Glory Be To 2025

Posted on | January 1, 2025 | 2 Comments

Mike Magee

More than once in the lead up to the launch of 2025 I have heard friends and colleagues express a range of sentiments that circled around the general notion that “This is too much to take.”

But throughout history, and into the current period, there are more than a few examples of human courage and resilience, and even a hopefulness that defies logic and reason.

One can hope, for example, that the long war between the Ukraine and Russia will be drawn to an end in 2025. President Zelensky’s address to the Parliament of the European Union in 2022 from a war bunker, did not mince words. 

“I don’t read from paper, the paper phase is over, we’re dealing with lives. Without you, Ukraine will be alone. We’ve proven our strength. We’re the same as you. Prove that you’ll not let us go. Then life will win over death. This is the price of freedom. We are fighting just for our land. And for our freedom, despite the fact that all of the cities of our country are now blocked…We are fighting for our rights, for our freedom, for our lives and now we are fighting for our survival, Every square today, no matter what it’s called, is going to be called Freedom Square, in every city of our country. No one is going to break us. We are strong. We are Ukrainians.”

In those words, Ukraine’s president was mirroring the emotions of other leaders facing an impossible foe in uncertain times. Poets, politicians, and religious leaders have tread this path before. Rome’s 1^st century CE intellectual, Seneca, stated with confidence that “Injustice never rules forever.” Was he really sure of that?

In his Inaugural Address on January 20, 1961, President John F. Kennedy, expanded on this theme. “Now the trumpet summons us again – not as a call to bear arms, though arms we need; not as a call to battle, though embattled we are; but a call to bear the burden of a long twilight struggle, year in and year out, ‘rejoicing in hope, patient in tribulation’, a struggle against the common enemies of man: tyranny, poverty, disease and war itself.”

St. Augustine understood well the interlocking nature of human justice when he wrote, “Charity is no substitute for justice withheld.” And the Talmud cautions that timing is of the essence with this passage, “Three things are good in little measure and evil in large: yeast, salt and hesitation.”

As Shakespeare reminded, one person, large or small, can make a difference. “How far that little candle throws his beams! So shines a good deed in a naughty world,” he wrote. Goodness in the human world requires as much light as possible from every corner of society. Reality is real, as the Irish repeated often enough till the words “All sins cast long shadows” became a proverb.

Back in 2022, Zelensky closed his remarks to the European Parliament with this appeal, “Do prove that you will not let us go. Do prove that you indeed are Europeans. And then life will win over death and light will win over darkness. Glory be to Ukraine.”

But at the end of the day, it comes down to this, do you believe in the fundamental goodness of human nature? Walt Whitman did. He wrote, “I am as bad as the worst, but, thank God, I am as good as the best.”

A Message From Elizabeth II This Christmas Day

Posted on | December 23, 2024 | Comments Off on A Message From Elizabeth II This Christmas Day

As the New Year approaches, Hcom offers this piece for your quiet consideration and contemplation.

Mike Magee

Hanukkah, the Jewish communities 8-day Festival of Lights begins this Wednesday on December 25, 2024. This is a rather rare calendar coincidence, one that will not repeat again until 2052. Those who witnessed the conspicuous Trump and Musk-induced infighting last week over shutting down our government will have to agree that “enlightenment” couldn’t come soon enough.

Bad behavior is especially glaring at this time of year. Our holiday music is incredibly optimistic. Think of the phrases ingrained in our minds and hearts since childhood: “All is calm, all is bright,” “Good tidings we bring,” “Making spirits bright,” “Oh hear the angels voices,” “Sleep in heavenly peace,” “Have yourself a merry little Christmas,” “Comfort and joy,” “Do you hear what I hear?” “The stars are brightly shining,” “Let your heart be light.”

And that is why David French’s headline this week was so shocking, timed as it was. The headline asked, “Why are so many Christians so cruel?” French and his wife and three children have experienced the cruelty first hand since he openly expressed his opposition to Donald Trump during the 2016 Presidential campaign. That resulted in threats to his entire family by white supremacists who especially targeted his adopted Ethiopian daughter. Ultimately, he was “cancelled” by his own denomination, the small, Calvinist “Presbyterian Church of America.”

The entire article is worth a read and careful consideration. But to cut to the chase, French suggests the core problem is religious certainty. As he states it, the “answer often begins with a particularly seductive temptation, one common to people of all faiths: that the faithful, those who possess eternal truth, are entitled to rule. Under this construct, might makes right, and right deserves might.”

Of course, the notion that “might makes right” has been a recurring theme over human history. Notably, European empire building (and Royalty in lock step) aided by organized religions have unleashed centuries of death and suffering which arguably continue into the very present. Marshaling fear and worry, and targeting vulnerable “others,” often accelerated by new technology-induced societal turmoil, arrived long before the emergence of Trump and Musk. It is as old as human history.

Consider King George VI, Queen Elizabeth’s father. His nickname, “Bertie,” derived from his given name, Albert Frederick Arthur George. The name was not a casual choice. He was born on December 14, 1895, which by poor luck happened to be the 34th anniversary of the death of Queen Victoria’s husband, Albert (“Bertie’s great-grandfather). As you might imagine, this was not the aging Queen’s happiest day of the year, and bonding with her new grandson was not a foregone conclusion, in fact the new parents were informed that the Queen was “rather distressed.” 

