Clinical Governance Quotes

The first task of the doctor is ... political: the struggle against disease must begin with a war against bad government." Man will be totally and definitively cured only if he is first liberated...

In Venezuela Chavez has made the co-ops a top political priority, giving them first refusal on government contracts and offering them economic incentives to trade with one another. By 2006, there were roughly 100,000 co-operatives in the country, employing more than 700,000 workers. Many are pieces of state infrastructure – toll booths, highway maintenance, health clinics – handed over to the communities to run. It’s a reverse of the logic of government outsourcing – rather than auctioning off pieces of the state to large corporations and losing democratic control, the people who use the resources are given the power to manage them, creating, at least in theory, both jobs and more responsive public services. Chavez’s many critics have derided these initiatives as handouts and unfair subsidies, of course. Yet in an era when Halliburton treats the U.S. government as its personal ATM for six years, withdraws upward of $20 billion in Iraq contracts alone, refuses to hire local workers either on the Gulf coast or in Iraq, then expresses its gratitude to U.S. taxpayers by moving its corporate headquarters to Dubai (with all the attendant tax and legal benefits), Chavez’s direct subsidies to regular people look significantly less radical.

All American politicians are bought and paid for by American lobbyists. We no longer have representative government here. We breed monsters like Kissinger and Nixon and Ronnie Reagan. Our senate and congress are run by pay-offs and special interest money. And the fun part is that most Americans are asleep about it. Give 'em a new SUV and a good J-Lo or Tom Cruise kung-fu flick and a few jolly abortion clinic bombing news clips on the six o'clock news and everybody seems to stay content. Wasn't it Churchill that said any society gets exactly the government it deserves?

The major goal of the Cold War mind control programs was to create dissociative symptoms and disorders, including full multiple personality disorder. The Manchurian Candidate is fact, not fiction, and was created by the CIA in the 1950’s under BLUEBIRD and ARTICHOKE mind control programs. Experiments with LSD, sensory deprivation, electro-convulsive treatment, brain electrode implants and hypnosis were designed to create amnesia, depersonalization, changes in identity and altered states of consciousness. (p. iii) “Denial of the reality of multiple personality by these doctors [See page 114 for names] in the mind control network, who are also on the FMSF [False Memory Syndrome Foundation] Scientific and Professional Advisory Board, could be disinformation. The disinformation could be amplified by attacks on specialists in multiple personality as CIA conspiracy lunatics” (P.10) “If clinical multiple personality is buried and forgotten, then the Manchurian Candidate Programs will be safe from public scrutiny. (p.141)

But it’s not enough just to discuss things. We are the elites. We can’t just talk about human rights, while we conveniently forget that we condemn thousands of children to die because we couldn’t agree on the best policy to help. Or in my government, if we can’t agree on a pay cut so that a little clinic out in the country can be built. Those kinds of choices make us part of the international complicity of men of good conscience.

When he moved to New York after college, in the eighties, Arthur Less tried his hardest to be a good gay. He joined a gym that turned out to be a sex dungeon. He joined a political party that turned out to believe a conspiracy theory about government health clinics. He joined a German-language society that turned out to be a sex dungeon. He joined a book group that turned out to be only for a political party. He joined a role-playing game club that turned out to be a sex dungeon. He joined a sex dungeon that turned out to be a government health clinic. It was all so confusing.

Our plutocracy, whether the hedge fund managers in Greenwich, Connecticut, or the Internet moguls in Palo Alto, now lives like the British did in colonial India: ruling the place but not of it. If one can afford private security, public safety is of no concern; to the person fortunate enough to own a Gulfstream jet, crumbling bridges cause less apprehension, and viable public transportation doesn’t even compute. With private doctors on call and a chartered plane to get to the Mayo Clinic, why worry about Medicare?

The Conservative government decided to “merge” John’s clinic with a new health trust, run by evangelical Christians who opposed prescription on principle. The patients panicked, because they knew what being cut off would mean—a return to abscesses and overdoses and scrambling for drugs from gangsters.

