I support the Canadian health care system.

I'm dying, but let's be honest, so are you. The difference is that I keep trying to die sooner than later. If my body were a car, I'd be recalled. No wait, I'd be repaired and restored and I guess that's just what's happening.

When I read stories about the awful health care in Canada, I shake my head. The stories are so simplistic and so wrong. Health care is a problem all around the world, not just in Canada. But there are also health care solutions and they too are appearing all over the world.

Health care is expensive and it's getting more and more expensive with each passing year. When I was born mitral valve heart repair didn't add a cent to health care costs. Why? The procedure hadn't yet been done. The first successful mitral valve repair wasn't performed until 1948. That lucky dude had his sternum cracked open and his rib cage spread in order to give surgeons access to his damaged heart. Trust me on this, I bet he considered himself very lucky.

da Vinci at work.

Eight years ago I had my badly leaking mitral valve repaired robotically right here in London, Ontario. I did not have to have my sternum split; I have no huge scar. All it took was a little incision hidden in a fold under my right nipple, some little surgical tools, a talented surgeon and one big robot: a million and a half dollar da Vinci surgical robot. I consider myself very lucky.

I came upon an article by Michelle Meadows on the SurgicalTechSuccess site that said: "complete robotic heart surgery, which is commonly done in Europe and Canada, is considered experimental in the United States."

It was an article from 2002, it was written almost a decade ago, and yet I was surprised. I had thought the U.S. had always led the world when it came to robotic surgery. But when I looked into the history of my robotic operation I learned that some of  "the first minimally invasive mitral valve surgery using Aesop (was done) in Austria and South Korea and the first robotic mitral valve surgery using DaVinci (was done) in England, India, Italy, and Thailand."

I don't want to get into a "who-was-first" argument. My point is that medical advances are being made all around the world. Clearly, more is being done in India than just running call centres and more is being done in Thailand than shrimp farming.

Hospitalized in California

Last summer, seven years after I had my heart repaired, I suffered a V-tach event in California. My heart raced to 300 bpm and I was rushed to emerg where doctors hit me with 200 joules, jolting my heart back to reality. One could say they "rebooted" my pump.

Once you have a V-tach event there is a good chance that you will have another. These events can kill you in minutes. This does not leave much time to get help. A few weeks ago Dr. James White at the Robarts Research Institute at Western in London used a high-tech 3-Tesla MRI to discover why I suffered the runaway heart event. My pump is badly scarred, possibly because of a relatively rare type of heart disease, leaving it electrically unstable.

It was clear I needed an ICD — an implantable cardioverter defibrillator — and I needed one soon. Just weeks later I have one. I no longer need to go to emerg to have my heart rebooted. I carry a micro defibrillator in my chest. The battery is good for seven years and maybe longer.

My ICD not available in U.S.

An ICD isn't cheap. I gather from what I read on the Web that implanting one can easily cost from $65,000 to more than $100,000 in the States depending on the sophistication of the device. The high price may be part of the reason that less than 40% of U.S. patients in need of an ICD receive one according to Dr. Kenneth Stein, chief medical officer for Boston Scientific's cardiac rhythm management division.

I found an interesting article How Much Will We Pay To Save A Life? by Douglas P. Zipes, MD. This American doctor warned: "In the final analysis, many medical decisions are based on how much money society is willing to spend to save a life." He wrote, "Some therapies are inexpensive and others are not, and society has to make difficult choices about how to use our limited resources."

If having an ICD implanted in the States can cost in the six figures, how much did mine cost to have implanted in Ontario? I don't know but I bet the Canadian approach saved money, coming in at the low end of the scale. My ICD was implanted in an outpatient setting. I entered the hospital at ten in the morning and left by mid-afternoon. The operation itself took a bit more than an hour. I was home for dinner.

My ICD, a Medtronic Protecta, is also used in Europe but it has not been approved in the States. I got something that, for the moment, is not available in the U.S.

If we, as a society, plan on offering everyone high quality health care, we've got to perfect methods of delivering such care at reduced cost. Whether it's European socialized medicine, the Canadian single-payer system or the very mixed approach in place in the United States, every health system must address the issue of climbing costs.