The suggested solution was to name the child after Victoria’s dead husband. It worked exceedingly well. A few days later the Queen wrote, “I am all impatience to see the new one, born on such a sad day but rather more dear to me, especially as he will be called by that dear name which is a byword for all that is great and good.”

Through a series of improbable happenings (including the abdication of his older brother, Edward, who served only from January to December 1936, so as to be free to marry commoner Wallis Simpson) Albert became King George VI on December 11, 1936.

Aside from his skill at collecting stamps (over 250,000 in 325 volumes during his lifetime), and overcoming a crippling speech impediment, he is best remembered for managing a short, inspiring Christmas message aired worldwide by a new technology – radio – in 1936.  His lasting legacy however was having helped create  Queen Elizabeth, his daughter and successor to the throne on his death from cancer of the lung on February 6, 1952.

Ten months after assuming the throne, but prior to her formal coronation on June 2, 1953,   the 27-year old Queen Elizabeth II  delivered her first Christmas message on December 25, 1952. It too was heard around the world thanks to radio. In that address, she began by paying tribute to her “beloved father.” But she finished that morning by humbly acknowledging her youthful inexperience and insecurity personally requesting that on the date of her formal coronation, “You will be keeping it as a holiday, but I want to ask you all, whatever your religion may be, to pray for me that day.”

Five years later, she delivered her 1957 Christmas Message for the first time using another new technology, television. expressing the hope that day that it would be a “more personal and direct” connect to her people. Direct she was, acknowledging that Christmas morning that, “It is inevitable that I should seem a rather remote figure for many of you.”

Ten years later, on Christmas Day, 1967, she had clearly grown into a world leader, speaking to an increasingly troubled world of “have’s” and “have-not’s” (this time on color television) with these words, “No matter what scientific progress we make, the message will count for nothing unless we can achieve real peace and encourage genuine goodwill between people and the nations of the world.”

A quarter century later, on November 24,1992, Queen Elizabeth II, in an uncharacteristic moment of despair, labeled 1992 “Annus Horribilis,” referencing worldwide turmoil, a fire that had destroyed a portion of Windsor Castle, and the divorces of three of her children.

Encouraging “public scrutiny” of the government and the Monarchy, she said aloud, “criticism is good,” and uttered these words that now, thirty two years later, seem to be directed to our incoming President.

“There can be no doubt, of course, that criticism is good for people and institutions that are part of public life. No institution – City, Monarchy, whatever – should expect to be free from the scrutiny of those who give it their loyalty and support, not to mention those who don’t. But we are all part of the same fabric of our national society and that scrutiny, by one part of another, can be just as effective if it is made with a touch of gentleness, good humour and understanding.”

Twenty-eight years later, in the midst of the pandemic, and with her lifelong companion, Phillip, now 99, failing, she reminded those who had lost love ones, “You are not alone,” and thanked caregivers worldwide for “joyous moments of hope and unity despite social distancing”. But in the end, as she said, “We need life to go on.”

In her 2021 Christmas Message she deflected concern for herself on the prior year’s loss of her husband, saying, “But life, of course, consists of final partings as well as first meetings; and as much as I and my family miss him, I know he would want us to enjoy Christmas.”

In what would be her final message, before passing on September 8, 2022, the aging Queen, now 96, chose to focus on the promise of children and rebirth. She said, “I am sure someone somewhere today will remark that Christmas is a time for children. It’s an engaging truth, but only half the story. Perhaps it’s truer to say that Christmas can speak to the child within us all. Adults, when weighed down with worries, sometimes fail to see the joy in simple things, where children do not.”

Her final words that day, resonate this Christmas Day in America, “As the carol says, ‘The hopes and fears of all the years are met in thee tonight’”.

Your Comments Matter – Reporter Resources for CODE BLUE.

Posted on | December 18, 2024 | Comments Off on Your Comments Matter – Reporter Resources for CODE BLUE.

Thanks to Mary Ellen, a veteran health care professional for the comment above. She is absolutely right. CODE BLUE: Inside America’s Medical Industrial Complex, was written intentionally to share with policy makers how our health care arrived at this moment in history, and suggest ways to improve it. For reporters interested in following this lead, find resources HERE.

A Clash of Values Playing Out In Full View.

Posted on | December 17, 2024 | 2 Comments

Mike Magee

As the new year, 2025, fast approaches, it’s wise to pause, and gather our thoughts as a nation. Few would argue that we’ve been through a lot over the past decade. And quite naturally, we humans are prone to blame individuals rather than circumstances (some of which have been beyond our control) for creating an environment that feels as if it is unraveling before our eyes.

How should we describe our condition – dynamic, tense, complex? Is peace, contentment, and security achievable in this still young nation? Have accelerationist technocrats, armed with bitcoins and Martian fantasy, short-circuited our moment in time that had been preserved for recovery from a deadly pandemic that eliminated a million of our fellow citizens seemingly overnight?

