Tuesday, July 31, 2007
The Case of the Barber
Via Political Theory Daily Review, in Cabinet Thomas Keenan and Eyal Weizman on the libel suit by Eyal Sivan against philosopher Alain Finkielkraut.
In February 2004, French-Israeli filmmaker Eyal Sivan filed a libel suit in the Paris courts against philosopher Alain Finkielkraut. The previous year, Sivan, working with Palestinian filmmaker Michel Khleifi, had released Route 181: Extracts from a Palestinian-Israeli Journey—a four-and-a-half-hour travel documentary tracing what remains, in the memories of the landscape and its inhabitants, of the violent expulsion in 1947–1948 of some three-quarters of a million Palestinians from the territory that would become the state of Israel. The film had been aired on the European cultural television channel Arte in November 2003, and a few days later, on November 30, Finkielkraut was interviewed on the French Jewish radio station RJC. In the radio broadcast, Finkielkraut launched an aggressive critique of the film, arguing that its entire meaning rested on a false analogy between Israel’s 1948 war of independence and the Nazi Holocaust, that the film was a “call to murder,” that Arte was guilty of “incitement to hatred,” and that Sivan himself was representative of a “particularly painful, particularly frightening reality—Jewish anti-Semitism.”
The case came to trial on 23 May 2006, and the official transcript of the proceedings at the Palais de Justice, Paris, is translated here in its entirety. The case revolved around witnesses, in the courtroom and in the film. To testify on his behalf, Finkielkraut called on the filmmaker Claude Lanzmann; historian and former Israeli ambassador to France, Eli Bar-Navi; and Anny Dayan, a cinema studies professor and pro-Israel activist based in Paris. Sivan called two left Israeli intellectuals: philosopher Adi Ophir, and film theorist Haim Bresheeth, as well as Parisian publisher/activist François Maspero, who established his radical publishing house against the background of the Algeria war.
Escort's "All Through the Night" Video
For Bergman, the face was always the same: always constant and always fresh
As an artist, Ingmar Bergman drew not just on the cinematic tradition, but on the great traditions of European art and philosophy. People such as Ibsen and Chekhov, Thomas Mann and Nietzsche are all there as influences. He drew on three centuries of European literature. Nobody else in the history of cinema was temperamentally capable of doing that. He was unflinching in his need to talk about the fundamental questions of life in a way that cinema didn't do before him and has hardly done since. That is why he was, to me, the most significant person ever to make movies.
more from Rick Moody and a host of other Bergman admirers at The Guardian here.
A GRADUALLY GRAYING book reviewer with several decades in the trenches, I've been nibbling at literary web sites and blogs for some time now -- out of curiosity, to be sure, but also from a sense of vocational self-preservation. I've been trying to make my peace with the changes -- and to decide once and for all if they represent an advance, a retreat, or simply the declaration of an emerging new order against which there is no point in kicking.
New, yes, and yet still deeply intertwined with the old. So far it's clear that the blogosphere is in vital ways still predatory on print, that the daisy-chain needs the pretext of some original daisy; its genius, its essence, is manifestly supplementary. This recognition gives some credence to the many who argue for coexistence, a meshing of print culture and digital, with the latter very much spawning from the former.
But I am also paranoid enough -- or maybe forward-looking enough -- to imagine the day when magazines and newspapers have begun to dwindle away and the world of text has shifted dominantly to screen. Indeed, I would say we are right now at what feels like a point of vital balance, and those of us involved with literary journalism and book-reviewing live with the sense of a balance teetering.
more from Boston Globe Ideas here.
ugly in poland
To rule like Mr Kaczyński wants to rule, you have to falsify and reshape the Poles' collective memory. You have to decree that the heroes of Poland's most recent history - Lech Wałęsa, Bronisław Geremek, Tadeusz Mazowiecki - were traitors or helpers of traitors. You have to call Poland's peaceful transformation - the country's single greatest success in the 20th century - an act of national treason. You have to teach the Poles to fear and mistrust their neighbours. And you have to teach them to believe in the infallibility of their new Leader - Jarosław Kaczyński. Judging by the Poles' traditional spirit of contrariness, that is hardly going to be an easy task.
more form Adam Michnik at Gazeta Wyborcza here (thanks to Filip Tomczak).
Bad Memories Tied to DNA
People haunted by traumatic memories could be missing a few amino acids, say researchers. A new study links a deletion in a neurotransmitter receptor gene to a marked increase in an individual's ability to remember emotionally charged events. The finding represents the first gene shown to play a role in emotional memory and could have implications for anxiety and other psychiatric disorders. For more than 10 years, neuroscientists have known that our brains' emotional memory circuits are linked to the neurotransmitter norepinephrine. Higher levels of this hormone, released as part of the fight-or-flight response, can increase a person's ability to recall emotional events. Because the clarity of emotional memories varies from person to person, a team of European and African researchers set out to determine whether a common deletion in a specific norepinephrine receptor gene called ADRA2B might be responsible.
The researchers recruited nearly 450 Swiss volunteers, as well as about 200 refugees of the Rwandan civil war. The Swiss volunteers were shown photos varying in tone from cuddly puppies to accident scenes. They were asked to rate the photos as emotionally positive, negative, or neutral and give the strength of the emotion. Ten minutes later, the researchers asked the volunteers to write descriptions of the photos. The two groups had equal success describing neutral photos, but for emotionally charged photos, the deletion carriers wrote descriptions judged "successful" 34% more of the time than did noncarriers
Who’s Minding the Mind?
From The New York Times:
In a recent experiment, psychologists at Yale altered people’s judgments of a stranger by handing them a cup of coffee. The study participants, college students, had no idea that their social instincts were being deliberately manipulated. On the way to the laboratory, they had bumped into a laboratory assistant, who was holding textbooks, a clipboard, papers and a cup of hot or iced coffee — and asked for a hand with the cup. That was all it took: The students who held a cup of iced coffee rated a hypothetical person they later read about as being much colder, less social and more selfish than did their fellow students, who had momentarily held a cup of hot java.