• Methods of doing more with less must be developed. Cutting the time spent in the hospital cuts costs dramatically.
• Encouraging manufacturers to develop sophisticated equipment that cuts costs by increasing efficiency. This is a balancing act, of course, the additional expense must be offset by greater efficiency. The 3T MRI unit used to diagnose my heart condition is one example. I ran up a $25,000 hospital bill in California and yet the cause of my V-tach event went undetected. One scan in a high-powered 3T MRI could have answered all the questions that were swirling about my heart.
• We must take advantage of technological breakthroughs. Robots, controlled by experienced surgeons, may very well work better and quicker than surgeons on their own. Minimally invasive surgery performed robotically can cut hospital stays dramatically and speed patient recovery.
• Careful patient selection is important, and we may have to make some tough, unpopular choices when it comes to medical treatments that are covered.With limited resources, only those with a good chance of benefiting from a medical procedure should be considered. And some procedures are very expensive and yet have very poor track records. I know a person who was so desperate to lose weight that they longed to have their stomach stapled. OHIP refused to cover the cost and no Canadian hospital was interested in performing the operation. This person was told that the procedure they sought would be very risky for them and that in the end they might well put back all weight they lost following the surgery. The person turned to a hospital in the States. The U.S. hospital performed the operation for a fee and today, four years later, this person has ballooned right back to their former obese size. They needed a new attitude toward food and not a new, smaller stomach.

And maybe all hospitals don't have to have the latest and greatest equipment to enjoy some benefits from advancing technology. There are indications that the original da Vinci robot may be getting a little long in the robotic tooth. Children's Hospital Boston demonstrated a tiny surgical robot at TEDMED that put the size of tools used by da Vinci to shame. Maybe smaller hospitals can pick up a used da Vinci robot on the cheap.

As I recuperate from my ICD operation, it'll be a month before I can lift my granddaughter again, as the wire lead screwed into my heart must heal firmly into the heart muscle. I wouldn't want to tug it free. I will follow all my doctors' orders faithfully.

I am going to use some of my free time to rewrite my will, add a codicil. I'm leaving something to LHSC and to the Robarts Research Institute. Our health system has earned my support.

Supporters want Baby Joseph sent home

Showing support for the family, dozens turned out Saturday to rally beside Moe Maraachli to protest LHSC's refusal to perform a tracheotomy on Maraachli's young son before releasing him into his family's care.

Baby Joseph is dying. On this both the Canadian hospital and Baby Joseph's parents agree. The dispute arises as to where the infant will die. Will it be in the hospital or at home?

Saturday dozens of supporters protested the hospital's refusal to perform a tracheotomy on the little boy before sending him home to face certain death.

Moe Maraachli is Baby Joseph's dad.

The 13-month-old son of Moe Maraachli and Sana Nader of Windsor Ontario, known to the world as Baby Joseph, was admitted to Victoria Hospital in London Ontario last October. 

The family was on the way home from Toronto, not quite halfway to Windsor, when their infant son developed life-threatening breathing difficulties. They rushed the boy to emergency in Ingersoll and from there he was taken to the London Health Sciences Centre's pediatric critical care unit. 

It is now March and the little boy is still being cared for in the Southwestern Ontario hospital. The doctors have determined he is dying of the same progressive neurodegenerative disease that claimed his sister, Zina, eight years ago. 

The doctors would like to remove the breathing tube keeping the little boy alive. His parents want the doctors to perform a tracheotomy and let them take their son home to die, as was done with Joseph's sister. She lived six months with a tracheotomy before succumbing to the fatal genetic disease.

For more on this story see the Digital Journal post.

Protesters supporting the parents of Baby Joseph lined Commissioners Road and Wellington Road at the busy intersection near the large hospital complex.

Stop fluoridation, London audience told

Dr. Paul Connett, who co-authored The Case Against Fluoride, speaking Wed. in London.

London - Fluoride is hardening more than teeth in London Ontario. In this Southwestern Ontario city it is also hardening positions. The battle to remove fluoride from the city's tap water appears to be gaining strength.

The talk by Dr. Paul Connett at the downtown Central library in London Ontario filled the 370-seat Wolf Performance Hall, forcing organizers to close the doors and turn many away who had hoped to attend the well promoted event.

Connett heads a New York state anti-fluoridation group called the Fluoride Action Network. These American activists have found Canadians receptive to their arguments against the decades old practice. Politicians in two major Canadian cities, Calgary in Alberta and Waterloo in Ontario, have voted to remove the chemical from their municipal water.

Connett said, "the evidence of benefits is very weak."

Connett challenged Dr. Bryna Warshawsky, associate medical officer of health for the Middlesex-London Health Unit to tackle his arguments publicly. "I want her to tell me where I'm wrong."