You can tell a lot about a country by its prisons. In hippy-dippy Socialist Sweden, rapists and murders (all three of them) while away their days making arts and crafts in what are essentially taxpayer-funded mental health clinics. The Swedes’ theory seems to be that a) anyone who commits such a crime must be crazy and b) with enough art therapy, the individual in question will soon become just another law-abiding, nude-sunbathing pot-smoker. In America, we think people in prison are either the victims of some terrible government conspiracy, the victims of “society”—whatever that means—or heinous evildoers. And if they are heinous enough, we fry them with electricity, unless of course they find Jesus first. The Swedes, in a nutshell, are tolerant and forgiving, verging on the naïve; Americans are religious and vengeful, suspicious of their government, and suckers for tear-jerking tales of redemption.

With this warning, Mussolini demanded and was given authority to do just about whatever he wanted; but his initial priority, surprisingly, was good government. He knew that citizens were fed up with a bureaucracy that seemed to grow bigger and less efficient each year, so he insisted on daily roll calls in ministry offices and berated employees for arriving late to work or taking long lunches. He initiated a campaign to drenare la palude (“drain the swamp”) by firing more than 35,000 civil servants. He repurposed Fascist gangs to safeguard rail cargo from thieves. He allocated money to build bridges, roads, telephone exchanges, and giant aqueducts that brought water to arid regions. He gave Italy an eight-hour workday, codified insurance benefits for the elderly and disabled, funded prenatal health care clinics, established seventeen hundred summer camps for children, and dealt the Mafia a blow by suspending the jury system and short-circuiting due process. With no jury members to threaten and judges answerable directly to the state, the courts were as incorruptible as they were docile. Contrary to legend, the dictator didn’t quite succeed in making the trains run on time, but he earned bravos for trying.

to be recorded as they were under normal circumstances. Just beyond the public areas lay a sprawling multifloor substructure of 153 classified rooms, including a massive power plant, medical clinic, dentist’s office, a 400-seat cafeteria, laundry facilities, three 25,000-gallon water tanks, and three 14,000-gallon fuel tanks, as well as a two-story communication facility for incoming and outgoing messages.

In 2003, a Dutch clinical psychologist named Christof van Nimwegen began a fascinating study of computer-aided learning that a BBC writer would later call “one of the most interesting examinations of current computer use and the potential downsides of our increasing reliance on screen-based interaction with information systems.”26 Van Nimwegen had two groups of volunteers work through a tricky logic puzzle on a computer. The puzzle involved transferring colored balls between two boxes in accordance with a set of rules governing which balls could be moved at which time. One of the groups used software that had been designed to be as helpful as possible. It offered on-screen assistance during the course of solving the puzzle, providing visual cues, for instance, to highlight permitted moves. The other group used a bare-bones program, which provided no hints or other guidance. In the early stages of solving the puzzle, the group using the helpful software made correct moves more quickly than the other group, as would be expected. But as the test proceeded, the proficiency of the members of the group using the bare-bones software increased more rapidly. In the end, those using the unhelpful program were able to solve the puzzle more quickly and with fewer wrong moves. They also reached fewer impasses—states in which no further moves were possible—than did the people using the helpful software. The findings indicated, as van Nimwegen reported, that those using the unhelpful software were better able to plan ahead and plot strategy, while those using the helpful software tended to rely on simple trial and error. Often, in fact, those with the helpful software were found “to aimlessly click around” as they tried to crack the puzzle.

Audio of interview - http://www.youtube.com/watch?feature=... "it's not surprising that in that first group I worked with over 20 years ago I had 2 accounts of Jimmy Savile being an abuser where I did support some people to go to the police but it was seen as something impossible to consider at the time." "We have improved a lot as a society in the last 20 years in accepting the reality of abuse, even though it's still so hard for us." "When we look at adults who were abused in childhood we find that nearly all of them had told somebody..." "The culture of the police has changed dramatically but 20 years ago when even counselors and social workers didn't think the abuse could be so widespread the police were obviously part of that culture too. I mean it's hard to realise that in the 1980s there was a point where it was thought that there were only 486 children on the abuse register. Now the government accepts that 1 in 4 adults will have been abused at some point in their lives. That is a huge change." "This is really different for any survivors listening now if a police officer doesn't listen sympathetically and offer a believing response then something has gone wrong because the police really do have this in their guidelines now." - Dr Valerie Sinason, Clinic for Dissociative Studies, London