New studies have found that people tidy up more thoroughly when there’s a faint tang of cleaning liquid in the air; they become more competitive if there’s a briefcase in sight, or more cooperative if they glimpse words like “dependable” and “support” — all without being aware of the change, or what prompted it. Psychologists say that “priming” people in this way is not some form of hypnotism, or even subliminal seduction; rather, it’s a demonstration of how everyday sights, smells and sounds can selectively activate goals or motives that people already have.
More fundamentally, the new studies reveal a subconscious brain that is far more active, purposeful and independent than previously known.
The Out Campaign
Richard Dawkins at his website:
In the dark days of 1940, the pre-Vichy French government was warned by its generals "In three weeks England will have her neck wrung like a chicken." After the Battle of Britain, Winston Churchill growled his response: "Some chicken; some neck!" Today, the bestselling books of 'The New Atheism' are disparaged, by those who desperately wish to downplay their impact, as "Only preaching to the choir."
Some choir! Only?!
As far as subjective impressions allow and in the admitted absence of rigorous data, I am persuaded that the religiosity of America is greatly exaggerated. Our choir is a lot larger than many people realise. Religious people still outnumber atheists, but not by the margin they hoped and we feared. I base this not only on conversations during my book tour and the book tours of my colleagues Daniel Dennett, Sam Harris and Christopher Hitchens, but on widespread informal surveys of the World Wide Web. Not our own site, whose contributors are obviously biased, but, for example, Amazon, and YouTube whose denizens are reassuringly young. Moreover, even if the religious have the numbers, we have the arguments, we have history on our side, and we are walking with a new spring in our step – you can hear the gentle patter of our feet on every side.
Ingmar Bergman has died at age 89
David Gritten in The Telegraph:
It would be stretching a point to claim Ingmar Bergman invented art-house cinema. Other directors before him had presented visions of cinema so austere and serious as to exclude entertainment values completely; but Bergman was the first to attract such wide audiences to his work.
Buñuel's experiments with Dalí qualified as high art, but were so experimental as to be museum pieces. Italian neo-realists such as De Sica and Rossellini tackled serious social themes, but always addressed themselves to audiences' emotions. Bergman seemed grandly indifferent to such considerations; the rigour, seriousness and intellectual questing of his films became their unique selling point.
He became a giant on the stage of world cinema with The Seventh Seal, re-released last week in Britain on its 50th anniversary to gushing reviews.
New magazine targets prostitutes
Reuters via CNN:
An exclusive magazine for prostitutes is offering a snapshot of life in some of India's biggest brothels, reporting the murky world of pimps and violent customers and showcasing the dreams and talents of sex workers.
"Red Light Despatch," a monthly publication, is full of emotional outpourings of women sold to brothels as children, personal accounts of torture and harassment, poems and essays by prostitutes, book and film reviews and advocacy articles.
Health workers and prostitutes sit together once a week in a tiny newsroom located inside a brothel in India's financial capital to discuss stories, headlines and the design of issues.
The reporters, often themselves prostitutes or their relatives, file their contribution after scouring the brothels of Mumbai, Kolkata and New Delhi and some smaller cities.
Monday, July 30, 2007
Gustav Mahler: 'Though I sang in my chains like the sea'
A recent performance of the Sixth Symphony at the Sydney Opera House put me in a continuing Mahler mood, as could be expected. This great work imposed its cataclysmic lurch from exaltation to vertiginous despair and its final pizzicato abandonment of hope with the usual directness. However, this time, some vitality and inwardness stayed after the performance, something that countered the tragic import of this most brutal of symphonic works.
My reactions to performances of Mahler's music always vary. There is so much malleable psychic energy in it. Pain and beauty rear and twist in the air with never-to-be-resolved tensions. Dylan Thomas' line from 'Fern Hill'—'Though I sang in my chains like the sea'—seems true to the Mahler soundscape: bound in flesh, yearning for transcendence, alive to the beauty of the world but always aware of looming disaster, the whole threaded with nervelines of alpine respite or ominous farewell. Sometimes the endings are heroic and confident, as in the Second, Third and Eighth symphonies; at other times, as in the Sixth, the final sense is one of exhaustion. Unchained melody liberates from the sheltering sky an apparent freedom to explore the boundless world of our feelings, the Alma-inspired celebrations at the end of the first movement and the hammer blows in the final movement of the Sixth paralleling our own confrontations with fate.
Ever since I was a teenager, I have loved Mahler's music. I remember being at the first Australian performance of Deryck Cooke's performing version of the Tenth at one of the Sydney Proms, conducted by the indefatigable John Hopkins, seeing Solti take the Chicago Symphony through a chilled Ninth, hearing a grave, burnished Seventh with Dean Dixon, near the end of his life, and so much more. Always, new revelations, new orders of feeling.
The sickly young boy from Kalischt who became the director of the Vienna State Opera and universally-admired composer never had easy successes. The struggle to get through the rampant anti-Semitism of his time left markings that eventually led to transatlantic crossings. There were also his own personal tragedies to contend with—the death of his siblings and of his daughter, the diagnosis of his heart disease. Kindertotenlieder, the songs on the death of children, are a lugubrious reminder of Mahler's personal biography. It's hard not to think of Schiele's emaciated figures when listening to them. Though Mahler was triumphant at the Opera, he was particularly vexed at Richard Strauss' musical successes, his own being so much harder-won. Taking up with Alma Schindler, Kokoschka's bride of the wind, wasn't going to lead to a settled existence either. The Mahler world: a combination of sensuality and puritanism, composed by a liberal, conducted by a martinet. What did Mahler want to be when he grew up? 'A martyr' replied the man-child. All of this can be felt in the music. Overriding all is a love of the world and a celebration of the self that is liberating, when, as in the performance of the Sixth in Sydney, the music is given its due.
