian influenza A (H5N1) virus caused severe pneumonia in tigers and leopards that fed on infected poultry carcasses. This finding extends the host range of influenza virus and has implications for influenza virus epidemiology and wildlife conservation."). It also apparently is fairly dangerous to ferrets.

Fifthly, Tamiflu, the trade name for oseltamivir, is (3R,4R,5S)-4-acetylamino-5-amino-3- (1-ethylpropoxy)-1-cyclohexene-1-carboxylic acid ethyl ester, not "crushed aniseeds." It's a synthetic, orally active neuraminidase inhibitor -- an antiviral drug similar to treatments for shingles and herpes. Wikipedia entry on oseltamivir

In future, a little more skepticism before hitting that "Forward" button, please?


Jesus Christ, how many of these things do I have to write. I am not your fucking fact-checking staff, folks! I do have better things to do with my time than spend hours refuting all your bullshit because you'd rather read someone's shitty conspiracy theories than peek in on two blogs and a handful of newspaper and journal articles!! On the other hand, apparently you need some damn help...