The Mediterranean diet is part of the answer

There is a misconception, often spread in the media, that dietary fats are no longer linked to cardiovascular disease. I have heard folks admit to great confusion when it comes to the question of diet as a result of all the conflicting stories boldly featured in the media.

One week it is reported doctors are claiming fat is bad for you and then the very next week, or so it seems, the reports flip, reporting dietary fat is of no consequence. The heart-disease-and-dietary-fat story flip flops in the media as often as a fish out of water.

According to one of my London, Ontario, doctors, J. David Spence, "Patients at risk of cardiovascular disease should limit their intake of cholesterol." Period. For Spence, this is not debatable. The well respected doctor and his co-researchers are certain that "Despite widespread belief to the contrary, it is simply not true that dietary cholesterol is harmless."

Instead of reading newspaper reports, I would suggest reading "Dietary cholesterol and egg yolks: Not for patients at risk of vascular disease." This report can be found in Pulse: The Canadian Journal of Cardiology and found posted online by the U.S. National Library of Medicine.

This report states, "A widespread misconception has been developing among the Canadian public and among physicians. It is increasingly believed that consumption of dietary cholesterol and egg yolks is harmless. There are good reasons for long-standing recommendations that dietary cholesterol should be limited to less than 200 mg/day; a single large egg yolk contains approximately 275 mg of cholesterol (more than a day’s worth of cholesterol)."

The report blames the confusing media stories on "the remarkable effectiveness of the sustained propaganda campaign of the egg producers' lobby. . . . In the past year, two studies funded by egg marketing agencies led to media reports promoting the benefits of eggs." Although Spence et al. agree egg white is a valuable source of high-quality protein, egg yolk, on the other hand, should not be eaten indiscriminately.

If eggs are bad, what about butter? I've had friends say that they once ate margarine for health reasons but have now switched back to butter. They honestly believe the fat in butter is superior to the fat used to produce soft margarine. Despite the media stories, this isn't the case.

One friend loves to say margarine is made from petroleum products, oil sands oil. It's plastic he says and he makes these false claims in front of his young granddaughter. This is a pointless urban legend according to Melissa Wdowik, a nutrition specialist at Colorado State University.

As a man battling arteriosclerosis, I shake my head. People are ignorant about the true position of most doctors when it comes to dietary fat. I lay the blame for this squarely on the media. Take this headline from the Daily Mail in Britain. "At last, the truth: Butter is GOOD for you - and margarine is chemical gunk" The story claims the public has been conned by profit-grabbing manufacturers ignoring decades of scientific evidence in order to peddle their tubs of margarine.

I'd list more links to media stories but I'll let you do the googling. You will be swamped. But approach this search by looking for university supported data rather than media stories. If you do this, you will learn that soft, non-hydrogenated margarine is best -- but like any fat that is being used as spread, it must be used sparingly.

Life is complicated and the media hates a complicated story. No one would dispute the fact that fat is essential in our diets. Medical researchers are concerned with both the total amount of fat in our diets and the type of fat. The recommendation is to avoid trans fats completely. This bans hard margarine from our diets

After eliminating trans fats, one should choose unsaturated fats over saturated ones. This cuts butter from our diets and severely restricts consumption of red meats. According to the American Heart Association, "In general, red meats (beef, pork and lamb) have more cholesterol and saturated (bad) fat than chicken and fish.

I like the attitude of Dr. J. David Spence. I first met Spence while covering a medical story for the local paper. I met Spence again recently when he sat down with my wife and me to discuss the plaque discovered in the arteries leading to my brain.

Dr. Spence laid out a battle plan for us to follow in fighting my increasing stroke risk. I don't want to give anyone the idea that the only weapon in our arsenal is a change in diet. Diet is but one arrow in a large and growing guiver. But, an improved diet, with the accompanying loss of excess weight will play an important role in the coming fight. I quote from Dr. Spence's book: How to Prevent Your Stroke.

"I encourage people to take a positive attitude, thinking of their meatless day every other day not as their punishment day but as their gourmet cooking-class day. You can learn to make chili, pasta, stir-fries, barbecued vegetables, and other dishes without meat, and to make them delicious not with butter and cheese, but with herbs, spices, onions, green peppers, lemon juice, balsamic vinegar, and so on."

The doctor swayed me. My wife and I are going to try the Mediterranean diet made famous by the cooks on the Isle of Crete. Before we head off for Chapters to find a Med-diet cookbook, I'm going to check out the foodie recipes posted by Elena Paravantes on her website "Olive Tomato." But my first foray into Mediterranean cooking will be one of recipes given to me and my wife by Dr. Spence. Stay tuned.

My first attempt at Mediterranean cooking, delicious on a bed of brown rice.

C'est la vie or caught between a rock and a hard place

A risky but bold work of art by Fiona, age 4. One cannot escape risk.

Wednesday my wife and I met with a doctor, an expert in stroke treatment. He is associated with both University Hospital and with the Robarts Research Institute. He laid out the detailed findings from the investigation into the health of my arteries down on the desk. He looked at us for a moment and then told me, "You are trapped between a rock and a hard place."

The tests revealed the arteries in my neck are laden with plaque. My arteries hold three times the amount of plaque as that found in healthy men of my age. This plaque can flake and the small bits can be carried in the blood to the brain. This explains the TIAs, transient ischemic attacks, I have been having. TIAs, also known as "mini-strokes", are taken very seriously by doctors as they can be harbingers of a massive stroke in one's future.

I already take some pretty powerful medications. If all had gone well with these recent tests, I might have had some of my meds cutback. Strong meds often carry risks. Instead, I was given another cholesterol fighting drug which will also boost the benefits gained from the statin I am already taking. These drugs can mess with some important chemicals in the body. To counter this I must add 200mg of another drug taken twice a day. Unfortunately, this drug can increase the bleeding potential resulting from taking the anticoagulant Pradaxa. I take Pradaxa.

My history of heart arrhythmia demands I take an anticoagulant. Arrhythmias increase the risk of blood clots forming in the heart. These can then travel to the brain. An anticoagulant cuts this risk. Unfortunately, because micro bleeding was discovered in my brain, I cannot take the common and inexpensive anticoagulant Coumadin. It would increase my risk of having an uncontrolled cranial bleed.

There is an alternative, the anticoagulant Pradaxa. It will lessen my chance of stroke without increasing my risk of bleeding in the brain. The downside is that Pradaxa is expensive, very expensive, and if I should have a serious bleeding problem, for any reason, the blood thinning achieved by Pradaxa cannot be as quickly reversed as it can with Coumadin.