Who do we turn to for answers, now that we’ve largely lost faith and trust in our politicians, our religious leaders, and our journalists? And how exactly do you create a healthy nation? Certainly not by taking doctors and nurses offline for miscarriages, and placing local bureaucrats in exam rooms. Are they prepared to deal with life and death decisions? Are they trained to process human fear and worry? Do they know how to instill hopefulness in parents who are literally “scared to death” because their child has just been diagnosed with cancer? It certainly must require more than a baseball cap with MAHA on it to heal this nation.

Historians suggest this will take time. As Stanford Professor of Law, Lawrence M. Friedman, wrote in A History of American Law, “One hundred and sixty-nine years went by between Jamestown and the Declaration of Independence. The same length of time separates 1776 and the end of World War II.” 

During those very early years that preceded the formal declaration and formation of the United States as a nation, our various, then British colonies, fluidly and independent of each other, did their best first to survive, and then to organize into shared communities with codified laws and regulations. It was “a study of social development unfolding over time” impacted by emotions, politics and real-time economics. At the core of the struggle (as we saw with the pandemic, and now the vaccine controversy) was a clash between the rights of the individual and those of the collective community.

This clash of values has been playing out in full view over the past five years of the Covid pandemic. In 2023, Washington Post columnist, Dr. Leana Wen, asked, “Whose rights are paramount? The individual who must give up freedoms, or those around them who want to lower infection risk?”

This battle between “individual liberty and communal good” is ancient and current at the same time, and still a source of conflict wherever and whenever humans attempt some version of “nation building.” In our current case, it has been further complicated by purposeful misinformation and misdirection on an industrial scale. In a world of “alternative facts,” who and what do you trust?

Through the past five years, public trust in doctors and nurses have managed to remain high. Literally, they have been “a bridge over troubled waters.” That is why it has been such a glaringly obvious public policy blunder to forcefully separate them from the women they care for in half of the states of this nation. By compromising the health of our women, we have compromised the health of our democracy.

It is useful to recall that we humans on these shores have come a long way. From the beginning on the shores of Virginia in 1607, these early wild settlements were essentially lawless – that is without laws. They also were wildly different in their dates of entry and their range of issues. Consider that more than 100 years separated the beginnings of the Massachusetts Bay colony and the colony of Georgia. And as historian Lawrence  Friedman noted, “The legal needs of a small settlement run by clergyman clinging precariously to the coast of an unknown continent were fundamentally different from the needs of a bustling commercial state.”

And yet, here we are together, doing our best to push back against a manmade culture war, ignited in Florida, and designed to halt our human progress, as we pursue policies that will not only widen the gap between rich and poor, but also reward billionaire technocrats with unimaginable deregulation that will almost certainly place our citizens health and safety at risk.

In many ways, the struggle to act in a civil and wise manner, that mines common values, and finds a balance between individual freedom and wise collective rules and regulations, remains our hill to climb.  

Not surprisingly, RFK Jr. finds himself under a microscope. His past pronouncements, replete with his own “alternative facts,” struggles with addiction, celebrity seeking, and mixing of good and bad ideas have placed him in a well-deserved hot seat. If trust is what we need, he may not be the best choice for MAHA.

As a fact starter, check out The History of American Law. It “presents the achievements and failures of the American legal system in the context of America’s commercial and working world, family practices, and attitudes toward property, government, crime, and justice.” Medicine lives and breaths at these very same interfaces.

How should we describe our condition – dynamic, tense, complex?  Historians might say yes to all of the above, but also proclaim that the timing for progress is perfect. We should advantage this fluid opportunity, and make the most of it. Public Health policy, debating it and formulating it, can help us manage our differences, and make wise choices for our still young nation. This is because Public Health exists at the intersection of Law and Medicine.

Not My Final Column.

Posted on | December 11, 2024 | 6 Comments

Mike Magee

As my wife often reminds me, “Comparisons are toxic.” And, in general, I agree and try to respect this cardinal rule. But these are extraordinary times. So grant me this exception.

On December 9, 2024, in my early morning survey of the news, two articles demanded my attention. The first was an editorial in the New York Times with the self-explanatory title, “My Last Column: Finding Hope in an Age of Resentment” by Paul Krugman. The second was an article published that morning in Nature titled “Quantum error correction below the surface code threshold” authored by “Google Quantum AI and Collaborators,” a blanket label for a team of 300+ engineers led by Founder and Leader, Hartmut Neven. More on him in a moment.

As a loyal reader of Krugman, I read his “last column” carefully – twice. Over 25 years I’ve admired this specialist’s (global economics) willingness and interest to wander often into generalist, cross-sector, liberal arts territory. No match for his Nobel winning intellect or pure-bred education at MIT, Yale and Princeton, I do share a history of common geography (upstate New York in our early years, and the New York metropolitan area later on); an upbringing in religious households (Jewish and Catholic); and more than two uninterrupted decades of weekly published columns.

Though I have not always agreed with his take on every issue, I count myself as an admirer. The issues that have interested him, both pro and con, over the years, are more often than not the same issues that have troubled or encouraged me. So I was not surprised that he chose, in his “last column,” to reflect on the recent election, and the current levels of anger, violence and resentment in our society. And while I agree with the findings in his examination of the body politic, we arrived at a different diagnosis.

