• People Talk and My Ear Bleeds


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    Tuesday, June 26, 2007

    Societal Maturity

    In today's world, the elephant in the middle of the room is Mature Responsibility. There it sits, huge, unmoving, affecting everything and everyone that moves into and out of the room -- and nobody will address it.

    People clamor from both sides, "Let me live my own life! Let us govern ourselves!" but little importance is placed on actions.

    Look at soccer. Across the world, hooliganism infects and destroys perfectly good matches like a virulent virus. The latest example of such stupid immaturity happened yesterday in Argentina. Fans unhappy with a referee's call in the 2-1 Tigre win over Nueva Chicago, stormed the field. People threw rocks, swung metal pipes, and torched a bus. One man died, fourteen were injured, and 78 people arrested. Security was overwhelmed and had to be backed up by police shooting rubber bullets and tear gas.

    This should go without saying, but soccer is a SPORT! Sure we all love to watch it--the artistry and power that accompany truly great soccer is a beauty to behold--but ultimately, win or lose, we all go home and live our lives. We go back to work, love, play, and live. Never has soccer reached the importance that we must kill over it, and definitely not at some small game merely deciding the relegation of a team to the second league. If people can't control themselves watching a match, they shouldn't be given the luxury of watching it. Italy did this a couple months ago. If fans are going to act like children, then governing bodies will have to treat them as such.

    But this incident is just a harbinger of larger manifestations of the elephant in our world room. Iraqis want control of their own destiny, yet they continue to kill each other. More innocent Iraqis are killed every day than American troops or terrorists. The country has split in two in many places, Shi'a against Sunni, because people can't maturely put down their weapons of war, quell their emotions, put aside their differences and work for a peaceful compromise and future.

    The situation is similar in Palestine. After Palestine achieves semi-recognition in the international community, and Hamas wins a general election and gains a stake in the democratic future of their country, they throw it away, killing people, stomping on Yasser Arafat's picture, and controlling the Gaza strip--effectively splitting the small Palestinian state in half. Why? Because they didn't have the patience to continue gaining political power through democratic means, they didn't believe in the ability of the people to choose for themselves, they didn't believe in a joint West Bank-Gaza Palestine?

    America's idealistic view doesn't help. We seem to think that every child is perfectly capable of obeying those most basic sandbox rules--the ones your mother taught you while you played in the sandbox at the park: have patience, share, and no hitting/biting. However, children who know no education, no discipline, seen no prior example, find it hard to share toys when the situation arises. So too Americans think Palestine and Iraq should be able to govern themselves, yet the more autonomy they are given, the less they seem to be able to manage it.

    In both Iraq and Palestine, as in Argentine soccer yesterday, people have shown an paucity of those most basic sandbox rules. If you didn't follow those rules, mom took away the privilege to play with your toys in the sandbox until you could show you were fit to play again. Since people in Argentina, Iraq, and Palestine can't seem to follow the rules either, perhaps they need their toys and sandbox taken away too.

    Monday, June 25, 2007

    Shame on the Media, Go USA!!

    Congratulations to the USA soccer team, for their 2-1 victory of Mexico yesterday. I was not able to watch the game in English, because no basic cable (Comcast, Houston, TX) channel carried the game.

    (Above is a 1:48 video of the winning goal and this is the whole second half)

    I find this fact sad--depressingly so--and a grave error by Rupert Murdoch, Ted Turner, and every other media mogul who had a chance to broadcast this game but did not.


    The semifinals and final of the CONCACAF Gold Cup were played at Soldier Field in Chicago. I was in Chicago from Thursday through Sunday for the American Medical Association's Annual Meeting (Medical Student Section). Unfortunately, I was not able to join Sam's Army in the stands because America played against Canada in the early game, and I did not get out of my meetings in time. To add insult to injury, my flight left Sunday morning, so I could not stay and go to the final, either.

    I arrived home hoping to catch it on TV, and instead I find only Univision broadcasting the game. Boy, was I disappointed. I love watching soccer on the Spanish Channel because of the awesome announcers, so watching it in Spanish didn't bother me, but rather that no English language channel covered it.

    If there are enough viewers and ratings to justify broadcasting Major League Soccer matches, surely there's at least that many people willing to watch the USA in the final of the Gold Cup?

    Let's give props to the USA team--often regarded as a weak side, they are now 10-0-1 on the pitch under new coach Bob Bradley. Although we are not bringing all our veteran starters to South America for the Copa America, I think we'll still put in a good showing. American soccer is steadily improving, and deserves our support, and we deserve the opportunity to support it.

    Put our team on the air, ESPN!

    Thursday, June 07, 2007

    The TB Lawyer

    When I read this a couple days ago, I was incredulous. How many things went wrong? What, if anything, should be done?