Yes, I am trapped between a rock and a hard place. But, I am not alone. I am trapped there with my doctors. They have no perfect answers to my health problems. Try this and that may go wrong. Try that and this may go wrong. And either answer is accompanied by the risk of some truly awful side effects, of unwanted consequences.

Our blood clots for good reason. There is no mystery as to why anticoagulants carry risks. All my drugs mess with important functions in my body and messing with those functions is risky. Period. Being a doctor is all about balancing risk. Doctors do a damn amazing job at balancing those risks. I am in awe of the talents, the skills, the knowledge and the bold risk-taking of my doctors.

It was more than a decade ago that I had the mitral valve in my heart repaired robotically. I was the first person in Canada to have such an operation. It was risky but it was clearly worth the risk. My ICD/pacemaker was a risk, some doctors questioned whether I actually needed one. Today my heart is being paced 93 percent of the time. I have had my heart rebooted by my built-in defibrillator at least three times. My doctors and I have taken a lot of risks over the years and so far they have made the right calls.

As of today, I am taking a mixture of ten tables and capsules a day. I chew 'em; I wash 'em down with water; I take 'em with food; I take 'em on an empty stomach. I never did a lot of drugs as a young man growing up in the '60s, but as a senior my world is veering toward Jefferson Airplane country and the land of the white rabbit.

One pill makes you larger,
And one pill makes you small,
And the ones that mother gives you,
Don’t do anything at all (maybe but doubtful).

If I should have a stroke, I know my doctors will wonder what could they have done differently. If I am lucid after the event, I will tell them there is nothing they could have done differently. Nothing. They balanced the risks and we lost.

C'est la vie.

It's a wonderful life!

I'm pushing 67. I'm retired. My heart is failing — slowly. This is not the life I expected to be living in my senior years.

I planned on traveling in my retirement. I still long to visit Romania and Bulgaria. Yes, Romania and Bulgaria. Why? It's a long story and not too relevant today as my chances of actually visiting those countries is fading with each passing day. Getting insurance may be impossible and no insurance means no trip.

Still, I'm happy — exceedingly happy. I have found a sweet spot in life of which I had not an inkling when I was young. One's senior years are, to steal the words of Rod Serling, "A dimension not only of sight and sound, but of mind." With a positive outlook, a willingness to take delight in the moment, life is grand.

I have three grandchildren. It doesn't get any better than that — unless you have four.

I've read that we tend to dwell more on unpleasant events in our lives and to use stronger words to describe them than happy ones. Not me. Don't get me wrong. I love a good personal disaster story as much as anyone. Ask me about sailing. I can tell as good a terror-filled sailing tale as the next sailor but press me and I'll slip into wonderful memories from my days of solo sailing. I loved to sit at the front of my boat, legs straddling the sharply pointed bow and dangling so low that my feet got wet from the surge forward as the boat slashed through the waves of Lake Huron. I'd sit leaning forward with arms resting on the stainless steel bow pulpit.

I loved solo sailing. I'd put my one-degree robot at the helm, a black English autopilot, I'd grab a beer and relax. Drinking on a large sailboat was not illegal back then. Trust me, there is nothing like a cold one enjoyed all alone on a sailboat thrust by the wind into a darkening night. (And yes, I did wear a harness. Fall off a boat with Auto at the helm and the boat will simply sail away.)

I also recall my English roadster — a Morgan — another wonderful memory maker. My Morgan didn't just take me places, it took me to new places. Unheard of places. Places in need of discovery. And it didn't just take me there but it also reveled in revealing the people living in those hidden places. My Morgan spent its first years of our life together traveling the American South: Kentucky, Tennessee, Georgia, Alabama, Mississippi were among its favourite destinations.

I vividly recall one of my best Morgan adventures: Corinth, Mississippi. Need I say more? Back then the bars in the Deep South were among the greatest dive bars in the world. Cheap beer, even cheaper burgers, great music — the musicians were often back up players from Nashville earning a little extra cash — and did I say buckets of cheap beer?

I wore my hair long back then and when I entered the bar in Corinth I had just about the longest hair in the place. If it had been possible for the place to go quiet, my entrance would have done it. But it wasn't possible and it didn't. The rock and roll alternated with country and western and both pounded not just one's ear drums but one's whole body. Good time rock and roll pounded down the local's resistance to the long haired foreigner trespassing on their turf. I spent the night drinking and dancing and measuring my hair length against all comers. I bested a lot of women whose tightly bouffanted locks were teased high and tight on top of their heads. There wasn't a man who could compete with me, nor would have wanted to. When the bar closed the party didn't stop; It moved.

Away from the prying eyes at the bar, the women let their hair down, so to speak, and the who-has-the-longest hair contest began anew.

According to the New York Times, Roy F. Baumeister, a professor of social psychology at Florida State University, wrote a paper Bad Is Stronger Than Good after conducting research showing this is a basic and wide-ranging principle. Bad emotional experiences supposedly have more impact than good ones. They are quicker to form and harder to forget than good experiences. It is simply human nature, he claimed.

Not for me. I have to admit that I spent a lifetime rehashing bad times but no more. Time is short and getting shorter. I have discovered that not only do I no longer dwell on the bad stuff, I can hardly remember the worst stuff. It is all fading as well it should. Remembering the past so that history does not repeat itself has its place when one is younger, I guess, but now, in my senior years, there is little danger of repeating those painful missteps.

People make up the biggest chunk of my good memories. My friends from my childhood, my chums from my youth, my school buds. I have good memories of employers and neighbours and even passing acquaintances. As Maude positively tells Harold when talking about people: "They're my species."

I've know a lot of wonderful people. Some are famous and can easily be found by searching the Net — like the super-achieving Denny Wilcher who gained fame as a conscientious objector during the Second World War. I met Wilcher when he and his wife Ida were  living in Berkeley, California, along with their two youngest daughters. Another somewhat well known person from my past was photographer Andy Whipple who recently passed away. He had just completed a fine art book documenting the Columbia River. Another remarkable person I am proud to know is the Canadian author Joan Barfoot, author of numerous best-selling novels. (I first met Joan Barfoot when she was still an editor for The London Free Press.)

And then there are the wonderful people I have had the luck of knowing but who seem to have passed under the Internet radar. Think of John Hoffman, one of the founders of Big V pharmacies in Ontario. Today both Mr. Hoffman and Big V are gone. There is little to be found about Mr. Hoffman despite the role he played in creating one of the biggest, most successful drugstore chains in Ontario history.

For years, I ran a seminar for photojournalists. In my role as chair of the seminar I met people like Pulitzer Prize-winning photojournalist, Eddie Adams, who, in his role as a combat photographer in Vietnam, produced many powerful images of the war. The first evening of the annual seminar I sponsored a speakers' dinner. Sitting next to, and across from, some of the greatest news shooters in the world was an honour and a delight.