The anti-fluoride group believes support for the tap water additive is crumbling in North America, especially in Canada.

"They've got to admit," says Connett, "fluoridation is a huge mistake and has got to stop."

The gauntlet has been thrown down: "I don't say fluoridation is the biggest threat (to our safety) but it is the easiest one to correct." Connett clearly hopes London will be another victory in the battle to remove fluoride from our water.

Read more: http://digitaljournal.com/article/304245

Detroit: Send a poet, not a reporter

The Michigan Central Station is a sad reminder of  Detroit's former glory.

Detroit — It wasn't so many years ago that Detroiters called their booming town "The Third City." They proudly bragged that when American cities were listed in order of greatness Detroit had a firm hold on third place after New York and Second City (Chicago). And those Detroiters would have been right. Back then Detroit was also known as "the Paris of the Midwest". But that was then and this is now.

It is all too sad. And, for me, it's an eye-opener. As a child I wondered how the Roman Empire, so big and so powerful, could collapse so quickly and so completely. It was unfathomable. From my perspective, so many centuries after the fact, it seemed to have happened almost overnight.

Today I have the answer. The urban fabric is fragile. For proof, I simply look at Detroit. It was the perfect city of my youth. It offered something for everyone. It was, in the words of today's city planners, one big example of placemaking.

An abandoned dental office in Detroit.

What makes Detroit stand out is the utter collapse of its economic underpinnings. Proud buildings were abandoned essentially over night, and with no money to demolish them they were left to slowly decay.

Along with the economic collapse, there was a vast upheaval in the social fabric of Detroit itself. As jobs left, the upper and middle class left. Poverty and the problems associated with poverty became the blight.

Detroit neighborhoods suffering from the blight rotted and died. And the blight was infectious; It spread into adjacent neighbourhoods. Hardly a neighbourhood was spared.

On the 25th anniversary of the Detroit riots, The London Free Press sent a reporter and me to Motown to discover what had changed with the passing of two and half decades. The reporter didn't have a feel for the Detroit of the past. He didn't share my sense of loss. It was an assignment for a poet and not a reporter. He missed the story.

I took this shot back in the mid '60s in Detroit.

Please take a look at the posted pictures from a new book, The Ruins of Detroit. Read about the authors in this The New York Times post. The accompanying NYT slide show is good but it duplicates some of the shots from the first link. Or read Ruin with a View, a NYT review of two books examining the collapse of a Detroit: The Ruins of Detroit and Detroit Disassembled.

Quoting the last paragraph of the NYT review:

"Ruins are a loaded subject, one that puts metaphor within easy reach. Marchand and Meffre show us a flag lying on the floor of a deserted church. The images here constitute a requiem for an American empire in a state of precipitous decline. Both books feature the same clock on a classroom wall, its frozen hands and melted face right out of a Dalí painting — as if time in Detroit had ticked to a halt, distorted, when in fact, with our gridlocked government and blind faith in our own exceptionalism, time is passing us by."

London train station build in1886-7 and demolished in 1937.

Truth be told, most of us don't have to look as far as Detroit to see the fragility of our civilized world. We only have to look at our own cities and towns. Try to recall what has been ripped from your city's fabric over the years. I warn you this can be tricky; We have very short collective memories.

Documenting my own city's disappearing heritage is far harder than documenting Detroit's. In some ways it is even harder than documenting the losses suffered by ancient Rome. In London, Ontario, we tear down and replace and then tear down again. The station pictured above stood at the south-east corner of Clarence and Bathurst Streets and was designed by F. H. Spier, a famous Detroit architect. It was demolished in the '30s.

Waiting room of '37 station

After the loss of this little jewel, CNR built a passenger station nearby in 1937. The new station had "broad landscaped station grounds extending from Clarence to Richmond streets. It has a semi-circular concrete driveway and walkway approach to the main entrance. It has shrub-topped terraces . . . "

This new jewel didn't last three decades. It was replaced by a couple of structures, one being the 10 storey CN Tower Building, which has now also been demolished.

Today London has a new station, and it has already undergone changes since its opening. Few remember the now gone food counter which graced the new station on its opening, even fewer recall the rich history of prior railroad stations. I doubt many passengers realize the underground route to the VIA trains is a last, lingering memory of the long gone '37 station.

On the bright side, the newest London station, although possibly influenced by fast food restaurant design, is a better train station than many found in Canadian cities.