Mahler's biographer, Henry-Louis de la Grange, may have marked out the life biography comprehensively, but the spiritual biography of the music remains elusive, containing, as it does, so much contradictory and combustible emotional material. I don't believe in the predictive powers of music—I don't think Mahler foresaw the Holocaust. But I do know his music expresses our fears and joys, wonder at nature, spiritual doubts, and splendour. And his music is equal to tragedy, swooping from above, covering all in the shimmer and glint of tremolo, brass fanfare, harp glissando. The wound of life sometimes shrieks or offers praise. Suddenly, all is lost, or won. Summer marches in. Autumn prepares for final things.
Finally driven from Vienna, the Mahlers set up home in New York. A moment I should like to have witnessed. Mahler has just finished a rehearsal of the complete Rachmaninov Piano Concerto No 3 with Rachmaninov at the piano. Just as the orchestra is about to break Mahler insists on a repetition of the entire concerto. Rachmaninov fears an outbreak of 'a taxi for the maestro'. But Mahler gets his way. Just as he makes us listen to his supersized symphonies with their Promethean heights and depths. Perhaps Mahler's feeling for the poetic helps here, the sensitive settings of Des Knaben Wunderhorn and Rückert, a feeling that gets into all of his music. It could all be seen, and sometimes has been, as straining for significance by those who don't like the music. When some cultural product now resembles landfill, how good to have every bar alive with energy and poetry, to find, amid today's contemporary brouhaha, a gold standard for our uncertain leaps to the sublime, in which we don't believe, our slippages into convenient self-approval. However, the price to be paid for this standard was Mahler's relative unsuccess in his own life. The cult of Mahler came later with its cycles of recordings, the Ken Russell film, the festivals and scholarship.
When some are now discontent with their first life, pursuing a second one in cyberspace, Mahler asks that we confront our first life directly, no squirming into an avatar's disguise possible. But Mahler does not make it easy going for us on the journey. He insists on you considering your own seriousness, which some don't want to do.
Vorbei!—it's over—Gustav Klimt commented as the Mahlers left Vienna, bound for New York, the perceived cultural richness of the Sezession beginning to fragment.
But no. A faltering heartbeat. Veni creator spiritus. A drinking song of the earth's sorrow. Resurrection. The great cyclothymic spirals of musical DNA cross, connect and part, forever trying to reconcile the fraught human condition in song, hymn and elegy.
Sir Simon Rattle conducts the end of Mahler's Symphony No 8 with its setting from Goethe's Faust here. The National Youth Orchestra of Great Britain is performing at the 2002 London Proms. 7' 42''
Dispatches: Harry Potter and Hallowed Death
With thanks to M.A., who let me know that I'm not too cool for the Hogwarts School of Witchcraft and Wizardry... see?
Harry Potter? I know, as a self-respecting member of my peer group, I'm supposed to remind everyone that they should be spending their Potter time revisiting something more important - maybe Elements of the Philosophy of Right, or Jude the Obscure? Or, as Alex Balk drolly tells us, Harry Potter is only for children or feeble-minded adults - meanwhile he's reading Michael Ondaatje's latest (damn, son, that's supposed to be better?). There's also this polite version of the dodge, made by formidable HT of That Was Probably Awkward: "I tried to read it, but gave up after twenty pages and am now ensconced in William T. Vollman's amazing Europe Central." Well, la di da, HT.
We can't all be that brainy and stylish. Some of us have become addicted to these books somewhere along the way. In my case it happened after six years of studiously, hiply ignoring the things, until a Potter-mad friend took me to the third movie. Alfonso Cuaron's Harry Potter and the Prisoner of Azkaban is a great children's film, convincing and complete. Most impressive to me was the movie's unabashedly frightening, depressing and even fatalistic tone: from the opening image of Harry reading at night by wandlight to the Munchian creatures ("dementors") who board his train, there was a visceral, dank sense of fearfulness in it that made its happier moments feel that much more thrillingly earned. At that point I went out and read all the books, and while the first two were pretty simple, I (like so many other "adults") found books three through five enthralling. The other movies, too (again excepting the first two), are particularly impressive in the quality of their execution and in the consistent tone imposed by their producers, even while directors come and go, even though their attempts to adapt seven-hundred page novels for the screen necessitate near-fatal overdoses of plot.
The series' setting is not static; it's a slow zoom outwards that reveals more and more of the wizarding world, and as J.K. Rowling continually enlarges it, it comes to resemble our own (often with frustrating new layers of bureaucracy and political pettiness). Through this expansion, the novels provide to adults both a return to the simplicities of childhood, and a return to that adolescent feeling of growth, of increasing knowledge and sophistication: the optimistic mastery of youth. The books also explore the following laudable theme of the bildungsroman: growing up involves demystifying the idea of authority, whether personal or institutional, and learning to act for oneself. Harry's burgeoning awareness that everyone, from the Minister of Magic to the beloved, avuncular Sirius to the big Daddy, Dumbledore himself, is flawed and human is the mark of real change in the books. This is the true story arc, not the episodic pursuit of the monomaniacally evil Voldemort.
Politically, however, the heart of the struggle in Harry Potter is between Voldemort's racialist love of "purebloods" and the liberal multiculturalism of Harry and his allies. It's a reassuring if somewhat superficial multiculturalism, featuring many token characters (Cho, the Patil twins, Kingsley, Seamus), none of whom betrays any difference other than the sound of their names. Harry Potter and the Deathly Hallows even includes a subplot recounting young Dumbledore's regetted flirtation with fascism. It's hard not to read this as a warning about and revision of the pastoral longings of much fantasy literature: for instance, in J.R.R. Tolkien or C.S. Lewis, the sense that monstrous technology wielded by subhuman invaders is to blame for the loss of the world's innocence. Or consider Roald Dahl, another fantastist with strongly nativist politics. Rowling does inherit most of the elements of Tolkien-style Christian allegory, modernizing them around the edges and thankfully dispensing with the donnish snobbery. But the real difference between her and her predecessors is her willingness to think about what happens after the books end, beyond the fantasy. It's the parents' perspective, and genuinely new in the genre.