Now sensitiveness to the state of mind of the public is a difficult thing to achieve or maintain. Any man can tell you with more or less accuracy and clearness his own reactions on any particular issue. But few men have the time or the interest or the training to develop a sense of what other persons think or feel about the same issue. In his own profession the skilled practitioner is sensitive and understanding. lhe lawyer can tell what argument will appeal to court or jury. “The salesman can tell what points to stress to his prospective buyers. The politician can tell what to emphasize to his audience, but the ability to estimate group reactions on a large scale over a wide geographic and psychological area is a specialized ability which must be developed with the same painstaking self-criticism and with the same dependence on experience that are required for the development of the clinical sense in the doctor or the surgeon. The significant revolution of modern times is not industrial or economic or political, but the revolution which is taking place in the art of creating consent among the governed. Within the life of the new generation now in control of affairs, persuasion has become a self-conscious art and a regular organ of popular government. None of us begins to understand the consequences, but it is no daring prophecy to say that the knowledge of how to create consent will alter every political premise. Under the impact of propaganda, not necessarily in the sinister meaning of the world alone, the only constants of our thinking have become variables. It is no longer possible, for example, to believe in the cardinal dogma of democracy that the knowledge needed for the management of human affairs comes up spontaneously from the human heart. Where we act on that theory we expose ourselves to self-deception and to farms of persuasion that we cannot verify. It has been demonstrated that we cannot rely upon intuition, conscience or the accidents of casual opinion if we are to deal with the world beyond our reach.

At the same time that he was devising a response to the Afghanistan incursion, Carter had to confront a much more acute crisis in Iran, where he had brought the greatest disaster of his presidency down upon himself. In November 1977, he welcomed the shah of Iran to the White House, and on New Year’s Eve in Tehran, raising his glass, he toasted the ruler. Though the shah was sustained in power by a vicious secret police force, Carter praised him as a champion of “the cause of human rights” who had earned “the admiration and love” of the Iranian people. Little more than a year later, his subjects, no longer willing to be governed by a monarch imposed on them by the CIA, drove the shah into exile. Critically ill, he sought medical treatment in the United States. Secretary of State Cyrus Vance warned that admitting him could have repercussions in Iran, and Carter hesitated. But under pressure from David Rockefeller, Henry Kissinger, and the head of the National Security Council, Zbigniew Brzezinski, he caved in. Shortly after the deposed shah entered the Mayo Clinic, three thousand Islamic militants stormed the US embassy compound in Tehran and seized more than fifty diplomats and soldiers. They paraded blindfolded US Marine guards, hands tied behind their backs, through the streets of Tehran while mobs chanted, “Death to Carter, Death to the Shah,” as they spat upon the American flag and burned effigies of the president—scenes recorded on camera that Americans found painful to witness.

In March, while people were dying at the rate of 10,000 patients a week, Dr. Fauci declared that hydroxychloroquine should only be used as part of a clinical trial.104 For the first time in American history, a government official was overruling the medical judgment of thousands of treating physicians, and ordering doctors to stop practicing medicine as they saw fit. Boldly and relentlessly, Dr. Fauci kept declaring that “The Overwhelming Evidence of Properly Conducted Randomized Clinical Trials Indicate No Therapeutic Efficacy of Hydroxychloroquine (HCQ).”105 Dr. Fauci failed to disclose that NONE of the trials he had used as the basis for that pronouncement involved medication given in the first five to seven days after onset of symptoms. Instead, all of those randomized controlled trials targeted patients who were already sick enough to be hospitalized.

Liquor, guns, motorcycle helmets (legislation had gone back and forth on that)—mainly white masculine pursuits—are fairly unregulated. But for women and black men, regulation is greater. Within given parameters, federal law gives women the right to decide whether or not to abort a fetus. But the state of Louisiana has imposed restrictions on clinics offering the procedure, which, if upheld in the U.S. Supreme Court, would prevent all but one clinic, in New Orleans, from offering women access to it. Any adult in the state can also be jailed for transporting a teenager out of state for the purposes of an abortion if the teen has not informed her parents. Young black males are regulated too. Jefferson Davis Parish passed a bill banning the wearing of pants in public that revealed "skin beneath their waists or their underwear" and newspaper accounts featured images, taken from the back, of two black teenage boys exposing large portions of their undershorts. The parish imposed a $50 fine for a first offense and $100 for a second.