One last note: This post sat queued, forgotten and unposted for many weeks. I have to thank a Montreal reader for jogging my memory. This reader sent me a link to the Quebec blog Ma Revue. Many of the photos of Detroit shown in that Ma Revue post are ones I had linked to earlier. Thank you D.N.

Deadlines in the 140 character world

While reading The New York Times op-ed columnist Maureen Dowd, I thought about the similar constraints affecting newspaper writers, Twitter posters and Internet bloggers. All face the constraints of time and space.

With the Internet there is a great push to get it, whatever it is, out there immediately. There is a rush to publish. Newspapers suffer from this same pressure. Newspapers have even given this rush to publish a name: The deadline. Putting out a paper is no different than putting out any other product from a highly automated plant. To deliver the product on time, in this case the newspaper, one must meet deadlines.

Dowd quotes Nicholas Carr, author of “The Shallows: What the Internet is Doing to Our Brains.” Carr claims technology amplifies everything, good instincts and base. While technology is amoral, he says, our brains may be rewired in disturbing ways.

“Researchers say that we need to be quiet and attentive if we want to tap into our deeper emotions,” he said. “If we’re constantly interrupted and distracted, we kind of short-circuit our empathy. If you dampen empathy and you encourage the immediate expression of whatever is in your mind, you get a lot of nastiness that wouldn’t have occurred before.” 

One would never describe newsrooms as quiet spots of gentle contemplation. The best newsrooms are high energy places, pressure-cookers for ideas. Dump ideas in, turn up the heat, and serve almost immediately. The results may not be perfect but the system is fast and what is served, the daily news, is amazingly "nutritious" for a "fast food."

Now add the constraint of space to the constraint of time and you have the ingredients for a serious problem. If you have every found yourself hamstrung by the 140 character limit imposed by Twitter, you have gained a small insight into the problem newspaper writers face daily.

On returning from a story a reporter may be told, "Quick. We're ten minutes from deadline. Give me seven inches. Maybe we can expand your story for City." (But reporters know that editors can only redo a limited number of pages for City. If the other pages are more important, the original seven inches will be it. So, reporters must do the best job they can in eight minutes. A few minutes must be left for editing and placing the copy on the page before being released to the back shop.)

I often hear folk talking about the 24-hour news cycle. Just last night I had a guest for dinner who works in the media industry and he blamed the 24-hour news cycle for a lot of the problems facing the industry today. Maybe, maybe not.

He also said how once something is up on the Internet is there forever. Maybe, maybe not. When I left The Free Press I started a blog that I soon took down and it is gone. Not even I can bring it back. It has vanished from the blogosphere.

Today newspapers should enjoy a 24-hour addition and correction cycle. Deadlines should be dead. Post just the minimum and then "Think." The Internet is always open to revision.

Unfortunately, many newspapers have not realized this fact and once they post something, even if it later proves to be balderdash, they feel they are stuck with it. They aren't. Newspapers can keep a record of changes made to a story, and I suggest this is a good idea. But truth and accuracy should have a path to the top.

As for the uncalled for nastiness that sometimes creeps into copy, enabled by too little time spent thinking and before speaking, maybe the years of meeting deadlines have rewired the brains of newsroom folk. Maybe its time for some new wiring, some new thinking, in the newsroom.

Dowd ended her piece:

"Leon Wieseltier, literary editor of The New Republic, recalled that when he started his online book review he forbade comments, wary of high-tech sociopaths.

" 'I’m not interested in having the sewer appear on my site,' he said. 'Why would I engage with people digitally whom I would never engage with actually? Why does the technology exonerate the kind of foul expression that you would not tolerate anywhere else?' "

When it comes to my newspaper, I am sometimes appalled by the nastiness I find there. Why would I engage with people over my breakfast table who voice the kind of foul, angry expression that I would not entertain anywhere else?

Who is Eric Duhaime, freelance editorial writer for The London Free Press?

Today's Free Press carries an editorial on the Comment page: "Right-wingers aren't the scary ones." It was written for the paper by freelancer Eric Duhaime.

I've been suspicious of right wing-left wing labeling since watching Mort Sahl on the family black and white television decades ago. I sat transfixed, sitting on our patterned faux carpet, it was actually linoleum, while watching Sahl explain and clarify the right-left political divide using his trademarked blackboard.

Saul would quickly scribble a name above a line representing the political continuum, placing the name to the left or right of centre as demanded by the person's stated political beliefs. As I recall, the simple exercise soon expanded past the boundaries of the original blackboard and two more boards were brought on stage to handle the overflow. (Maybe Glenn Beck could be hit for copyright infringement.)