That's why, at first, Deathly Hallows seems not quite up to the previous standard. Actually, parts of it really aren't up to the previous standard. It often reads like a communiqué to faithful cultist-curators who have grown up (or gotten old) obsessing over the books, rather than with a sense of fresh invitation and invention. The massive popularity of the series, which must have encouraged Rowling to Take Herself Too Seriously, may be to blame. (And don't think that old "It's only a kid's book!" excuse flies - compare it to her best books, Prisoner of Azkaban and Order of the Phoenix.) In Deathly Hallows, after five hundred pages of strangely penitent plot starvation comes an emetic span in which the main storylines, and masses of other loose ends, are tied up within a hundred pages: plot bulimia. And when the novel does move, it's far too often by narrative fiat, or as Sam Anderson puts it: "Rowling has cranked the "coincidence" dial up to eleven and is now flagrantly abusing her "imminent-death-thwarted-at-the-last-possible-moment" privileges." Actually, you know what? Just read Sam's entire reading diary for a nice account of the problems with the novel.
Rowling has always delighted in creating rules, standards and procedures: this curse is unforgivable, this Vow unbreakable, this spell doesn't work in this location, this is a Horcrux, that a Hallow. But she never resolves Deathly Hallows' endless crises with the intricate feats of logical navigation that all these impediments make you expect. Instead, the plot moves ahead in the time-honored but facile way of bad novels: coincidental appearances, secret passageways, and unexpected reversals. It's as if Rowling is reminding us that these are fantasies and she's in charge, playing with events in an almost childlike way. Which, anyway, fits the logic of these novels: encroaching adulthood is a form of death. For Harry, this is literally true. And for the adults: Harry's parents are killed at twenty-one, his older friends (Sirius, Lupin) have their best days behind them, and the rest are schoolteachers or parents of Harry's classmates - incorrigibly second order. Of Rowling's two most textured characters, Severus Snape and Hermione Granger, one reaches death after a life that never surpasses a childhood love's intensity, the other reaches adulthood after a precocious childhood... and we learn no more (sniff!). Rowling's first allegiance is to children: we merely eavesdrop on something that belongs to them.
The promise of death, though, has always animated these books. Deathly Hallows' first epigraph, from Aeschylus, begins with the following lines:
Oh, the torment bred in the race,
the grinding scream of death
and the stroke that hits the vein,
the hemorrhage none can staunch, the grief,
the curse no man can bear.
The epigraph is deliciously scary, but not surprising: we've always known that one of the three friends would die. Wondering which one it would be provided most of the suspense, since you knew the result of the good versus evil conflict wasn't going to surprise you. Finally discovering that they all survive felt like a cheat, a failure of nerve. Thinking about it again, though, this might be a more generous, more brilliant ending. For Rowling is a most prosaic of fantasists: she exults more in the invention and naming of magical pranks than in the political victories of her adults. Her battle scenes and final confrontations are less convincing than her detailing of school culture. Heroism, in Harry Potter, is a mantle to be put back down and forgotten as soon as things are safe. And with the epilogue, Rowling has made clear that her characters, having become mere adults, should make room for their own children's fantasies and marvels, rather than prolonging their own. It disappoints the reader because the dramatic death of Harry or Hermione would prolong the fantasy, in the form of mourning a beloved character who will always remain seventeen. You could stay a kid forever that way. Instead, Rowling, by letting them survive, has written a more mature, more parental ending.
Most fantasy twins the reader and main character: both simultaneously discover and explore an unsuspected world. For the reader, it lies inside the book, for the protagonist, beyond the Shire, or at a faraway school, or, in Lewis' brilliant metaphor, at the back of a wardrobe, between coats spread apart like pages. Losing oneself in the other-world is magic, and fantasy literature's metaphor for the reading process is the plot, a journey to the end. When one completes the book, the magic, as it must, ends and real life beckons - and that lies outside the purview of such books. Rowling, a late and self-conscious practitioner of her genre, includes the closing of the book in her book. Harry grows up, becomes a dad himself. The quest over, he disenchants himself, and, like the rest of us, goes on living.
Below the Fold: Pitching Prescriptions and Patient Empowerment
An elderly couple is at the piano, the wife playing and the husband standing next to her turning the pages of the music. They have been to see their doctor. The husband has Alzheimer’s disease, and he has been prescribed Aricept. The result: he can follow a piano score and turn pages on cue.
Remarkable. For the 5 million suffering from Alzheimer’s and for the several million people who care for them, this television ad offers hope. The message is that high cognitive functioning – reading music, responding to the pianist’s behavioral cues, and turning the pages in time – is within their grasp if Alzheimer’s patients take Aricept. Lulled by a reassuring female voice, the figure of a helpful and informative doctor in a white coat seated with the patient and his spouse, a beautiful house replete with piano, and the figure of a loving couple, they forget (as I admit I do) that the people in the ad are actors. They forget that this ad is no less an act of persuasion than the Mazda “Zoom-zoom.” They forget, or are not told, that the scene is a fake and interaction is scripted. Nor are they told that the results of taking Aricept are modest, and the drug is costly.
Aricept, according to the Alzheimer’s Association, has been approved by the Food and Drug Administration to treat symptoms of mild to severe Alzheimer’s disease. “Its benefit in treating Alzheimer’s,” they write, “is also modest, often described as postponing progression for an average of six months for some, but not all, individuals.” A recent study reported in the New England Journal of Medicine (June 9, 2005) showed that Aricept delayed the onset of Alzheimer’s disease for 12 months among persons already diagnosed as having mild cognitive impairment. As compared with control groups taking a placebo or vitamin E, the small advantage noted for Aricept-takers disappeared by the 3-year end of the study. The investigation was funded by the National Institute on Aging, Eisai, Aricept’s maker, and Pfizer, its promoter.
Aricept is expensive. According to Pillbot.com, a site that gathers current retail prices for drugs sold by major outlets like CVS, Rite Aid, and COSTCO, a 30-day prescription for 10 milligrams of Aricept, the usual dose, costs an average of $134, or $1608 a year. If a patient buys the same dose with a 90-day script, the cost is an average of $368, or $1272 a year.