Krugman writes, “What strikes me, looking back, is how optimistic many people, both here and in much of the Western world, were back then (25 years ago) and the extent to which that optimism has been replaced by anger and resentment. . . some of the angriest, most resentful people in America right now . . . are billionaires who don’t feel sufficiently admired.” 

As for the diagnosis, in response to the question he himself raises (“Why did this optimism curdle?”), he answers, “As I see it, we’ve had a collapse of trust in elites.” And the treatment for this disease? “if we stand up to the kakistocracy — rule by the worst — that’s emerging as we speak, we may eventually find our way back to a better world.”

Now that sent me back to Hartmut Nevin and the Nature article for a reality check.  Were American oligarchs and technocrats, with wild wealth and even wilder ideas, the cause of every day people jumping aboard the Trump cult train? 

Hartmut is 9 years younger than Paul. He is a German trained PhD physicist who came to the University of Southern California as an entrepreneurial research professor in computer science in 1998. His several start-ups which were focused on “face recognition technology and real-time facial feature analysis for avatar animation” helped make him famous and rich when they were purchased by Google in 2006. But his fantastical dream was to create a “quantum chip” that would outperform anything that currently existed. 

Six years later, he launched the Quantum Artificial Intelligence Laboratory, and by 2016, he had come up with an experiment (still ongoing) to prove “quantum supremacy.” Starting his own chip fabrication factory in Santa Barbara, his dream became concrete. He took a world view in 2020, stating:  “It’s not one company versus another, but rather, humankind versus nature — or humankind with nature.”

Nevin believes he is in the right place at the right time. The AI Arms Race is full on and relies on ever increasing data consumption to support generative self-learning. That demands enormous consuming power. In his words, “Both (quantum computing and AI) will prove to be the most transformational technologies of our time, but advanced AI will significantly benefit from access to quantum computing. This is why I named our lab Quantum AI.”

Quantum computing is measured in “qubits” (which are the size of a single atom) versus the binary digit measure of standard computers, called the “bit.” As the New York Times explained, “Quantum bits, or ‘qubits,’ behave very differently from normal bits. A single object can behave like two separate objects at the same time when it is either extremely small or extremely cold.” The test, using exotic metals cooled to 460 degrees below zero, reported out on October 9th, declared that Nevin’s quantum chip “performed a computation in under 5 minutes that would take one of today’s fastest supercomputers 10,000,000,000,000,000,000,000,000 (10 septillion) years to compute.” 

But that’s not the amazing part. In past experiments, the device was error prone, and the more qubits, the less reliable the computations. But now, for the first time, this group was able to demonstrate the more qubits in play, the more accurate the outcome. As Nevin explained, “This historic accomplishment is known in the field as ‘below threshold’ — being able to drive errors down while scaling up the number of qubits.” How big was that? According to Javad Shaman, director of the Center for Quantum Information Physics at NYU, “one of the highlights of the recent decade.”

Nevin doesn’t seem to “worry about being admired.” In his blog this week he tied his qubit “below threshold” accomplishment to “helping us discover new medicines, designing more efficient batteries for electric cars, and accelerating progress in fusion and new energy alternatives.” That seems a far cry from Paul Krugman’s highlighting of “the pettiness of plutocrats who used to bask in public approval and are now discovering that all the money in the world can’t buy you love.”

Gallup has been conducting an annual survey of “Americans Satisfaction With The Way Things Are Going In The U.S.” for roughly a half century. Currently only 22% say they are satisfied. Back in 1986, that number peaked at 70%. That was the year that Robert Fulcrum wrote a little book that remained on the New York Times Best Seller list for nearly two years. Some criticized the book as “trite and saccharine,” but 17 million copies of his books remain in circulation.

The 1986 book was titled, “All I Really Need To Know I Learned in Kindergarten.”   Here are his top ten learnings: 

1. Share everything.
2. Play fair.
3. Don’t hit people.
4. Put things back where you found them.
5. Clean up your own mess.
6. Don’t take things that aren’t yours.
7. Say you’re sorry when you hurt somebody.
8. Wash your hands before you eat.
9. Flush.
10. Warm cookies and cold milk are good for you.

I was trying to figure how members of my own family could vote for a man to lead our nation who routinely and deliberately breaks most of these rules. I’ve come up with two reasons:

1. Greed. They simply don’t want to share any of their wealth or good fortune with others.
2. Religious certainty. They do not believe in separation of Church and State, and do not respect individual self-determination and free will. And yet values can not be enforced on human beings. They must be freely embraced to become permanently embedded.

Comparisons may be toxic, but Hartmut and Paul point us toward the truth. We the citizens of America (not our leaders regardless of their human deficits) need to get our act together. We are responsible for the outcome of this past election. What will the future hold? As Nevin the information scientist teaches, optimism flows from purpose and the promise of service.  And Krugman, the Nobel economist, teaches that money alone can not buy you love – or peace, or lasting joy, or contentment.

AI and Medicine: A Brief History and Where We Are in 2024

Posted on | December 10, 2024 | Comments Off on AI and Medicine: A Brief History and Where We Are in 2024

(printable PDF)

Mike Magee

The history of Medicine has always involved a clash between the human need for compassion, understanding, and partnership, and the rigors of scientific discovery and advancing technology. At the interface of these two forces are human societies that struggle to remain forward looking and hopeful while managing complex human relations.