I believe my senior years are a time for both enjoying the present and savouring the past. At this late stage in my life, dwelling on the bad is of no value. It is time, as my granddaughter says, to "just let it go." In keeping with this suggestion, I'm going to go open a beer and think good if somewhat alcohol-blurred thoughts.

Cheers!

It's art!

About a month ago Mike Moffatt, an assistant professor at Ivey business school at Western University, in London, Ontario, discovered an apparently coded note tucked into a book in the university library. Curious as to the meaning, Moffatt offered a hundred dollars to anyone who could solve the riddle.

Today the riddle has been solved. The note found by Moffatt is art. Jordan Himelfarb, a member of the Toronto Star editorial board, followed the clues. They led him to the Western University fine art department and Kelly Jazvac.

Himelfarb traveled from Toronto to London to meet Jazvac at a London coffee shop:

She explained that the Weldon code was an art project that came out of a second-year sculpture and installation class she taught in 2012. The artist, then an undergraduate student, placed 121 letters in the Weldon stacks and moved on with her or his (but probably her) life. Jazvac told me the artist was shocked by the project’s recent fame and wished to remain anonymous lest she be treated unkindly in the media.

The reporter discovered the symbols correspond to capital and lower case letters but the order is random, making the code impossible to crack. For the full story read Himelfarb's interesting story in The Star: I cracked the code at the Western University library.

I'm not surprised at the outcome. Using the Internet and social media I contacted visual artists, writers and poets around the globe. Most of those contacted replied to my inquiry. The majority felt the apparently coded works were art. Some suggested that I google "asemic writing." The local paper, The London Free Press, was onto this art lead but failed to pursue this thread to its logical end.

A Free Press story reported Peter Schwenger of Western had contacted the paper. "I’m pretty sure that these are examples of asemic writing ­— that is, art that looks like writing but is not intended to communicate a meaning, only to represent the feel of writing," he told the paper in an e-mail.

A number of the artists I contacted said the works found in the Western library reminded them of the lettrist movement from the '50s. To my surprise, one artist attacked the concept of asemic writing. The works were lettrist as there is no such thing as asemic writing. "It's a philosophic misnomer," I was told.

As a retired newspaper photographer, an old geezer whose free time is being consumed by trips to the hospital as doctors investigate a genetic-based heart condition, I decided that a trip to the fine art department at Western was the next logical step but I simply didn't have the time. The Toronto Star writer did and I doff my hat to his stick-to-intuitiveness.

The big riddle left unanswered is why did it take a Toronto reporter to track down the answer at Western? The Toronto Star broke the story Saturday. The London Free Press reported the riddle was solved Sunday.

There are a number of online newspapers that essentially ripoff the mainstream media for stories, rewrite them and publish them online as their own. I find this practice disgusting but it is not unique to these online journalistic vultures. The MSM has done this for years, ripping off competing media outlets. It appears that Sunday the online version of The Free Press ripped off the Saturday Star and without so much as a credit in passing.

And here is one last riddle: Why are newspapers failing in this electronic age? Hint: There are clues in the media handling of the strange notes found in the Western library.

OER & Language Learning: Internet Specific Tools

I've mentioned this before but today I got an e-mail that brought the idea of open educational resources back into my mind. If such an online approach was well done, I can envision certain students completing a course online without ever attending a class. Later they could take an exam to prove their competency, earn a credit towards a degree and move on.

I knew a girl who entered high school fluent in at least four languages. Forcing her to take years of high school French was insane. She should have been offered the chance to write all the appropriate exams and put the entire French curriculum behind her. Heck, she spoke French better than some of her teachers. They asked her questions because she not only knew Parisienne French, she new Quebecois. She had lived in France and now that she lived in Canada she was spending her summers in Montreal.

A few years ago, I took a French language course from Western University in London. It was not a good experience. There were too many students and not enough instruction. It was an unfocused course that ran for a number of weeks and then just ended. There was no homework during the course and no exam at the end. The university took my money but gave me little in return. It was a no credit class and with good reason.

That course left me thinking: There must a better way to teach French to English-speaking Canadians. My curiosity led me to The Center for Open Educational Resources & Language Learning (COERLL) at The University of Texas. COERLL is one of 15 National Foreign Language Resource Centers funded by the US Department of Education.

COERLL creates educational materials designed for dissemination over the Internet. Called open educational resources (OERs), the online language tools (courses, reference grammars, assessment tools, etc.) are of great interest to me.

The material is free for anyone to use but may require permission to re-mix, improve, and redistribute. COERLL aims to promote a culture of collaboration. In addition, COERLL stated aims are to reframe foreign language education in terms of bilingualism and/or multilingualism.

I wish the university in London would host something similar. If offered in conjunction with a course such as the one that I took, possibly more could be accomplished. And, at the end of the course there could be an exam. Pass the exam and earn a credit from the university.

If you'd like to see what I am talking about, click the Le Vin de Vouvray link. This will take you to one of the COERLL French exercises posted by the University of Texas. I took the liberty of creating a vocabulary quiz in Quizlet using the vocabulary supplied with the Le Vin de Vouvray post.

I'm going to share a link to this post with one of the teachers at the French public school my granddaughter  attends. I'm seeking feedback on this open educational resource concept. I'm trying to decide whether I should proceed further in my attempt at interesting educators in London to offer something similar.

Are anticoagulants underused in Ontario?

In writing the following post, I came upon the paper How Can We Avoid a Stroke Crisis in Europe? If you do nothing more, read this paper. You found my blog because you were searching for information on anticoagulants, heart rhythm problems and risk of stroke. Read the linked paper. You may find it answers many of your questions.

When done, if you want to know more, read the rest of my post. There are also more links of interest.

Cheers,
Rockinon -- a patient with ongoing heart problems
___________________________________________________________________________

Are anticoagulants underused in Ontario? This is the question I asked myself upon learning that a friend in constant heart flutter was not taking an anticoagulant to lessen his chances of suffering a debilitating stroke.

I found an article in The American Journal of Medicine looking at this very question. I learned there are clear guidelines for managing atrial fibrillation and atrial flutter with recommendations for anticoagulation based on a patient's overall stroke risk. I also learned that the guidelines are not always being followed.

In a study of more than 170,000 patients in the States, less than 50% of high-risk patients were given anticoagulant therapy. The study concluded that the anticoagulation guidelines are not being routinely followed in clinical practice. The study did not conclude this was resulting in harm to untreated patients but decided another study, one looking at treatment outcomes, was warranted.

I can understand doctors being hesitant to immediately give anticoagulants to all patients with high CHADS₂ scores. Although I am now taking an anticoagulant daily, it was a tough call for my doctors.