Aricept, Nexium, Lipitor, Prevacid, Zocor, Viagra, Plavix, Pravachol, Paxil, Ambien, Celexa, Caduet. These brands are among a score or more of the drugs that are advertised during the nightly national news. Sometimes you can switch channels and find the same drug being advertised at the same time.
The pharmaceutical industry in the United States and worldwide is a big business. That’s why its critics (and now some Wall Street analysts too) call it “Big Pharma.” In the United States last year, the pharmaceutical industry grossed $275 billion. To put this figure into perspective, consider that the American people spent more on pharmaceutical drugs than they did on new cars last year.
Product “promotion” is key. No doubt you have noticed pharmaceutical representatives in your doctor’s waiting rooms. Young, clean-cut, always smiling, they are the detailers hoping to get a word in with the doctor before she sees you. Blandishments include those free samples, “starter kits,” of drugs your doctor passes on to you. Big Pharma spent $6.7 billion in 2006 on detailing, and another half a billion dollars a year advertising in professional journals. They spent $4.8 billion on consumer advertising. In all, Big Pharma spent $12 billion to push its products.
Like the old senator used to say: “A billion here, a billion there, and pretty soon it adds up to real money.” It is consoling perhaps to know that there are other industries –11 in fact – that spent more last year on consumer advertising than Big Pharma. They include auto producers and retailers with $20 billion each, and telecom and financial services industries between $8 and $10 billion a piece. Personal care, airlines and hotels, films, media, and restaurant industries spent around $5 billion each last year, as did advertising for non-prescription health remedies.
Against these industries, Big Pharma’s $4.8 billion spent on advertising seems positive prudent – a mere 1.8% of their American revenues, while the auto industry spent the equivalent of 10% of sales on ads.
Getting well, however, is not like buying a Chevrolet. You can’t kick the tires and road-test a drug, even if from time to time you are offered money like a cash back rebate for getting your doctor to prescribe it. Big Pharma knows that its product is unique, and that because few in the audience can understand what the drugs do and how the drugs do it, the companies must sell trust and well-being. They invite us into a world where nothing is fatal – at least not yet – and most illnesses have cures. To build trust and to offer well being, they put actors in white coats, surround actors pretending to be sick with other actors who pretend to be their spouses, children, or grandchildren. The drug world, once the actors pretending to be patients leave the doctor’s office, is a sunny, green, outdoor world. It could be Walden Pond, a corral in Kentucky blue grass country, or a suburban playground filled with beautiful children, one among them the actor portraying someone’s child or grandchild. In the drug world, there is love all around, including a helping hand extended by Big Pharma.
“Ask your doctor about….” Fill in the blank. It is almost always the cut line. And with good reason, because people do. A survey of 784 physicians reported in the 2004 Archives of Internal Medicine conducted by a team headed by Dr. Andrew Robinson found that 80% of the doctors indicated that patients had asked them for prescriptions for specific drugs by name, even though a companion study of 500 Colorado households showed that only 29% of those surveyed thought drug advertising was a good thing. Do as I say, not as I do, those households seem to be saying.
Advertising and a patient’s suggestion seem to work on doctors too. Another study reported in the April 2005 issue of the Journal of the American Medical Association an experiment in which actors pretending to be fatigued were sent to 152 doctors. When they mentioned that they had heard of the antidepressant Paxil, they were five times more likely to be prescribed the drug than if they had made no mention of the drug during the office visit. As a supplemental finding, the study found that 50% of the actors were diagnosed with depression!
Pharmaceutical companies were prohibited from advertising directly to consumers until the Food and Drug Administration in 1997, during the Clinton Administration, gave them the green light. Since then, the FDA with few exceptions has given Big Pharma carte blanche. Its FDA Magazine in the July-August 2004 issue featured a glowing article on the impact of direct consumer advertising. Of the 736 doctors reported surveyed by the FDA, 53% believed that they had better discussions with their patients; 42% felt that their patients had better awareness of treatment options. The article quotes Peter Pitts, then the FDA associate commissioner for external relations: "The goal here is getting truthful, non-misleading information to consumers about safe and effective therapeutic products so they can be partners in their own health care. Better-informed consumers are empowered to choose and use the products we regulate to improve their health." (emphasis mine)
What is the value of empowerment when one is provided a few highly selective facts in a gauzy, feel good frame? One remembers the emotion and the drug name, and probably little else. As far as those better discussions doctors say they are having, one might take this response with a grain of salt, given Dr. Jerome Groopman’s report in his new book, How Doctors Think, that physicians begin making their diagnosis within seconds of seeing their patients.
Doctors no less than their patients are being led along by Big Pharma. Research is sponsored by Big Pharma, and only now are these funding sources mentioned in scientific journals alongside findings. Conferences, seminars, calendars, pads, pens, clipboards, anatomical diagrams, plastic replicas of organs – and even the Friday afternoon staff pizza – are being paid for by Big Pharma. And doctors watch TV too.
Could we ban drug advertising to consumers once again? It would take a revolution at the FDA, an act of Congress, or both. And then, our runaway Supreme Court could outdo itself in ignoring institutional prerogatives and legislative history and proclaim drug advertising an exercise in freedom of speech.
As a practical matter, though, young people don’t even know that cigarette television advertising was banned and the rest of us probably don’t remember much about it either – save that hunky Marlboro man.
It could be done. Knowledge about our health and remedies could acquire a professional filter once again. Rather than the motivation of an emotion and a name, a higher standard of judgment could be applied as to what drugs work, and what drugs are worth the expense. Perhaps it would be a good thing as well to eliminate those junkets for doctors, the detailers’ blandishments, and all of the other inducements carefully placed in our physicians’ paths.
Evening up the odds with Big Pharma -- now that could be empowerment.
perceptions: chaos or choreography?
Harry Callahan. Circus, Chicago, 1955.
Gelatin silver print.
Teaser Appetizer: Sally Does Yoga
I buttoned my white coat, adjusted the stethoscope around my neck, opened the door and entered the examination room.
I hadn’t seen Sally for a few years.