The question has been “How can science and technology improve health without undermining humans’ freedom of choice and rights to self-determination.” The rapid rise of Artificial Intelligence (AI) feels especially destabilizing because it promises, on the one hand, great promise, and on the other, great risk.

The human imagination runs wild, conjuring up images of robots taking over the world and forcing humankind into submission. Yet it is important to take a deep breath and place science’s technologic progress in perspective. (Read on . . . )

Ten Wizards Who Shaped Our Health Care System.

Posted on | December 2, 2024 | Comments Off on Ten Wizards Who Shaped Our Health Care System.

Mike Magee

The incoming Trump Administration nominees for positions in Health and Human Services (like RFK Jr. to direct the department and Mehmet Oz to head Medicare and Medicaid Services) are names you know and apparently many trust? In this week’s New York Times, Dr. Ashish Jha, President Biden’s Covid lead, thinks he knows why. He said, “You have a large swath of the population facing a health crisis, and they feel like medicine and public health isn’t delivering…They’re much more open to people saying, ‘The whole system is corrupt and we have to blow the whole thing up.’”  As Ashish knows better than most, we didn’t arrive here out of the blue. Over the years, many of the players who had the greatest impact on America’s health care system as we know it, remain hidden behind an  historic screen. Here (in no particular order) are 10 of the least known but most influential figures who shaped U.S. health policy in our lifetime.

Sam Massengill

In spring 1937, the head of sales for S.E. Massengill Company in Bristol, Tennessee, went to the company head, Samuel Evans Massengill, with an idea generated by customer feedback. Massengill salesmen were passing along reports from doctors that there was demand among parents of young children suffering from strep throat for a liquid version of their new sulfa drug.

Massengill, charged the company’s chief chemist, Harold Cole Watkins, to find an effective solvent in which powdered sulfanilamide could be dissolved. His choice was diethylene glycol, which smoothly dissolved sulfanilamide powder and led to a concoction that was 10 percent sulfanilamide, 72 percent diethylene glycol, and 16 percent water. Flavored with raspberry extract, saccharine, and caramel, it passed the taste and smell tests, but in keeping with then current federal regulations—or lack thereof—there was no test for safety.

In fact, no one did even a rudimentary check of the literature on diethylene glycol, which would have quickly revealed that it was a highly toxic component of brake fluid, wallpaper stripper, and antifreeze that had caused a fatality in 1930.

Instead, perhaps sensing that its competition would be right behind, Massengill rushed its “Elixir Sulfanilamide” into production, then shipped 240 gallons of the red liquid to 31 states through a network of small distributors in early September 1937.

Within two weeks, children began to die. In all, more than 100 children died, but only after going through 7 to 21 days of wrenchingly painful illness including “stoppage of urine, severe abdominal pain, nausea, vomiting, stupor, and convulsions.”

The whole disaster was vigorously reported in the press, and drug safety soon inched its way up the list of New Deal priorities. By June 11, 1938, bills from the Senate and House of Representatives had been reconciled, and on June 25, 1938, President Roosevelt signed into law the 1938 Federal Food, Drug, and Cosmetic Act.

Samuel Massengill belatedly issued a statement on behalf of his company: “My chemists and I deeply regret the fatal results, but there was no error in the manufacture of the product. . . . I do not feel there was any responsibility on our part.” Unfortunately, Massengill’s morally blind position reflected the letter of the law at that time. In short, the absence of effective legal sanctions meant that a company or an individual could indeed sell a deadly medication and get away with it.

Mary Lasker

Born in 1900, Mary Lasker was the daughter of Frank Elwin Woodard, the head of the local bank in Watertown, Wisconsin, and a shrewd businessman with Chicago connections. By her own account, she was a campaigner almost from birth, and she traced her interest in promoting medical research back to an event she experienced at the age of three or four. Her mother, a local community supporter and civic activist, took Mary to see their ailing servant, a Mrs. Belter, who had undergone a double mastectomy as treatment for breast cancer. “I thought, this shouldn’t happen to anybody,” Mary Lasker later wrote.

As a young adult, she began to focus on health policy issues and became a devotee to Margaret Sanger. Mary sought out financial support for the organization, turning to a dynamic advertising man, Albert Lasker, who had launched some of America’s most recognizable consumer brands, including Lucky Strike cigarettes. Known as the “father of modern advertising,” Lasker is credited for suggesting that the Control Federation of America be renamed the Planned Parenthood Federation.

When Albert asked Mary what she wanted to accomplish, she listed reforms in health insurance, cancer research, and research against tuberculosis. Albert responded, “Well, for that you don’t need my kind of money. You need federal money, and I will show you how to get it.”

When Mary and Albert married in 1940, the world was preparing for war.

Beginning in 1942, the Laskers began to cultivate science luminaries who shared their commitment to maximizing government funding of applied research. The Laskers realized early that they would need a credible health-related national organization to anchor and launch their campaign and set their sights on the American Society for the Control of Cancer, an organization created in 1913 by 10 physicians meeting at the Harvard Club in New York City. The leadership was more than happy to grant the Laskers easy entry to their Board of Trustees in return for financial support. By 1944, the Laskers had seized control of the Board, largely dumped the doctors, and renamed the group the American Cancer Society (ACS). Its leadership was now composed of name-brand corporate heads, entertainment giants, and advertising executives.