What are the health effects of the choice between austerity and stimulus? Today there is a vast natural experiment being conducted on the body economic. It is similar to the policy experiments that occurred in the Great Depression, the post-communist crisis in eastern Europe, and the East Asian Financial Crisis. As in those prior trials, health statistics from the Great Recession reveal the deadly price of austerity—a price that can be calculated not just in the ticks to economic growth rates, but in the number of years of life lost and avoidable deaths. Had the austerity experiments been governed by the same rigorous standards as clinical trials, they would have been discontinued long ago by a board of medical ethics. The side effects of the austerity treatment have been severe and often deadly. The benefits of the treatment have failed to materialize. Instead of austerity, we should enact evidence-based policies to protect health during hard times. Social protection saves lives. If administered correctly, these programs don’t bust the budget, but—as we have shown throughout this book—they boost economic growth and improve public health. Austerity’s advocates have ignored evidence of the health and economic consequences of their recommendations. They ignore it even though—as with the International Monetary Fund—the evidence often comes from their own data. Austerity’s proponents, such as British Prime Minister David Cameron, continue to write prescriptions of austerity for the body economic, in spite of evidence that it has failed. Ultimately austerity has failed because it is unsupported by sound logic or data. It is an economic ideology. It stems from the belief that small government and free markets are always better than state intervention. It is a socially constructed myth—a convenient belief among politicians taken advantage of by those who have a vested interest in shrinking the role of the state, in privatizing social welfare systems for personal gain. It does great harm—punishing the most vulnerable, rather than those who caused this recession.

The city had changed beyond recognition. Wrecking balls and bulldozers had leveled the old buildings to rubble. The dust of construction hung permanently over the streets. Gated mansions reached up to the northern foothills, while slums fanned out from the city’s southern limits. I feared an aged that had lost its heart, and I was terrified at the thought of so many useless hands. Our traditions were our pacifiers and we put ourselves to sleep with the lullaby of a once-great civilation and culture. Ours was the land of poetry flowers, and nightingales—and poets searching for rhymes in history’s junkyards. The lottery was our faith and greed our fortune. Our intellectuals were sniffing cocaine and delivering lectures in the back rooms of dark cafés. We bought plastic roses and decorated our lawns and courtyards with plaster swans. We saw the future in neon lights. We had pizza shops, supermarkets, and bowling alleys. We had trafric jams, skyscrapers, and air thick with noise and pollution. We had illiterate villagers who came to the capital with scraps of paper in their hands, begging for someone to show them the way to this medical clinic or that government officee. the streets of Tehran were full of Mustangs and Chevys bought at three times the price they sold for back in America, and still our oil wasn’t our own. Still our country wasn’t our own.

WHY ADDICTION IS NOT A DISEASE In its present-day form, the disease model of addiction asserts that addiction is a chronic, relapsing brain disease. This disease is evidenced by changes in the brain, especially alterations in the striatum, brought about by the repeated uptake of dopamine in response to drugs and other substances. But it’s also shown by changes in the prefrontal cortex, where regions responsible for cognitive control become partially disconnected from the striatum and sometimes lose a portion of their synapses as the addiction progresses. These are big changes. They can’t be brushed aside. And the disease model is the only coherent model of addiction that actually pays attention to the brain changes reported by hundreds of labs in thousands of scientific articles. It certainly explains the neurobiology of addiction better than the “choice” model and other contenders. It may also have some real clinical utility. It makes sense of the helplessness addicts feel and encourages them to expiate their guilt and shame, by validating their belief that they are unable to get better by themselves. And it seems to account for the incredible persistence of addiction, its proneness to relapse. It even demonstrates why “choice” cannot be the whole answer, because choice is governed by motivation, which is governed by dopamine, and the dopamine system is presumably diseased. Then why should we reject the disease model? The main reason is this: Every experience that is repeated enough times because of its motivational appeal will change the wiring of the striatum (and related regions) while adjusting the flow and uptake of dopamine. Yet we wouldn’t want to call the excitement we feel when visiting Paris, meeting a lover, or cheering for our favourite team a disease. Each rewarding experience builds its own network of synapses in and around the striatum (and OFC), and those networks continue to draw dopamine from its reservoir in the midbrain. That’s true of Paris, romance, football, and heroin. As we anticipate and live through these experiences, each network of synapses is strengthened and refined, so the uptake of dopamine gets more selective as rewards are identified and habits established. Prefrontal control is not usually studied when it comes to travel arrangements and football, but we know from the laboratory and from real life that attractive goals frequently override self-restraint. We know that ego fatigue and now appeal, both natural processes, reduce coordination between prefrontal control systems and the motivational core of the brain (as I’ve called it). So even though addictive habits can be more deeply entrenched than many other habits, there is no clear dividing line between addiction and the repeated pursuit of other attractive goals, either in experience or in brain function. London just doesn’t do it for you anymore. It’s got to be Paris. Good food, sex, music . . . they no longer turn your crank. But cocaine sure does.