On this day, what I remembered of her was: a high-strung person with recalcitrant belly pains, which I had not been able to palliate, in spite of all available drugs. She suffered from irritable bowel syndrome of unusual severity, which responded neither to neglect nor therapy.
There she was: sitting on the examination table wearing a bright orange shirt, smiling under the bight fluorescent light.
I extended my hand. “How are you, Sally? How long has it been?”
Seven or eight years” she said, shaking my hand
“ Nice to see you again.” I said.
Looking at her medical chart, the last entry eight years ago showed she took four different kinds of drugs for intestinal colic relief.
“What medicines are you taking now?”
“None” She replied
“How come?” I was surprised.
“You told me to meditate and I did. My pain got better and I stopped taking pills.”
My jaw would have dropped at this miracle, if I hadn’t learned the Marcus Welby technique of suppressing astonishment.
I had not written ‘meditation’ in her chart but I had no reason to disbelieve her.
I recalled having told her to meditate, not out of conviction, but out of sheer frustration, as she had responded to none of the chemicals that I had loaded her with.
And meditation had worked! She told me that she wanted to help others and wanted to know the opportunities in the field. “Surely” she said, “ some aspect of meditation has not been exploited yet.”
Before I talk any further about Sally’s visit, I will summarize what we know about ‘meditation.’
‘Meditation’ is but one of the many steps in Yoga, a metaphysical technique developed over thousands of years in ancient India. Patanjali, a sage, who probably lived around 200 BC, compressed all that was practiced and known at his time into 195 aphorisms - known as Yoga Sutra. Nothing much has changed in the essence of this philosophy and all the variations of Yoga and meditation that are popular now emanate from this original source.
Yoga philosophy says, mind exists in four states: awake, sleep, dream and a state called ‘Thuriya’ - a Sanskrit word - which simply translates into “fourth’ state, where the mind is a pure ‘consciousness and bliss’ and devoid of thoughts. The aim of Yoga - which means ‘to unite’- is to reach this fourth state of mind and be one with the ‘ultimate reality’ which they called ‘Brahman.” The practice is hard, takes many years and only a few succeed.
Patanjali describes eight steps to calm and discipline the mind to arrive at the ‘fourth state’. The commercial ‘ gurus’ emphasize usually just one of the eight steps to create their own brand of ‘Yoga’ and differentiate themselves form other competing ‘gurus.’ The eight steps are:
1. ‘Yama’ (Sanskrit): Abstain from violence, covetousness, sexual indulgence and greed. The first two steps are not different from the teachings of other religious systems, but in Yoga, this is just a prelude, a beginner’s exercise to calm the mind, which prepares the novice for next steps.
2. ‘Niyama’: Practice purity, contentment, austerity, introspection and devotion. These two steps are the most important but least popular. They also have no commercial value for entrepreneurs - no customer pays for advice to abstain from sex and greed.
3. ‘Asana’: Posture exercises to make the supple and flexible. Also called ‘Hatha Yoga’ -- this is the money making venture for the Yoga entrepreneurs. The contorted bodies of leotard hugging figures makes it a visual treat on an advertisement poster. The gyms, strip mall Yoga centers and unemployed celebrities have popularized this step for weight reduction, beauty enhancement and muscle toning.
4. ‘Pranayama’: Control of breath and breathing techniques. In yoga system breath is akin to the basic life source and perfect breathing technique can restore health. Nose is the primary inlet - outlet and abdominal muscles are superior to chest muscles to for breathing action. This step is also popular with the entrepreneurs, who use variations in breathing technique to establish their superior value. Faster breathing, slower breathing, exhaling against a closed glottis (Valsalva maneuver) and use of only abdominal muscles are some of the branded methods. These techniques may have immediate perceptible effects like slowing the heart rate by Valsalva maneuver or dizziness due to hyperventilation, which may impress the gullible customer.
5. “Pratihara’: Withdrawal of mind from the sensory stimulation. Monks and sages have retreated into monasteries, forests, mountains and holy cities to get away from the mundane distractions of the daily world.
6. ‘Dharana’: Concentration on a single object. Once the practitioner is adept in the in the first five aspects, it is time to practice contemplating on a single object, which could be a sound, breath, a syllable (Mantra) or even a common object like a candle.
7. ‘Dhyana’: The practitioner with a supple body, proper breathing technique, without distractions can now sit quietly in a silent place and contemplate. She tries to ignore the constantly erupting thoughts and concentrate on a single object. With practice the meditation sessions get longer and the mind becomes more thoughtless and she may rarely slip into the next stage of bliss.
In the commercial world, where execution speed is of value, a novice is initiated into this stage without prior preparation. The benefit to the customer is weak but the revenue stream is strong, which propels the Yoga centers oversell “meditation.’
8. ‘Samadhi’: Super conscious fourth state or bliss. A miniscule number of lucky meditators finally arrive at this level. Scientists who have worked on subjects reaching this stage have quoted the feeling of subjects in this stage as rapturous, tremulous and experience unprecedented bliss. Thoughts settle into a state of pure awareness and the observer, observed and the process of observation merge into one. The experience of deep meditation has encouraged articulate writers to give it a spin and compare this state with happenings at the “quantum” level and describe intriguing similarities to the uncertainty principle and even Bell’s theorem.
Does Yoga help health and well-being? Numerous scientific studies in the last 70 years have collected evidence that the practice of Yoga affects the body in many ways. Here is the summary of some salient findings.
--Heart rate slows during peaceful meditation and accelerates in moments of ecstasy. There are stories about the adept yogis stopping the heart in trance. Studies have shown, while the pulse may not be palpable, the EKG continues to show the electric activity.
--Meditation lowers systolic blood pressure in normal or people with mild hypertension, to the extent of 25 mmHg. Combination with other relaxation techniques, like biofeedback is more effective than meditation alone and the effect disappears if meditation is discontinued.
--Many studies have shown that meditators reduce the respiration rate; oxygen consumption, carbon dioxide elimination and can sometimes suspend breathing for longer periods compared to control subjects, without ill effects.