To add further glory to the idea of Big Science, Mary and Albert created the annual Lasker Awards, with the somewhat self-serving tagline “Sometimes called ‘America’s Nobels.’” She then began to collect academic researchers, promote their careers, injecting publicity and special placement on government bodies. Over a decade she was at the center of creating seventeen specialty Institutes within the new NIH, most built around her favored scientists.

Mary Lasker died in 1994, a controversial figure. In the assessment of author and political journalist Elizabeth Drew, “Mrs. Lasker has been considered an able woman who has done good things but is too covetous of power, too insistent on her pursuits, too confident of her own expertise in the minutiae of medicine.”

William Menninger

During the first major WW II battle in North Africa, a startling number of soldiers were incapacitated with “Shell Shock.” One neurologist in North Africa, Frederick R. Hanson, discovered that a bit of kindness in the form of a hot shower and a warm meal, combined with sedation-induced rest, was remarkably successful in rehabilitating the majority of the “mentally incapacitated” men under his care.

Hanson’s success did not go unnoticed by the Army’s chief of the division of neuropsychiatry in the Office of the Surgeon General, William C. Menninger. After studying his results, he decided that if psychiatric casualties in a standard unit exceeded one mental casualty for every four wounded in action, this was a harbinger of broader problems—like a breakdown in morale, leadership issues, prolonged combat fatigue, or a policy breakdown in the evacuation scheme.

Other observations included the fact that new units with limited combat experience had a higher percentage of mental casualties then seasoned units did, and that the medical officers in these units were more inclined to ship out those with “normal fear reactions.” On the other end of the spectrum, troops that exceeded 12 months of combat exposure began to experience a higher percentage of mental casualties.

The experience in North Africa had clarified for Army Chief of Staff, General George Marshall, that the plan for handling neuropsychiatric casualties in the field was seriously broken. At his request, Menninger came up with a plan that included psychiatric support close to the battlefield, reinforced by the heavy and liberal use of barbiturates and ether anesthesia if necessary for initial sedation of hysterical soldiers. In the most severe cases, other experimental treatments would be used, such as intravenous sodium pentothal, a.k.a. truth serum, to draw out (and ideally remove) the troubling traumatic memories of war.

Menninger immediately realized there were not nearly enough psychiatrists to execute the plan, so he came up with the idea to train a portion of the medical officers in what he called “forward psychiatry.” These officers were subjected to a 30-day immersion course to master Menninger’s system and make them comfortable with the liberal use of barbiturates. They were thereafter labeled “30-day wonders.”

Menninger’s plans were encoded in a diagnostic manual, Medical 203 (which was the basis of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, released shortly after the war). Today, the bible of mental health, and now in its fifth edition, the DSM-5 is a structured approach to the diagnosis and treatment of mental illnesses, including the use of those wartime barbiturates and the many chemical children they spawned.

The pharmaceutical industry responded to all these developments with an aggressive search for “blockbusters” to capture the expanding market. Some of these new medicines were designed to treat very real ailments; in other cases, the drug came first, after which the drug company’s newly energized marketing teams developed a problem for it to solve. By 1960, one out of every six American adults was being treated with pharmaceuticals for anxiety.

Hans Selye

In the early 1950s, Reader’s Digest published a ground breaking article titled “Cancer By The Carton”, informing the public that cigarettes caused lung cancer. As part of the fallout, the AMA eliminated cigarette advertising from their medical journals.

To continue selling cigarettes in the face of devastating scientific evidence of tobacco’s link to lung cancer was challenging enough, but newer evidence was beginning to reveal that the habit also led to deaths from heart attacks. The companies had to come up with an alternate explanation for the rise in cardiac deaths that clearly tracked the rise of cigarette sales.

Their savior was a Hungarian-born endocrinologist named Hans Selye, a man nominated multiple times for the Nobel Prize.  Selye was famous for his formulation of the concept of stress as the source of microscopic injuries to the cell. But he was also known for his ability to attract research funding, which was enhanced by his willingness to tailor the evidence to suit the highest bidder.

In numerous court cases during the 1960s and 1970s, the Tobacco Industry Research Council relied on Selye as an expert witness to make the argument that smoking, rather than being a health hazard, might actually provide a measurable benefit in the form of stress relief. Meanwhile, Dr. Selye was turning to the tobacco industry for major grants to support his growing research enterprise and to enrich himself.

Years later, as part of document disclosure during litigation by state attorneys general against the tobacco industry, communications between Selye and industry representatives proved that he had conspired to hold back supportive testimony and publications suggesting a link between tobacco use and stress reduction until he received his cash.

When Hans Selye died in 1982, he was regarded as a venerable scientist, but the tobacco industry’s funding of his work, and Selye’s willingness to recruit additional scientists to present tobacco’s messages in meetings and publications, was later cited by the US Department of Justice as a clear example of racketeering.

Lemuel Boulware

When the AMA began to look for someone to help fight the scourge of socialized medicine in 1960 Ronald Reagan was the ideal public opinion operative.  His training as a politician and public communicator lasted 10 years and was directed by Lemuel Boulware, who had served as Roosevelt’s operations vice chairman of the War Productions Board, and then moved on to one of the military’s largest suppliers, General Electric.