In the end, the names written on the far left and far right of the original board appeared more central after the addition of the two extra blackboards, one to the right and one to the left of the original board.

To add to the chaos, as Sahl recalled more statements from well known politicians he would erase their names and reposition them. Sometimes Sahl found it impossible to simply place a person on one point on his line. For these folk Sahl wrote their names on the political continuum line in several places. On this issue they were right but on this one left and on this one they were really on the extreme right.

I decided to google Eric Duhaime.

I discovered that Eric Duhaime is not a Londoner. He's a Montreal-based writer. The Toronto Star says "Duhaime is currently a political consultant and columnist for Quebecor’s papers." I wondered why The Free Press didn't say so.

If you are interested in knowing more about Eric Duhaime, here is a link to the Toronto Star article:
Quebec's 'Tea Party" is born

I also found an attack on Duhaime, but it is way more personal than I like. Still, I found one line in the post on Sister Sage's Musings that made me think. I had read: "Eric, in your right winged world, folks are supposed to work for a living, but it helps if there are actual jobs; companies that are hiring."

This brought to mind the more than 250 workers at Le Journal de Montreal who are now well into their second year of a lockout at the hands of the media giant Quebecor that controls The London Free Press

I thought how the largest French language newspaper in North America has been published for the past two years in what many argue is in defiance of the Quebec labour laws in order to maintain a lockout. I understand many in Quebec see Quebecor's use of its QMI news organization as an end run around labour laws written decades ago, before the birth of the Internet.

Click on image to enlarge and view.

If this sounds like a big story, it's not. Or at least, it is not a big story in the eyes of The London Free Press. The Le Journal de Montreal story has gone almost totally unreported in my local paper. I can't help but wonder if this story is dead because of its negative Quebecor connection.

If interested, you can read a recent article in The Montreal Gazette: Péladeau would welcome Labour Code changes to trim union power.

Now, what was it that Duhaime was saying about right-wingers not being the scary ones?

Free Press not accepting any blame for fluoride controversy

One angle to the present fluoridation controversy missing in the recent Patrick Maloney and Ian Gillespie articles is the part played by what is now called the Main Street Media in this whole messy argument.

There are people who  fear fluoride because they get very mixed messages from the media about fluoridation's value and it's dangers. These concerned readers don't have to look farther than the pages of Sun Media and the QMI news group.

According to Canoe health expert and Sun Media columnist Dr. Gifford-Jones, the fluoridation of water is useless and fluoride toothpaste is a dangerous biological poison. This newspaper columnist said in a Quebecor Media distributed story that several studies involving as many as 480,000 children found fluoride provided no protection against tooth decay.

Gifford-Jones even went so far as to raise the spectre of childhood death in his column. He claimed a 3-year-old died after swallowing fluoride at a dental office.

Gifford-Jones argues many European countries do not fluoridate their water and yet have have rates for dental carries that are comparable to ours. He fails to mention that many large European countries fluoridate salt and milk.

Click on image to read.

I'm posting the whole article here as I sometimes find links to Free Press stuff broken. Please click on the image to enlarge. Once enlarged you may have to click on it once again to make legible.

Some of those opposed to fluoridation are extreme; No doubt. But many others are simply people old enough to remember lots of half researched stories in the media which were written in support of stuff that later proved to be bunkum.

If you believe in fluoridation, then you accept the arguments for putting fluoride in tap water. If you are concerned, often the answers do not seem so convincing — especially as the answers keep changing.

According to online information which I downloaded just today and published by the Ontario Dental Association, the maximum acceptable concentration of fluoride in the United States is 4 ppm and in Canada 1.5 ppm. This huge divergence of opinion as to what is safe causes concern in those opposed to fluoridation. (Many would argue that the ODA is wrong, and way on the high side, when they claim 4 ppm is acceptable in the U.S.)

Last month the EPA in the States, along with the Department of Health and Human Services (HHS), lowered the recommended maximum acceptable level for fluoride in tap water to .7 ppm.

The joint HHS/EPA announcement only fanned the flames of doubt in the fluoridation opposition by stating: "The new EPA assessments of fluoride were undertaken in response to findings of the National Academies of Science (NAS)" in order to avoid the unwanted health effects from too much fluoride.

Moves such as this make fluoride opponents worry that adding fluoride to our water may be a decades old practice but it is still not one that is totally understood. For them this is not good enough.