--Muscle tension decreases and the brain electric activity (EEG) show frequent slow high amplitude alpha waves. Experienced meditators and those nearing ecstasy show bursts of faster waves rising from in the front brain. Epileptic like activity without the seizures in the temporal lobe on the side of the brain has prompted speculations that this part of the brain is the seat of religious experience.
--Adrenal hormones, lactate and cholesterol may decrease.
--Pain perception decreases and significant psychological improvements can occur in people suffering from chronic pain.
--Long-term meditators acquire a sense of equanimity, sensory detachment from the outer world and a growing sense of being a witness to their bodies.
--Controversy exists about improvement in memory, intelligence, and short-term concentration, though experienced meditators can control intrusion of irrelevant thoughts.
--Negative effects accompany positive benefits with any intervention and Yoga is no different. In a survey done in 1984 at Stanford, from 4 to 9 % long-term meditators reported adverse effects of anxiety, confusion, depression, emotional instability, frustration, suspiciousness, and withdrawal. In other studies, meditators have reported illusions, hallucinations, relapse of schizophrenia and suicidal thoughts. These effects correlate with the length and depth of mediation. The ancient texts describe Yoga path as “sharp like a razor’s edge.” For serious long-term practitioners, the tradition strongly recommends guidance of an experienced teacher.
Now, I come back to Sally. Meditation had relieved her from constant pain and drug dependence; it had given a freedom from chemical crutches. She had explored various commercial angles and had decided that writing a self – help book would have a larger market. She wanted me to co-author the book. I explained to her that, trained in the ‘scientific’ medicine, we have an acquired contempt for anything ‘eastern’ or ‘herbal” and we do not normally mention or commit such acts - that smack of quackery - in our medical practices.
“But surely you helped me and we could help others. Why would you not help?” She protested.
“It is plain prejudice, euphemistically called bias.” I said.
“ And what will be the title of your book?” I enquired.
“ Meditate, Don’t Medicate.” She announced.
Sunday, July 29, 2007
Old Fourlegs Revisited
Carl Zimmer in his blog, The Loom:
Last week the world press took note of a fish hauled up off the coast of Zanzibar. (AP, Reuters). Why did they care? Because the animal was one of the most celebrated fish of the sea: it was a coelacanth.
The coelacanth is an ugly, bucket-mouthed creature. At first scientists only knew it from its fossils, the youngest of which was 70 million years old. In 1938, however, a flesh-and-blood coelacanth was dredged up near East London, South Africa. The five-foot long beast had many of the hallmarks of fossil coelacanths, such as hollow spines in their vertebrae, peculiar lobe-shaped fins, and a joint dividing its eye and "nose" from its brain and ears. The coelacanth became a celebrity
in the, hailed as a "living fossil."
Its fame was reinforced by its elusiveness. It was not until 1952 that a biologist found a second coelacanth, caught this time off the Comoros Islands. Scientists chased the coelacanth so doggedly in part because of what it might reveal about ourselves. Fossils of the coelacanth lineage dated back over 300 million years to the Devonian Period. They belonged to the same group of fishes as our own ancestors (known now as lobe-fins). While the ancestors of coelacanths stayed in the water, our own fishy ancestors climbed on land and evolved into mammals, birds, reptiles, and amphibians. (See my book At the Water's Edge for more on this transition.)
RISE OF ROBOETHICS
Lee Billings in Seed Magazine:
In April, the government of Japan released more than 60 pages of recommendations to "secure the safe performance of next-generation robots," which called for a centralized database to log all robot-inflicted human injuries. That same month, the European Robotics Research Network (EURON) updated its "Roboethics Roadmap," a document broadly listing the ethical implications of projected developments like robotic surgeons, soldiers, and sex workers. And in March, South Korea provided a sneak peek at its "Robot Ethics Charter" slated for release later in 2007. The charter envisioned a near future wherein humans may run the risk of becoming emotionally dependent on or addicted to their robots.
The close timing of these three developments reflects a sudden upswing in international awareness that the pace of progress in robotics is rapidly propelling these fields into uncharted ethical realms. Gianmarco Veruggio, the Genoa University roboticist who organized the first international roboethics conference in 2004, says, "We are close to a robotics invasion."
Gary Snyder, Robert Hass, Wendell Berry
This Shoemaker & Hoard Poetry series features interviews and readings with three American poets/writers whose works have shaped and enhanced contemporary poetics: Gary Snyder, Robert Hass, and Wendell Berry. These recordings were brought to you by Shoemaker & Hoard, Publishers, and the interviews were conducted by host Joanne Greene.
Eternity for Atheists
Jim Holt in the New York Times Magazine:
If God is dead, does that mean we cannot survive our own deaths? Recent best-selling books against religion agree that immortality is a myth we ought to outgrow. But there are a few thinkers with unimpeachable scientific credentials who have been waving their arms and shouting: not so fast. Even without God, they say, we have reason to hope for — or possibly fear — an afterlife.
Curiously, the doctrine of immortality is more a pagan legacy than a religious one. The notion that each of us is essentially an immortal soul goes back to Plato. Whereas the body is a compound thing that eventually falls apart, Plato argued, the soul is simple and therefore imperishable. Contrast this view with that of the Bible. In the Old Testament there is little mention of an afterlife; the rewards and punishments invoked by Moses were to take place in this world, not the next one. Only near the beginning of the Christian era did one Jewish sect, the Pharisees, take the afterlife seriously, in the form of the resurrection of the body. The idea that “the dead shall be raised” was then brought into Christianity by St. Paul.
The Judeo-Christian version of immortality doesn’t work very well without God: who but a divine agent could miraculously reconstitute each of us after our death as a “spiritual body”? Plato’s version has no such need; since our platonic souls are simple and thus enduring, we are immortal by nature.