I have microbleeding in the brain, discovered during an MRI scan. For a very good discussion of the significance of cerebral microbleeds read the article Cerebral microbleeds: a new dilemma in stroke medicine posted in the Journal of the Royal Society of Medicine. In my case, as in all cases, doctors must weight the risks vs. the benefits of various treatments. All too often the answer is a trade-off.

Clearly, a slightly elevated CHADS₂ score is not always enough to convince doctors anticoagulants are the best response. They see the risk/benefit ratio as not favouring the immediate use of a blood thinner (an inaccurate name for anticoagulants.) I don't envy doctors. They find themselves forced to choose between a rock and a hard place every day.

So, should more Ontario patients be on anticoagulants to protect them against stroke? It is hard to say for certain but the answer may well be yes. The Canadian doctors, like their American counterparts, may be too conservative, too timid. In steering their patients down a path that avoids the complications resulting from the use of blood thinners, their patients may be on the road to a stroke.

If you have a heart arrhythmia and are not on a blood thinner, you should ask your doctor why not. There may be good reasons for not giving you anticoagulant therapy but you should know what they are. To get a handle on your risk of a stroke, here is a link to a CHA₂DS₂-VASc Score calculator.

To better understand your risk of bleeding, here is a link to a HAS-BLED calculator. Taken together these two calculators point to the difficult decisions forced upon your doctor.

Lastly, not all abnormal heart rhythms are created equal. All arrhythmias do not result in equal risk of stroke. And atrial flutter, when occurring alone, does not carry the same increased risk of stroke as atrial fibrillation. That said, atrial flutter is often accompanied by periods of atrial fibrillation.

So, should my friend be taking an anticoagulant to lessen his risk of stroke? Maybe. He was on a blood thinner but stopped taking his medication on his own. Possibly his doctor senses his patient's fears and this tips the scales against recommending anticoagulants in the doctor's mind.

But atrial flutter is not benign. It is associated with an increase in overall mortality. According to a  posting on Patient.co.uk, persistent atrial flutter when left untreated can become chronic atrial fibrillation (AF). Even after treatment, I had my atrial flutter eradicated by undergoing an ablation procedure, I continue to take the powerful arrhythmia fighting drug sotalol to help insure my flutter does not return. I also continue to take Pradaxa, a blood thinner, twice a day.

Lastly, I wonder if the perceived dramatic increase in cost of anticoagulant therapy in recent years has influenced doctors, especially in the States. The old drug of choice, coumadin, is relatively inexpensive and safe. Unfortunately, it is also a fair amount of trouble. Regular blood work is necessary to insure the dosage is effective. The bothersome constant need for monitoring is one reason many patients quietly stop taking coumadin without consulting their doctors.

Newer drugs, like Pradaxa (dabigatran), cost more but do not require the expensive regular blood work. Some studies, such as one in Denmark, have found treatment with dabigatran only costs about 10% more than coumadin, with the increased cost of the medication the main driver of the added Pradaxa expense. I take Pradaxa to protect me against stroke while minimizing my chances of suffering a cranial bleed.

Minimizing the occurrence of strokes is a win-win situation. Both patients and society benefit from anticoagulant therapy in high-risk AF populations. A French study found the mean cost of a severe stroke was €34,809, and the risk of a severe stroke is what accompanies AF. The mean cost of a mild stroke in the study was €10,530. Clearly, dabigatran saves society money by preventing severe strokes in AF patients.

So, why do doctors shy away from prescribing blood thinners when the cost is not exorbitant and the benefits appear to be clear? One study pointed to a misplaced fear of bleeding, especially cranial bleeding. The fear of bleeding seems to trump the fear of stroke among medical professionals.

And so, in seeking treatment for heart rhythm problems there is one risk that is often overlooked: The risk that one's doctor has a personal aversion, an unsubstantiated fear, of the side-effects of the what should be one of the drugs of choice -- an anticoagulant.

NASA claims no ties to research paper

National Post: Tuesday, March 18, 2014

It was quite the story: A NASA-funded study predicted the end of the civilized world as we know it. The controversial report calculated that our global civilization is headed for annihilation. The sky may not be falling now but come back in a few decades and bring a hard hat.

The Independent: Sun., Mar. 3, 2014

The story, published by The Independent and The Guardian in Britain, was picked up by The Huffington Post and immediately went viral. The story was repeated by media outlets around the world. Even NASA entered the fray with a comment. This was not unexpected as scores of media outlets around the globe reported on the NASA-funded and oh-so-damning report.

Did the NASA statement contain any surprises? In a word, yes. For one thing, NASA called the media reports "erroneous." The soon-to-be released study "was not solicited, directed or reviewed by NASA. It is an independent study . . . ," NASA claimed.

NASA was in damage-control mode, distancing itself from the story. A Google search found a link to the scholarly paper. The authors write, "This work was partially funded through NASA/GSFC grant NNX12AD03A."

The National Socio-Environmental Synthesis Center (SESYNC), one of the sponsors of the paper, reports:

" [Safa] Motesharrei [one of the authors of the paper] received minor support from NASA to develop a coupled earth system model. Some of this funding was spent on the mathematical development of the HANDY model."

The paper is not only connected to NASA by some minor funding, one of the report's authors, Eugenia Kalnay, was branch head at NASA Goddard Space Flight Center prior to heading off to the University of Maryland.

The media reports may have overstated the NASA connection but the NASA press release underplays the connection the space agency has to this University of Maryland paper. The respected-research-patina conveyed by an association with NASA is certainly there. The reason for NASA's backpedaling is clear.

The study in question found that the ongoing economic stratification of society -- think of the one percenters and the rich-get-richer world endorsed by right wing capitalist Kevin O'Leary on CBC -- makes the collapse of civilization almost unavoidable. Major policy changes to reduce inequality are desperately needed, according to the authors.

I find one of the most interesting features about this story is not how far and fast it spread but the limits to growth it encountered. Even the Club of Rome might find this interesting. I could find no evidence that Sun Media, Canada's right wing newspaper chain, featured the story at all.

Does U.S. educated reporter hate Canadian health care system?

The headline screams "Crohn's research at Robarts hits world stage." Is the headline true? Yes. Is it the whole story? Not by a long shot.

Dr. Brian Feagan is the director of Robarts Clinical Trials at the Robarts Research Institute in London, Ontario. Last year Feagan was among those awarded the 2013 Scientific Achievement Award by the Crohn’s & Colitis Foundation of America (CCFA). Feagan has long been known for, as they say, pushing the needle forward in the quest for cures to these diseases.