By April 23, 2014, thirty-four cases and six deaths from Ebola in Liberia were recorded. By mid-June, 16 more people died. At the time it was thought to be malaria but when seven more people died the following month tests showed that was the Ebola virus. The primary reason for the spreading of the Ebola virus was the direct contact from one person to the next and the ingesting of bush meat. Soon doctors and nurses also became infected. On July 2, 2014, the head surgeon of Redemption Hospital was treated at the JFK Medical Center in Monrovia, where he died from the disease. His death was followed by four nurses at Phebe Hospital in Bong County. At about the same time two U.S. health care workers, Dr. Kent Brantly and a nurse were also infected with the disease. However, they were medically evacuated from Liberia to the United States for treatment where they made a full recovery. Another doctor from Uganda was not so lucky and died from the disease. Arik Air suspended all flights between Nigeria and Liberia and checkpoints were set up at all the ports and border crossings. In August of 2014, the impoverished slum area of West Point was cordoned off. Riots ensued as protesters turned violent. The looting of a clinic of its supplies, including blood-stained bed sheets and mattresses caused the military to shoot into the crowds. Still more patients became infected, causing a shortage of staff and logistics. By September there had been a total of 3,458 cases of which there were 1,830 deaths according to the World Health Organization. Hospitals and clinics could no longer handle this crisis and patients who were treated outside died before they could get help. There were cases where the bodies were just dumped into the Mesurado River. The Ivory Coast out of compassion, opened carefully restricted humanitarian routes and resumed the previously suspended flights to Liberia. Ellen Johnson Sirleaf the president of Libera sent a letter to President Barack Obama concerning the outbreak of Ebola that was on the verge of overrunning her country. The message was desperate, “I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us.” Having been a former finance minister and World Bank official, Johnson Sirleaf was not one for histrionics however she recognized the pandemic as extremely dangerous. The United States responded to her request and American troops came in and opened a new 60-bed clinic in the Sierra Leone town of Kenema, but by then the outbreak was described as being out of control. Still not understanding the dangerous contagious aspects of this epidemic at least eight Liberian soldiers died after contracting the disease from a single female camp follower. In spite of being a relatively poor country, Cuba is one of the most committed in deploying doctors to crisis zones. It sent more than 460 Cuban doctors and nurses to West Africa. In October Germany sent medical supplies and later that month a hundred additional U.S. troops arrived in Liberia, bringing the total to 565 to assist in the fight against the deadly disease. To understand the severity of the disease, a supply order was placed on October 15th for a 6 month supply of 80,000 body bags and 1 million protective suits. At that time it was reported that 223 health care workers had been infected with Ebola, and 103 of them had died in Liberia. Fear of the disease also slowed down the functioning of the Liberian government. President Sirleaf, had in an emergency announcement informed absent government ministers and civil service leaders to return to their duties. She fired 10 government officials, including deputy ministers in the central government who failed to return to work.

They are running a secure operating system you’ve never heard of,” he explained. “It’s called Shiny Hat.” “Shiny Hat.” “Yes. The most clinically paranoid operating system in the world. Since you have an overdeveloped sense of irony, Stokes, you might like to know that we acquired it from hackers who were specifically worried about being eavesdropped on by shadowy government entities. Now they work for us.

Then the machine started to reel off infant-mortality rates and life-expectancy figures, sex ratios, types of diseases and their prevalence in the various strata of society, average incomes, the incidence of unemployment, per capita income as a ratio of total population in given areas, birth-tax and death-tax and the penalties for abortion and illegitimate birth; it talked about laws governing types of sexual congress, about charitable payments and religious organizations running soup kitchens and night shelters and firstaid clinics; about numbers and figures and statistics and ratios all the time, and Gurgeh didn’t think he picked up a word of it.