Translating Zbigniew Herbert
Yes, a few of us here at 3QD deeply love Zbigniew Herbert. In the NYT:
[F]or most of us, discovering “the Poland that is real” means reading works translated from Polish. The most significant such translation this year — possibly in many years — is Zbigniew Herbert’s “Collected Poems, 1956-1998” (Ecco/HarperCollins, $34.95), translated by Alissa Valles, which was published in February to (almost) universal acclaim. The book is significant for two reasons. First, Herbert himself is significant — like Frost and Auden, he’s a poet whose failure to win the Nobel Prize says more about the prize committee than about the writer. Second, his poetry is relatively difficult to find. Although most of Herbert’s collections have been translated by John and Bogdana Carpenter, many of those books are now out of print. For the casual reader, then, this “Collected Poems” is the likeliest path to this poet’s achievement.
That achievement is well worth the journey. Along with Tadeusz Rozewicz, Wislawa Szymborska and Czeslaw Milosz, Herbert is one of the principal figures in postwar Polish poetry — and by extension, in European letters generally. Born in 1924, he was active in the Polish resistance during the German occupation, then became an admirably uncooperative citizen of the subsequent Soviet puppet state. (According to a recent article in Süddeutsche Zeitung, whenever Herbert was asked by the secret police to write up reports on foreign trips, he would fill them “with interpretations of the poems of the Nobel Prize laureate Czeslaw Milosz ... as well as long-winded cultural-philosophical observations.”)
Andreas Huyssen on Gunter Grass
In The Nation:
I, too, felt betrayed by a literary idol of my youth when I first heard about Grass's membership in the Waffen SS. I, too, was tempted to ride the moral high horse: How could Grass, famous since the 1960s for accusing high officials in the West German government of hiding their Nazi past and insisting on public penance, keep this secret for so long? How could he have left even his biographers with the assumption that, like so many other teenagers in 1944-45, he served only as a Flakhelfer, a youth conscript, rather than as a member of the Waffen SS? And why reveal it now, just as his memoir was hitting the market? Was it the need of a writer approaching his 80th birthday to come clean, or was it a clever marketing strategy? Or was it simply his wish, as he claims unapologetically in the memoir, to have the last word, denying his many opponents the pleasure of finding out first? For discovery was inevitable. The POW papers documenting his Waffen SS membership are unambiguous. It was just that nobody, not even his biographers, had bothered to check the details.
The reasons for Grass's silence lie safely hidden in the memoir. And in his public statements since Peeling the Onion was published in Germany late last summer, he has been no more forthcoming about his decision to remain silent about this aspect of his past, further fueling the outrage of his critics (not a few of them disappointed admirers). To many, his legacy not just as a public intellectual but as a writer has been seriously damaged. After my initial reaction, however, I felt increasingly reluctant to point the finger at someone whose self-righteous moralizing about German politics had annoyed me time and again over the past few decades--particularly his stubborn insistence on the division of Germany as permanent penance for the crimes of Nazism and his often shrill anti-Americanism. To moralize about Grass's lack of candor just seemed too easy.
A Civil War Among the Jihadis?
There is a widening split between armed Islamists, as two recent incidents show. In March the local Taliban in the Pakistani tribal zone of South Waziristan killed foreign fighters from the al-Qaida-affiliated Islamic Movement of Uzbekistan. Almost simultaneously, infighting broke out between the Islamic Army in Iraq and the local branch of al-Qaida. The confrontation between the two strategies – and two different ideologies – of the Islamist struggle is getting more violent.
Many of the foreign volunteers who have flooded into Pakistan and Iraq since 2003 are Takfirists, who regard “bad Muslims” as the real enemy (see ‘Takfirism: a messianic ideology’). Indigenous Islamic resistance groups have reacted uncomfortably to the growth of this near-heresy within al-Qaida which, by waging war against Muslim governments, has brought chaos to the populations it claims to defend.
Adam in wonderland
From The Guardian:
Adam Gopnik, who has been writing for the New Yorker since 1986, is best known for his book Paris to the Moon, a collection of dispatches from the French capital which he wrote from 1995 to 2000. It's a beautiful book. Gopnik is a brilliant writer in any case - warm, witty, wise and learned - but his outsider status in France brought something extra to proceedings: a certain beadiness, perhaps. Now here's another book about a city, New York, to which he and his wife and their two children returned seven years ago and, to a degree, his outsider status is intact. Gopnik, though an American, grew up in Canada, and first came to New York, eyes on stalks, as a boy and then, to live, as a postgraduate.
For him, New York is not so much home as the ultimate achievement. But even if this were not so, as he points out right at the start, it's impossible to 'own' New York, even if its canyons are imprinted on your DNA. As a boy, he found the idea of it so wonderful that he could only ever imagine it as 'some other place, greater than any place that would let me sleep in it'. Installed in his great aunt Hannah's Riverside Drive apartment, the city was still a distant constellation of lights that he had not yet been allowed to visit. 'Ever since, New York has existed for me simultaneously as a map to be learned and a place to aspire to - a city of things and a city of signs, the place I actually am and the place I would like to be even when I am here.'
Anyone who has ever visited New York will recognise this feeling, but still, it's reassuring to have it articulated by one so urbane and clever.
Saturday, July 28, 2007
Gaden S. Robinson reviews two new books on bees, in TLS:
Man's obsession with the bee, for that is what it is, is founded on two most profitable premisses, honey and wax. The former is the sweetest natural substance widely available (Wilson points out that dates are sweeter) -it is a luxury in any society and was treasured throughout recorded history, its popularity only waning slightly with the advent of cheap sugar. The use of beeswax for candles, an obviously later innovation than the use of honey as a food, was a significant step forward in lighting technology. Beeswax burns cleanly and brightly with a steady flame and a pleasant smell, all features distinctly wanting in candles or wick-lamps burning animal fats or oils.
It is probable that man's taste for honey can be traced deep into his primate ancestry.
Gorillas and chimpanzees raid bees' nests as do monkeys and baboons. The Asian sun bear's claws may be adapted as much for breaking into hollow trees to feed on honey as to find insect larvae. And an African bird, the honeyguide, has evolved calls and behaviour to lure ratels or honey badgers to a bees' nest.
Jen Stark. Paper Anomaly. 2007. 12"x12"Construction paper.
More here from Cabinet.