    Andrew Speaker would be thrown in jail if he had done these actions with AIDS
    First, what is TB? Many people in the United States probably know it by name, but have little or no experience with it. TB is the common acronym for tuberculosis, the disease caused by the bacterium Mycobacterium tuberculosis.

    For those unfamiliar with microbiology, think of a bacterium (singular for bacteria) as a pill. Some come in ball shapes, others in more elongated brick shapes, just like your medicine. The genus Mycobacteria is a group of bacteria characterized by a brick shape and a thick waxy coat around the bacterium--like a long gel cap.

    Mycobacteria are typically the "jungle ulcers" and tropical diseases you think about when you see movies or read history books. They range from Mycobacterium ulcerans, the cause of Buruli ulcer (my personal favorite and target of research for many years), to Mycobacterium leprae, cause of Leprosy, to M. tuberculosis.

    M. tuberculosis typically causes a respiratory disease. The bacteria get into the lungs of a person, and your immune system tries to "wall it off" by encasing it because it is hard to kill. When looking at x-rays, you can usually see white spots showing these hard encasings in a person that had infectious TB in the past. Someone with TB will have "chronic, productive cough, low-grade fever, night sweats, easy fatigability, and weight loss" (Medical Microbiology, 4ed, Samuel Baron, ed.). As the disease progresses, the sick person starts coughing up blood.

    This month I am at a county hospital in Houston, TX and have seen a couple of tuberculosis patients. Pulmonary TB is highly infectious, and every patient suspected of having TB is put in isolation. Everyone who interacts with the patient must wear protective masks, because TB is spread by coughing.

    How bad is this disease? In America there are about 5 cases per 100,000 people (CDC data, 2003). In the rest of the world, it is
    the second-largest cause of death from an infectious agent worldwide—killing approximately 1.7 million people in 2003. Despite steady drops in the number of cases in some parts of the world, the number of new cases appears to be growing, with an estimated 8.8 million new cases in 2003. (Disease Control Priorities Project, Tuberculosis, fact sheet)
    Approximately 1/3 of the world's population is infected with latent TB, but fortunately only about 10% progress to disease every year.

    The short synopsis of Andrew Speaker's journey is thus: he was diagnosed with TB in America, and told not to go anywhere. At that time they didn't know it was the extremely drug-resistant strain he actually has (XDR-TB). He goes against medical advice and flies to Europe for his wedding. Then it is confirmed he has XDR-TB and he goes against medical advice again and against the USA "no fly" policy and flies into Canada and drives into the US. Now he's in isolation in Denver.

    You can get a more detailed timeline based on Speaker's view of the events, at abcnews.go.com

    In all this ruckus, people have forgotten the most important point--Speaker willingly flaunted medical advice more than once, blatantly snuck into the United States and, most importantly, exposed so many people to this disease.

    Mycobacteria are typically the "jungle ulcers" and tropical diseases you think about when you see movies or read history books
    He can blame his actions on ignorance, or "he said, she said" stuff, but the truth is he's a bright young man and can't seriously feel the ONLY place he could get treatment is in Denver, CO. He can't seriously believe that when doctors in Europe tell him not to leave, after already being told that in America, that he knows better than them and he should be ok to go to Canada. He can't be a good lawyer when he blatantly flaunts the law he went to school to learn and prosecute and adjudicate.

    Let's change the name for a minute. Instead of TB, it's AIDS. Imagine with me. Andrew is diagnosed with AIDS. He is infectious, but doesn't look overly sick. Doctors admonish him to be celibate or practice safe sex. He flaunts their advice and sleeps around without protection and without telling his partners he's sick.

    Then he moves to another area, and the doctors there tell him he has a rapidly mutating form of the virus that depletes the immune system far faster than the more prevalent form. They tell him again to be celibate/use protection and that he is required to tell his partners he has AIDS.

    Speaker proceeds to again have unprotected sex with many people and not tell them he's infected. Finally, he checks into a hospital.

    Andrew Speaker would be thrown in jail if he had done these actions with AIDS. In America it is a crime to knowingly infect or expose someone to HIV. But Speaker had TB, not AIDS. He had a disease that is easier to transmit, infects more people, and kills about as many people. He knowingly put other people at risk many times -- especially when flying to Canada WITHOUT wearing a mask and AGAINST both medical advice and US law.

    Many people walk out of hospitals against medical advice every day. Usually they only hurt themselves. TB is a special case. If you do not follow your treatment regimen, you can be locked in isolation until you finish your medication--9 to 12 months. So, a precedent was set by making TB a special disease under the law, and another set by prosecuting special diseases in criminal court (AIDS).

    Given what Andrew Speaker did, passengers on that plane have a very good basis for a civil suit, and possibly criminal charges, due to his reckless endangerment of their lives. And that opens up a whole new can of worms...