Why would the government want to track you, Pearl?" I asked icily. "I'm sure they have far more important things to be doing than watching you take multiple trips to the Botox clinic.

Senior Wal-Mart officials concentrated on setting goals, measuring progress, and maintaining communication lines with employees at the front lines and with official agencies when they could. In other words, to handle this complex situation, they did not issue instructions. Conditions were too unpredictable and constantly changing. They worked on making sure people talked. Wal-Mart’s emergency operations team even included a member of the Red Cross. (The federal government declined Wal-Mart’s invitation to participate.) The team also opened a twenty-four-hour call center for employees, which started with eight operators but rapidly expanded to eighty to cope with the load. Along the way, the team discovered that, given common goals to do what they could to help and to coordinate with one another, Wal-Mart’s employees were able to fashion some extraordinary solutions. They set up three temporary mobile pharmacies in the city and adopted a plan to provide medications for free at all of their stores for evacuees with emergency needs—even without a prescription. They set up free check cashing for payroll and other checks in disaster-area stores. They opened temporary clinics to provide emergency personnel with inoculations against flood-borne illnesses. And most prominently, within just two days of Katrina’s landfall, the company’s logistics teams managed to contrive ways to get tractor trailers with food, water, and emergency equipment past roadblocks and into the dying city. They were able to supply water and food to refugees and even to the National Guard a day before the government appeared on the scene. By the end Wal-Mart had sent in a total of 2,498 trailer loads of emergency supplies and donated $3.5 million in merchandise to area shelters and command centers. “If the American government had responded like Wal-Mart has responded, we wouldn’t be in this crisis,” Jefferson Parish’s top official, Aaron Broussard, said in a network television interview at the time.

India is a country that cannot afford to employ all the doctors it trains, which explains why some of them have migrated to Europe or America. It depends on volunteers and voluntary contributions to make up for services that the government cannot afford to provide. Sikhs do this by setting up clinics or dispensaries and day wards at gurdwaras. Here, medical care is given free of charge and minor operations can be performed.

After receiving the customary answer that the government was performing superbly, I generally asked the person how they arrived at this conclusion.  They often cited the construction of schools and clinics, solar panels and paved roads as signs of progress.  Mind you, the majority of this infrastructure was paid for and coordinated by the United States and other NATO countries.  Most were built by U.S. and other Coalition Forces, not the Afghan government, and not the Afghan citizens.  The typical Afghan citizen did not realize this however.  Most were under the impression that their own government had planned, funded and overseen these projects.  None ever stopped to think about how their government had miraculously come up with the billions of dollars necessary to complete these developments. 

There is something improbably about the silence in the [subway] carriage, considering how naturally gregarious we are as a species. Still, how much kinder it is for the commuters to pretend to be absorbed in other things, rather than revealing the extent to which they are covertly evaluating, judging, condemning and desiring each other. A few venture a glance here and there, as furtively as birds pecking grain. But only if the train crashed would anyone know for sure who else had been in the carriage, what small parts of the nation's economy had been innocuously seated across the aisle just before the impact: employees of hotels, government ministries, plastic-surgery clinics, fruit nurseries and greetings-card companies.

DNA will be stored by the clinic or government. Why not screen the baby before it’s born? Advances in genetic technology allow embryos to be screened for hundreds of genetic risk factors, including Down syndrome, breast cancer, and sickle-cell anemia, using nothing but a blood sample from the mother. Parents who desire the ideal baby, and nothing less, will go for that. Already companies are offering services from pre-implantation diagnoses to direct-to-consumer genetic testing. Genetic technology will impact our emotions and values. Some parents see genetic optimization as a great possibility and a basic right; others are morally appalled by the thought of designer babies. One thing we can be sure of is that genetic screening will lead to more abortions. Moreover, if parents decide

The ideal of free medical services collided against the reality of human behaviour, certainly in Singapore. My first lesson came from government clinics and hospitals. When doctors prescribed free antibiotics, patients took their tablet or capsules for two days, did not feel better, and threw away the balance. They then consulted private doctors, paid for their antibiotics, completed the course, and recovered.