The man is amazing. A quick Google search shows he has been at the forefront of inflammatory bowel disease research since late in the last century at least. His latest work is, not surprisingly, a continuation and a validation of research which has attracted global interest for years. He is a longtime player on the world health care stage.

Londoners should be proud of medical scientists like Feagan and proud of the work being done at the Robarts Research Institute. Researchers like Feagan and their studies are among the reasons I have the institute on my short list for an annual charitable donation. Because of the work done there, I am increasing my donation this year.

If you have been reading the series of articles run by The London Free Press and carried by Sun Media across the chain, you would think that Canadians are receiving second rate health care when compared to what is available south of the border in the States. The story tells readers "many provinces won't pay" for an aggressive approach for treating Crohn's disease.

A quick Google search turned up this online post by a woman in Salt Lake City, Utah:

In November, my new gastroenterologist . . . started me on Humira. It's a biological medication to decrease inflammation that has been successful to treat some people's Crohn's disease. . . .

The insurance denied the claim when the the pharmacy tried to get payment, because after a couple of refills at a local pharmacy, it's only covered when it comes from a "specialty pharmacy," called Acredo. After three hours either talking with people at Acredo, the specialty pharmacy, or having my doctor's office or the University pharmacy techs talk with people at Acredo and the insurance company, I left without the medication.

The patient ended her tirade saying, "Sigh. I wish private enterprise wouldn't get between patients and treatment"

Yes, some provinces resist paying for aggressive and expensive treatments for Crohn's disease as the first line approach -- but so do many private insurance plans around the globe. These are often plans that the patients thought were excellent until they were denied coverage for a drug like Humira.

I will leave the last word to Beth, the lady with Crohn's disease that I quoted out of Salt Lake City.

"I shouldn't be surprised [at the denial of coverage], since Anthem Blue Cross is beholden to stockholders before patients. Private business, in my opinion, is NOT always the best way to get things done, especially when it comes to health issues."

The Free Press article wasn't wrong. It wasn't error filled. But it wasn't balanced either.

Where are the editors?

The Globe and Mail needs to hire some editors. They are running way too thin. A recent story was trying to be hip and cool by making reference to "Llewyn Davis, the vagrant folk singer imagined by the Cohen brothers, who opened a show for Elvis Presley."

The problem is that the movie making brothers are the Coens. No 'h'. And the movie, Inside Llewyn Davis, shows Davis appearing on stage immediately before Bob Dylan. Not Elvis Presley.

It just makes one want to scream: "Aaauuugghh!"

When the James Bond film franchise hit the 50-year mark, Heather Hiscox on CBC went on and on about her favourite Bond film, Goldfinger, in which Bond stops Auric Goldfinger from stealing gold stored in Fort Knox. She goes on and on about the amazing planned theft. Trouble is Goldfinger never planned to steal the gold. Too bulky. Too heavy. He was going to explode a dirty bomb in Fort Knox. This would contaminate the gold and leave it worthless.

When newspapers and high-paid news anchors cannot get facts right, facts so easily checked, how are we to be certain  they are getting their facts right about a situation like the one unfolding in Ukraine.

That's Ukraine and not the Ukraine. When I worked at The London Free Press an editor put me straight.

What the world can learn from India concerning health care

Today I read an interesting article in the Harvard Business Review on what is being done right in India when it comes to keeping health care costs in check. It makes an interesting counterpoint to the stories being run by the local paper. The London Free Press seems to have hate on for the Canadian single-payer health care system. The writers at the paper deliver criticism in spades, not that our system doesn't at times deserve it, but the paper fails to offer many detailed solutions.

If you are interested in the rising cost of health care,  read: India's Secret to Low-Cost Health Care. The article makes a number of interesting claims, but two that really stood out are:

1. The health care available in Indian hospitals is cheaper even when you adjust for wages: For example, even if Indian heart hospitals paid their doctors and staff U.S.-level salaries, their costs for open-heart surgery would still be one-fifth of those in the U.S.
2. When it comes to innovations in health care delivery, these Indian hospitals have surpassed the efforts of other top institutions around the world.

Plus ça change, plus c'est la même chose.

The idea that "the more things change, the more they stay the same" is a common one around the world. No doubt because it's true.

The late Horace Judson was a famous and well respected journalist. His most famous book was Eighth Day of Creation, a history of molecular biology. Published way back in 1996, I believe this book is still in print. Of course, the fact that his daughter Olivia Judson is the well known evolutionary biologist and popular writer also keeps his name current.

While reading a review of Horace Judson's book on heroin addiction, published in 1974, I was struck by how little the world has moved forward in the intervening forty years.

The reviewer, Gerald McLaughlin, Associate Professor of Law at Fordham University School of Law, wrote:

Apart from government moneys being spent on drug law enforcement, apart from the countless government research grants given academics every year, entire industries have begun to grow up around the drug cure business - methadone clinics staffed by private physicians have become booming business, drug analysis and urinalysis centers have sprung up to serve their needs, and private drug research firms have been created. Like the fabled "military-industrial" complex of the Eisenhower years, a "drug abuse-industrial complex" has been created. Once created, it is hard to dismantle. To put it another way, with so much money at stake, there is an incentive not to let the problem die or at least there is an incentive to push for one's own special treatment modality. The law enforcers want to keep their funds, so they push for new law enforcement programs to end the heroin traffic; the methadone maintenance advocates push for more money for more centres; sociologists and psychologists request further grants to test this or that theory of addiction. Quite often some of these diverse elements or the "drug abuse-industrial complex" lobby against new alternatives simply to prevent money from being siphoned off to fund new programs or approaches. Fiscal preservation is an age-old vice of man.

Of course, some things do change. I must add that in the years following the publication of Judson's book, Heroin Addiction in Britain - What Americans can learn from the English experience, the British government turned more and more towards the American model. The Brits even appointed a drug czar in 1998. 

The changes failed.

Kalydeco: What is the whole story?

The other night I caught a little foreign film in which the woman protagonist was one difficult lady to love. She had a young niece who was also damn difficult. Thrown into the mix was a boyfriend who had his own little, and so little, quirks. The movie ended on an upbeat note but with such a convoluted story it was difficult to know how all would play out in the end.

Sun Media is using the story to attack Ontario Liberals.

Now take the news. Everyday we read, hear and watch stories reported in the media. They are usually good tales with strong, neat story lines. Maybe too neat. I often have the feeling there is more to these stories than we are being told. Life is depicted by the media more as bad fiction than rich reality.

Take the story of the young Ontario girl taking the very expensive Kalydeco (ivacaftor) to treat a rare form of cystic fibrosis (CF). Sun Media reports it costs $348,000 annually in Canada for this unique drug. This is completely out of the financial reach of most people. At this point, the Ontario government is refusing to assist this young girl and her family as they struggle to cope with this massive expense.