At GE Boulware had a philosophy of “going over the heads” of union leaders. Instead of confrontation, he employed comprehensive, ongoing communications and economic education directed not only at workers at all levels in his organization but also at their spouses and families. He fostered newsletters, symposia, book clubs, and courses that included a heavy dose of basic conservative economics, but they also touched on entrepreneurship, management philosophy, investment, retirement, health, and family education.

The new medium of television was becoming a factor in American life, so  Boulware decided to launch a new TV show called General Electric Theater. He turned to Ronald Reagan to host the weekly dramatic series. Over the next eight years, Reagan visited and addressed more than 250,000 GE employees and customers at 139 different GE sites, perfecting what came to be known as “The Speech.”.  The AMA hired Reagan on GE’s recommendation. Reagan’s speech and its’ views on Medicare aligned with those of the AMA, but they came out of GE,  thanks to his mentor, Lemuel Boulware.

Edward Annis

On May 20, at Madison Square Garden in New York City, President Kennedy delivered a major address on health care to a full house of 20,000 senior citizens. The speech was broadcast without advertising by all three major networks as a “news event,” and it reached an estimated viewership of 20 million. He directly challenged the AMA and its health care lobbyists, who were flooding the hallways and mailrooms of Congress.

The AMA was livid. It demanded equal time from the networks to give a formal response to what they saw as a Democratic Party political address, but it was refused.  Undaunted, the AMA board gave the go-ahead to rent Madison Square Garden and pay to televise their rebuttal.

As their voice, they chose a Tallahassee surgeon, Dr. Edward Annis, who had been a debater in high school and college. Part of the AMA speakers’ bureau, Annis, like Ronald Reagan, had been put on the road the year before to develop his own version of Reagan’s “ speech.” He had delivered it dozens of times over the past five months and along the way had publicly debated UAW officials and Senator Hubert Humphrey.

When he got to Madison Square Garden on May 22 to deliver a very personal rebuke to the president, Annis had two advantages. President Kennedy’s earlier address, as his staff would later admit, was not his best. The AMA also had Kennedy’s speech on film and was able to build a point-by-point reply.

Dr. Annis, in 30 minutes, mined the weaknesses of Kennedy’s address, referencing filmed portions of the president’s speech, and challenged the absent president directly as he went along. At the end of the speech, Annis admonished Kennedy: “The people have a right to remind their first servant that his election, even his present popularity, does not authorize him to change fundamental institutions that have proved a lasting value through the generations…There are few such things that touch so close to God. And the relationship between a doctor and his patient is one of them…To the millions of Americans who may have a doubt, who may want to take a moment to hear the views of one they know and trust, I implore you, ‘Ask your doctor. Ask your doctor.’”

And ask they did, in droves. The AMA’s paid televised address on the same networks Kennedy had accessed two days earlier was said to have reached 30 million viewers. On July 17, 1962, the health care bill went down in defeat in the Senate by a vote of 52–48.

Ed Pratt

In the 1980’s Pfizer CEO Ed Pratt was ideally positioned to lead the global charge on intellectual property (IP) protections. Pratt was chairman of the powerful US Business Roundtable and also the formal adviser to Reagan’s US trade representative, Bill Brock.

Pratt’s first move was to form a task force on intellectual property with his chief ally, IBM CEO John Opel. Their recommendation to Brock that a position be created within the Office of the US Trade Representative for a director of international investment and intellectual property sailed through.

Pratt also directed the creation of the Intellectual Property Committee (IPC) of the powerful US Council on Business. This provided a platform for the next step in organizing a global effort. In 1983, Pratt and Opel approached the leaders of 10 other large US-based multinationals, including General Electric, General Motors, DuPont, Johnson & Johnson, and Monsanto, requesting their participation on the Intellectual Property Committee and creating a united front across industries.

At Bill Brock’s request, Pratt, built a multi-sector global coalition of major corporations to engage the United Nations and World Trade Organization. Domestically, he worked the chambers of commerce, business councils, business committees, and trade associations. Pfizer executives, who occupied key positions in strategic business organizations, were directed to engage with their cross-sector colleagues in every industry.

Pratt persisted for over a decade until he won. As a direct result of his IP wins, pharmaceutical companies in the U.S. gained up to 20 years of patent protection for new drugs approved by the FDA.  In addition, the integrated internal public affairs team he created inside Pfizer for the project became the prototype for PhRMA’s  subsequent “government relations on steroids” and  the under-pinning for the integrated and strategic cross-sector 21^st century Medical Industrial Complex.

Louis Lasagna

In 1970, Lou Lasagna MD became chairman of the Department of Pharmacology and Toxicology at the University of Rochester’s School of Medicine where he founded the Center for the Study of Drug Development (CSDD), a common meeting ground for free market–minded academics, government, and corporate leaders. By 1976, he had moved his center to Boston’s Tufts University. He was now a renegade scholar, a successful entrepreneur, and a lightning rod for controversy.