The government has stated that it would like to help and to this end it and a number of other Canadian provinces are in negotiations with Vertex, the maker of the drug. At this point, the company and the provincial drug consortium in Ontario are at loggerheads over the price of the drug which is perceived by many to be outrageously expensive.

The kicker in this is that the genetic variation of CF the drug treats is rare. It is so rare that only about 20 people in the province would be helped by taking Kalydeco. The entire cost to the province would be less than $8 million.

Read the story at news.com.au.

What has the mainstream media left unsaid? Well to start, it is not just bureaucrats in Ontario balking when confronting the high cost of the Vertex drug. Health care bureaucrats around the world have choked when confronting the high cost.

A story similar to the one being played out in Ontario made headlines across Australia. Ellie Haikalis has the type of cystic fibrosis controlled by Kalydeco. Unfortunately, her family cannot afford the treatment and the Australian government refused to assist them.

Her mother, Rachelle, told the media  she and her husband had discussed selling their home but realized that even taking that drastic action would not raise the money demanded by the drug maker.

Almost thirty concerned American doctors banned together to pen a letter to Vertex. They wrote:

It is at best unseemly for Vertex to charge our patient's insurance plans (including strapped state medical assistance plans), $294,000 annually for two pills a day . . . This action could appear to be leveraging pain and suffering into huge financial gain for speculators, some of whom were your top executives who reportedly made millions of dollars in a single day (Boston Globe, May 29).

The dispute over the cost of Kalydeco is just one skirmish in a larger, ongoing war being fought in numerous countries scattered across the globe. But the Kalydeco story on its own is a good one. Many see the price charged for this drug as "unconscionable."

Read the fine Milwaukee-Wisconsin Journal Sentinel story.

A story in Medpage Today, Cystic Fibrosis: Charity and Industry Partner for Profit, points out Vertex developed ivacaftor (Kalydeco) "with the help of a $75 million investment from the Cystic Fibrosis Foundation -- as well as a hefty investment from taxpayers through grants from the National Institute of Health which underwrote the cost of early research."

It isn't just Yanks who have some skin in this game. There are Canadians at the table too, such as Lap-Chee Tsui and John R. Riordan of the Hospital for Sick Children in Toronto. The two research scientists, along with Francis Collins of the University of Michigan, led a team isolating the gene responsible for cystic fibrosis. Medical breakthroughs do not occur in a research vacuum.

On the upside, the drug cost isn't out of sight for everyone. Ian Smith, Vertex executive vice president and chief financial officer, exercised stock options to gross more than $60 million in one day, according to the Milwaukee-Wisconsin Journal Sentinel.

If Smith had the type of CF in question, he could live to be a hundred and never experience any difficulty in paying for his supply of Kalydeco thanks to his after tax profits from just that one day.

Of course, Smith does not have CF. The millionaire has no reason to worry. He can breath easy.

Comparing apples to oranges

Jonathan Sher, a Sun Media investigative reporter working for the chain's London, Ontario, newspaper has filed another story in a series examining health care in Ontario: Health ministry data on hospital overcrowding riddled with errors. From the tone of Sher's past articles and the frequent positive references he has made to the American health care system, one might surmise Sher is no fan of Canadian single-payer health care.

Sher, who may have been born an American citizen, is one bright fellow. After graduating from the University of Virginia with a B.A in history and foreign affairs he went on to earn his Doctor of Law from the University of Southern California in 1992. It has been reported he is a member of the New York State bar association. With his strong background in law, Sher knows how to build a strong argument.

I believe it is safe to say that when Sher slides an apples and oranges comparison into a story he does so knowing full well what he is doing.

Sher tells Sun Media readers:

Ontario has 2.4 hospital beds for every 1,000 residents, less than half the European average. Of 39 countries compared by the Organization for Economic Co-operation and Development, only three had fewer hospital beds: Mexico, India and Indonesia. 

This is not the first time that Sher has compared a Canadian province with the entire continent of Europe. He goes on to compare Ontario with 39 countries in an Organization for Economic Co-operation and Development list. I addressed this debating trick in an earlier post: Hospitals too full to be safe? Not in London, Ontario.

As I wrote in the earlier post:

Let's try comparing apples to apples: countries to countries. According to the most recent numbers released by The World Bank, Canada has 3.2 beds per 1000 people. Both The United States and Britain have a smidgen less at 3.0 beds per 1000. Sweden fared even worse with only 2.7 beds.

According to the newspaper article, Ontario has only 2.4 hospital beds per 1000. It sounds bad and it is bad but Ontario cannot lay claim to the worst numbers on the continent. For lower numbers look south. Ontario has more beds than almost 40% of the American states according to The Henry J. Kaiser Family Foundation. Oregon only has 1.8 beds per 1000 and California, Hawaii and Vermont have numbers that are little better.

Kudos to Sher for discovering that the overcrowding data compiled by the province had serious errors. Good work. (Here is a second link to the story.)

Overcrowding of hospitals is a serious global problem and not unique to Ontario. Many industrialized countries do attempt to keep occupancy rates at or below 85 percent, just as Sher claims. And many, many hospitals throughout the industrialized world fail at the attempt.

Cuts hammering journalists

The headline warns "Cuts hammering elderly." Oddly, the online picture accompanying the story shows a happy senior being patiently spoon-fed by a caring health care worker.

The image is jarringly inappropriate and, no surprise, it is phony. It is a staged, stock photo image — stock photos are cheap but they are not journalism. I'd say cuts are hammering journalists, too.

Recently I briefly traded tweets with a local reporter who was offended when I called the balance in one of his stories "faux."

I not only stand by my previous comments but I'd like to expand upon them. The media in general, it is not just the local paper, all too often seem to believe that a story is not complete until it is balanced. They believe this until the cost of balance, either in time or money, is deemed too high.

Which brings us to today's article. My guess is the journalist was instructed to write a story on the report "Pushed Out of Hospital, Abandoned at Home" released by the Ontario Association of Speech-language Pathologists and Audiologists (OSLA) and the Ontario Council of Hospital Unions (OCHU).

Before continuing, I want to make one thing clear: I am not claiming the report is error-filled. I am simply saying that a story as inflammatory as this one demands context, demands balance. How does what is happening in Ontario compare to what is taking place outside the province? Are these local problems or are they endemic in the health care approach embraced in a multitude of places?

For instance, the report by the unionized hospital workers and some therapists tells us "one in six patients has an unplanned readmission within 30 days." My response is to ask, "How does this compare to the readmission rate for seniors in other localities?"

A little searching discovers a report, The Revolving Door, on readmissions in the United States. This American report tells us:

The U.S. health care system suffers from a chronic malady — the revolving door syndrome at its hospitals. It is so bad that the federal government says one in five elderly patients is back in the hospital within 30 days of leaving.

Where this all gets interesting is newspaper report places the blame on underfunding. The answer from the union et al. is simple: Throw money at the problem. But the U.S. report puts the blame on its badly fragmented health care system. According to the American report, if patients get the right care the first time many return trips are prevented. Done properly, this costs less money, much less money, not more.

According to The Revolving Door report out of the U.S.:

The [U.S.] federal government has pegged the cost of readmissions for Medicare patients alone at $26 billion annually, and says more than $17 billion of it pays for return trips that need not happen if patients get the right care. This is one reason the Centers for Medicare & Medicaid Services has identified avoidable readmissions as one of the leading problems facing the U.S. health care system and now penalizes hospitals with high rates of readmissions for their heart failure, heart attack, and pneumonia patients.

As a senior, in what I hope is just the early stages of congestive heart failure, I read the news report with great personal interest but I was left with more questions than answers. I know the reporter who wrote The Free Press piece and I am sure that that reporter was also left with lots of unanswered questions. Sadly, neither the reporter's questions nor mine will be answered. I blame cutbacks, newsroom cutbacks.

Take the congestive heart failure example. I keep returning to CHF because the news story told of a patient with CHF who was sent home after being taken to ER. As there isn't enough information in the newspaper concerning this incident, I read the report itself.

It seems the gentleman in question was 89 at the time he was admitted to the ER suffering from pulmonary edema. The doctor in ER immediately gave the gentleman Ventolin. This is widely accepted as a good first response. The ER doctor then wanted to send the gentleman home but his daughter fought this decision.

In the end she was successful at having her dad admitted to the ICU and given morphine. Morphine is a traditional drug for dealing with pulmonary edema but is falling our of favour. According to University Hospital, Cleveland, morphine is no longer indicated to treat pulmonary edema.

The daughter was happy with the morphine but upset about the Ventolin. I don't believe the daughter is a doctor. I'm not sure how much weight to give to either the daughter's praise or to her criticism of her father's care.

Survival times for those 80 years or older are often measured in months rather than years. The gentleman in question lived to be 94. Clearly, something was being done right for this senior. Cuts did not seem to be hammering his man, at least not until he hit 94. The fellow died after undergoing an gastroscopy during which the doctor apparently perforated his esophagus. He died from an actual medical cut.

A link to: Le Monde diplomatique

“If you don’t give the people social reform, they will give you social revolution,” Quintin Hogg, a leading light in the Tory party, told the British parliament in 1943.

I read the above in Le Monde diplomatique in a piece by Benjamin Selwyn discussing what he calls "development by the elite for the elite." I can't say I agree whole heartedly with Selwyn but his views counter the capitalist-apologist arguments I often see published in my local paper, The London Free Press.

If interested, here's a link to: The Working Class Does The Job. 

Follow the above link if you agree that the world’s workers should be paid what they are worth and  countries left to develop free of condescending international meddling.

Capitalism: The best system?

I posted this some time ago. Recent business closures in London, and the responses claiming capitalism is still the best system bar none, have made its reposting appropriate.
____________________________________________________________

"Even Paul McCartney has admitted capitalism is the best system. And he was a big pinko back in the day." [source: Dan Brown of The London Free Press]

I groaned when I read Brown's claims and then I thought this could be a blog post — and it is.

Paul McCartney caused a stir in 1972 with his song "Give Ireland Back to the Irish." The song was banned on the BBC. I'm old enough to recall all sorts of silly stuff being said about the Beatles when they were at their peak, but I don't think Paul McCartney was ever a communist — but that's just my opinion. Go google this and get back to me. I did, and failed to find a solid connection.

But, I don't think McCartney's politics are really relevant. You might say this talk of his being a pinko is a bit of a red herring. The statement in which we're really interested is: "Capitalism is the best system." True or false?

This is a hard one to answer, especially for someone who is not an economist. I'll attempt answer, of sorts, but I'm going to come at the answer sideways. I'm not looking to get deep into an economic or political argument.

My first thought is that when I was young I would have agreed rather quickly with the statement. But with the passing of sixty some years I've changed and it is has not only me that has changed but capitalism. Capitalism today is not the capitalism of my childhood.

I believe the boosters of capitalism would say this is a strength of the capitalist system. It adapts to meet the demands of the day. This sounds good on the surface but what does that mean in reality? Have the changes I have experienced during the passing of some six some decades made capitalism better? If not, maybe the best system was some version of capitalism now adapted out of existence.

My grandfather was born on a farm in Princeton, Ontario. He was an outstanding student and I understand that at his graduation it was said he was the youngest pharmacist in the province of Ontario. It's hard to prove the truth of this statement as he graduated back in the early 1890s. Let's just agree that he was one very bright young man.

On graduation, he went to the States to work for Cunningham Drug Stores. This was an up and coming chain. My grandfather had a chance to get in on the ground floor, make big bucks, but he declined.

He moved back to Canada, to Brantford, Ontario, where he started his own independent neighbourhood drugstore. He didn't get rich but he did have a beautiful wife and he raised a fine family. He never owned a car; he didn't need one as he walked to work. He lived in the type of walkable neighbourhood that is today thought so desirable. It was a different world.

Today, a young man graduating as a pharmacist would have a difficult time starting his own independent corner drugstore. The large chains pretty well control everything in the pharmacy business.

The Cunningham's Drug Store chain, the one my grandfather snubbed, went on to become one of the major players in the American Midwest but a few decades ago it was taken out by another player in the capitalist game. A lot of people lost their jobs.

When I was a boy, my neighbourhood had a least three independent drugstores. Each one employed people in the neighbourhood while providing an important service. There were no big parking lots at any of these stores as big parking lots weren't necessary. Most people walked to these drugstores — even the staff.

I worked for one of those drugstores. It became one of the first Big V pharmacies. Big V was formed by a small group of independent Windsor, Ontario, pharmacists intent on saving the neighbourhood drugstore. A few years ago Big V was taken over by the giant Shoppers Drug Mart chain. In 2013 Shoppers was bought by Loblaws in a deal worth about $12.4B.

Capitalism, the best system? I'm not sure that my grandfather would recognize today's capitalism. And I honestly believe that he would tell you the system under which he started his business, a business that lasted him a lifetime, was better.

Found a neat site featuring documentary films

While searching for something I would have thought was quite unconnected, I discovered a site called Top Documentary Films. I would tell you more but, other than the fact that the posted documentaries are free, I know very little about the site or the videos posted there.