From the start, Lasagna’s CSDD was a multifaceted and highly productive platform, providing professional development courses in clinical pharmacology, drug development, research processes, and pharmaceutical regulations. It generated influential white papers and reports on everything from clinical research design to the growing trend of outsourcing work to contract (or clinical) research organizations (CROs). It also provided customized reports helping individual clients design their government-relations strategies in pursuit of favorable policies.

He laid the statistical groundwork to “prove” that the pharmaceutical industry was “high risk/high gain.” Lou pegged the cost of bringing a new drug to market at $800 million and the losses associated with a one-month delay in a product review by the FDA at $10 million for the sponsoring company. Multiplied by the average approval time required for a new drug application—31 months—that added up to real money.

Lasagna labeled the problem as America’s “drug lag” and positioned himself and his fellow physicians as friends of the industry. For individual drugs, Britain in 1980 beat the US to the market for new drugs, on average, by two years. At the time, the country was in a stubborn recession. Lasagna argued that the cost of drug innovation was way too high, and that part of the problem was government ownership of any discoveries that had been funded with NIH grants.

As a brilliant strategist, Lasagna could see a number of these issues breaking his way. The stubborn recession combined with the escalating cost of employer-based health benefits was beginning to fuel the demand for innovative solutions. Lasagna was skilled at converting concern about cost into demands for efficiency and less regulation of industry. He successfully led the charge to release government patents back to medical scientists and their institutions. A decade latter, the HIV/AIDS epidemic would push massive liberalization of drug approval over the line, and Lasagna would be the director of the government’s expert committee with a young researcher, Anthony Fauci as his NIH ally.

Paul Weyrich

in 1970, a Nixon-era journalist named Paul Michael Weyrich arrived on the political scene.  A staffer at the Milwaukee Sentinel who served as a weekend anchor at the local ABC affiliate WISN-TV, Weyrich went on to serve as press secretary to Colorado senator Gordon Allott. From there it was a short walk to the offices of conservative beer mogul Joseph Coors, who was funding the creation of a new right-wing think tank called the Heritage Foundation. Weyrich became its first director, and he summed up his mission this way: “The New Right is looking for issues that people care about. Social issues, at the present, fit the bill.”

Over the next decade, working with televangelists Jerry Falwell and Pat Robertson, they together fashioned Christian white nationalists into a political body, “The Christian Right”, and helped elect Jimmy Carter. When Carter was unwilling to oppose Roe v. Wade and homosexuality, they mobilized in support of Reagan and what they now termed “The Moral Majority.” Four decades latter, with the Dobbs decision, their dream came true.

Linda Robinson

In 1997, at the age of 44, Linda Robinson was already a legend in the field of Crisis Communications on Wall Street. Well known for her role in the leveraged buyout of RJR Nabisco, the story at the center of the book and film “Barbarians at the Gate”, she had been featured in a 10-page cover story in Vanity Fair. This piece described her as “the most powerful public relations broker in the country.”

Her husband, James D. Robinson III, was the chairman of American Express, and she was on first-name terms with most of the major players in media and politics in New York City. Her father, Freeman Gosden, had been a radio personality (Amos of Amos ’n’ Andy) and a longtime Hollywood fixture close to many political figures, including Ronald Reagan. When Reagan entered the 1980 presidential race, Linda became assistant to the campaign’s press secretary. After Reagan’s victory, she became press secretary to the secretary of transportation just as America’s air traffic controllers went on strike, and the showdown between them and President Reagan became one of the lead stories of the year.

In the mid-1990s, Pfizer CEO Bill Steere was ramping up to support a product that he already knew would become infamous, Viagra.  He knew it would unleash a huge public debate, and he was focused on identifying every possible issue or public challenge that might arise. In short, he wanted to be prepared and avoid a crisis. So he quite naturally turned to Linda Robinson to head up Pfizer’s secret, internal Viagra Advisory Board filled with ethicists, theologians, sex therapists, scientists and representatives of four of the largest public relations firms in New York, including her own company: Robinson Lerer & Montgomery. This was a full 18 months before the drug was slatted to be approved.

Robinson imbedded her own staff at Pfizer headquarters at 42^nd and 2^nd Avenue, and ran the Viagra “War Room” for the first 12 months after approval until the product’s success was assured. Rather than dismantle the team, it was then repurposed as Robinson and her people helped direct the successful “hostile takeover” of Warner Lambert. The prize? Lipitor, the statin drug, which by 2010 was the first drug ever to exceed $10 billion in annual sales.

___________________________________________________________________

These stories and more in CODE BLUE: Inside America’s Medical Industrial Complex (Grove/2020)

« go back — keep looking »

"Available Everywhere Now"
"Code Blue INDEX online"

 

  Ralph Snyderman
Prospective Health Blog
BIOGRAPHY   Eric Dishman
NIH Precision Medicine
BIOGRAPHY   Barbara Ficarra
Health in 30
BIOGRAPHY   William L. (Larry) Minnix, Jr.
Larry's Letters
BIOGRAPHY     Eric Dishman
Precision Medicine, Euthanasia, Abortion, Communism, Trillions of Dollars, Losing Freedom, and Town Hall Mobs BIOGRAPHY   Michael Millenson
Yearning for Universal Coverage Is Not Universal
BIOGRAPHY

 

 

 

 

Search

Search