After I have viewed some of the videos, I may reopen this post and add some more information.

Cheers.

Check it out,
Top Documentary Films

For lovers of French

As readers of this blog will know, I've been trying to learn French. Why? One, because I like the language, two because I find TV5, the French television network available on cable, is an excellent source of both movies and documentaries and three because my granddaughter is attending French public school. I wish to support the little girl in her effort to learn another language.

When it comes to reading French, I do fairly well. I often watch French movies and catch the gist of what is being said by turning on the French subtitles for the hearing impaired. Unfortunately, a lot of the newscasts are not subtitled.

What has me truly stymied is understanding spoken French. The words seem to fly by, merging together. To get past this hearing boondoggle, I have been listening to French songs and other sources of spoken French.

For my own education, I have posted a video of the French song Tu Trouveras sung by Natasha St. Pier. I have also posted the lyrics both in French and translated into English with links to the source on the Web. (I would appreciate any suggestions on improving the translations.)

If interested, listen to the song, check out the vocabulary and then take the test posted on Quizlet. Bonne chance! (Good luck!)




Lyrics to Tu Trouveras:                                         Lyrics to You Will Find:

Comme tout le monde j'ai mes défauts                  Like everybody I have my faults
J'ai pas toujours les mots qu'il faut                        I don't always have the right words
Mais si tu lis entre les lignes                                 But if you read between the lines
Tu trouveras dans mes chansons                           You will find in my songs
Tout c'que je n'ai pas su te dire                             All that I don't know how to say to you

Il y a des fautes d'impression                                There are wrong impressions
Des "Je t'aime" un peu brouillon                             Some "I love you's" a little muddle-headed
Malgré mes accords malhabiles                              Inspite of my clumsy chords
Tu trouveras dans mes chansons                            You will find in my songs
Tout ce que je n'ai pas osé te dire                          All that I haven't dared to tell you

{Refrain:}
Tu trouveras . . .                                                  You will find . . .
Mes blessures et mes faiblesses                             My wounds and my weaknesses
Celles que j'n'avoue qu'à demi-mot                        Those that I only say in a low voice
Mes faux pas mes maladresses                              My slip-ups, my blunders
Et de l'amour plus qu'il n'en faut                             And more love than is necessary
J'ai tellement peur que tu me laisses                      I'm so afraid that you are leaving me
Sache que si j'en fais toujours trop                        Know that if I'm always trying too hard
C'est pour qu'un peu tu me restes                          It's to make you stay with me a little
                                                                               longer
Tu me restes                                                          You stay with me.

Il y en a d'autres que tu aimeras                              There will be some others you will love
Bien plus belles, plus fortes que moi                        More beautiful, much stronger than me

[Je leur laisserai bien sûr la place                            Of course I'll give them my place       
Quand je n'aurai plus dans mes chansons                 When I don't have in my songs
Plus rien à te dire en face                                        Anything else to say in front of you
Le temps vous endurcit de tout                                Time makes you stronger
Des illusions, des mauvais coups]                             From illusions, from hard blows

Si je n'ai pas su te retenir                                        If I didn't known how to retain you
Sache qu'il y a dans mes chansons                            I want you to know that in my songs
Tout c'que je n'ai pas eu le temps de te dire             Is everything I didn't have time to tell
                                                                                 you

Le temps vous endurcit de tout                               Time makes you strong
Des illusions, des mauvais coups                             From illusions, from bad beats
Si je n'ai pas su te retenir                                        If I wasn't able to make you stay
Sache qu'il y a dans mes chansons                           I want you to know that in my songs
Tout c'que je n'ai pas eu le temps de te dire             Is all I didn't have the time to tell you

{au Refrain: x3}
Tu trouveras . . .                                                  You will find . . .
Mes blessures et mes faiblesses                            My wounds and my weaknesses
Celles que j'n'avoue qu'à demi-mot                        Those that I only say in a low voice
Mes faux pas mes maladresses                                My slip-ups, my blunders
Et de l'amour plus qu'il n'en faut                            And more love than is necessary
J'ai tellement peur que tu me laisses                     I'm so afraid that you are leaving me
Sache que si j'en fais toujours trop                       Know that if I'm always trying too hard
C'est pour qu'un peu tu me restes                         It's to make you stay with me a little
                                                                              longer
Tu me restes                                                        You stay with me.

[ These are Tu Trouveras lyrics on http://www.lyricsmania.com/ ]

The fable of the plant closure

Once upon a time there was a little widget factory operating in a not-so-little town. The factory made good widgets, not great ones, but they were good quality and the price was right. The business flourished.

The widget factory owner, his wife and all his children flourished. All the widget makers at his widget factory flourished. The little town, which had lots of little factories like this one, flourished. All was good.

Then one day the widget making factory owner was approached by a beautiful temptress. The factory owner fell for her charms and tumbled into bed with her. He had an affair. His wife discovered and she left him. What she didn't leave was her half ownership in the widget factory.

The factory owner had to face the shocking reality that he wasn't the sole owner. He and his estranged wife were co-owners. What was he to do?

The factory owner hired good lawyers -- good for him, bad for his wife. It was soon learned that in another city in a country not all that far, far away there was another widget maker. A greedy widget maker who grew his business by buying other widget factories that, for whatever reason, could be bought for a song.

The big widget maker was known as Mr. Acquisition because he had grown his business into one of the biggest in the entire world by buying one after another competing businesses. He had acquired dozens and dozens and dozens of both small and large widget-making plants.

The little widget factory operating in a not-so-little town was sold to Mr. Acquisition. The money paid was split between the divorcing couple. The husband opened another widget factory, a smaller one, and named it Widget Factory Two. The lawyers fashioned all this so that the cheating husband was able, as they say, to stick it to his wife one last time.

As for Widget Factory One, the little factory operating in a not-so-little town, well Mr. Acquisition continued on his buying spree until his business got too big and too complex. His prices were too high and his quality too low. The value of his company crashed. Mr. Acquisition was forced to close Widget Factory One.

Mr. Acquisition had taken a lot of his profit in shares in his once ever expanding business. This meant that as the share value of his Big Widget Company collapsed he lost millions. He began closing plants all over the world. His grossly inflated business had burst like an overfilled balloon. Workers and shareholders around the world were left, as they say, high and dry.

Mr. Acquisition, in trouble financially, was himself acquired -- or at least what remained of his widget business. But don't worry about Mr. Acquisition. The new owner gave the former owner a handsome golden parachute worth many millions of dollars. As you can tell, it wasn't really a parachute but it was handsome and it was golden and, as they say, two out of three ain't bad.

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This little fable was inspired by stories still being played out in the real world.