One of the biggest obstacles on the path of peace, or even peaceful coexistence, between Israelis and Palestinians was placed by the international community and media when it redefined Hamas as an "organization." One result is that outsiders try to reach a solution based on the assumption that Hamas has structure and leaders. It does not. It has no "political wing" or "militant wing." Hamas is a loosely-knit band of terrorists. Its leaders are whoever has weapons, plans, and influence. Hamas is thuggish and cowardly. Those who fly the green flag are not military combatants. Nor do they represent, or care a whit, for the Palestinian people, as evidenced by their strategy of hiding in and fighting from schools, clinics, hospitals, and people's homes. After what passed for an election some Hamas terrorists were further redefined as politicians and diplomats, though they were neither politic nor diplomatic, evidenced by the fact that many "govern" from Israeli prisons. Prior to the Second Intifada, which began in 2000, Hamas had been emasculated and nearly eradicated by Yassir Arafat, who rounded up, disarmed, and imprisoned the terrorist "leaders," leaving its remaining members to return to their homes. Arafat ensured that members of Hamas had no place to hide among the Palestinian people. And that is the only way the terrorist cancer in Gaza will be excised today. In the absence of Arafat, the task falls by default to Israel, which would do better to enable the citizens of Gaza to purge themselves of Hamas and reward them for doing so than try to get rid of the bad apples by blowing up the barrel, if you'll excuse the mixed metaphor.

In 1924, Native Americans were granted U.S. citizenship, and the federal government considered it a national duty to “civilize” them,13 including Alaska Natives. Education was seen as an important force in this mission, and teachers were sent to native settlements to encourage changes in culture, religion, and language. School was taught in English, churches were constructed, and monogamous marriages and patriarchal households were encouraged or enforced, breaking up communal households .14 Historically nomadic Alaska Natives began settling around the schools and churches, often by order of the U.S. government, which in turn provided small-scale infrastructure and health clinics.15 What is now the village of Kivalina, for example, had originally been used only as a hunting ground during certain times of the year, but its intermittent inhabitants were ordered to settle permanently on the island and enroll their children in school or face imprisonment.

increases in expenditures remains a top imperative for policymakers due to the unsustainable growth forecasts and concerns that health care will absorb an increasingly larger share of government budgets, leaving very little funding available for other important government programs.

A recent Economist article on dialysis perfectly illustrates the inflationary impact of cost-plus pricing. Since U.S. clinics are paid on a cost-plus basis, they prefer to use expensive drugs rather than cheaper ones. In fact, many appear to order drugs in units that exceed what a standard dosage requires because they can charge the government for the wastage. Quoting a stock research firm, the article noted that many clinics preferred an injected drug with a price of $4,100 a year over the identical drug in oral form, priced at only $450 a year. Not surprisingly, the manufacturer of the oral drug responded by increasing its price above that of the injected version to make it more competitive!

in the 2014 assault, over 16,000 buildings were rendered uninhabitable, including entire neighborhoods. A total of 277 UN and government schools, seventeen hospitals and clinics, and all six of Gaza’s universities were damaged, as were over 40,000 other buildings. Perhaps 450,000 Gazans, about a quarter of the population, were forced to leave their homes, and many of them no longer had homes to go back to afterward.

In the 1980s, Pharma therefore moved most of its clinical trials to poor nations where human guinea pigs are cheap and even the most severe injuries will rarely delay the study. Government complicity and anemic corporate liability laws allow vaccine makers to write off injuries as collateral damage with little consequence or accountability.

In March, while people were dying at the rate of 10,000 patients a week, Dr. Fauci declared that hydroxychloroquine should only be used as part of a clinical trial.104 For the first time in American history, a government official was overruling the medical judgment of thousands of treating physicians, and ordering doctors to stop practicing medicine as they saw fit.

Merck maintained it had not tested either vaccine against an inert placebo in pre-approval trials, so no one could scientifically predict if the vaccines would avert more injuries or cancers than they would cause. Nevertheless, the sister FDA panel, VRBPAC, approved Gardasil—to prevent cervical cancer—without requiring proof that the vaccine prevented any sort of cancer, and despite strong evidence from Merck’s clinical trial that Gardasil could dramatically raise risks of cancer and autoimmunity in some girls.82 ACIP, nevertheless, effectively mandated both jabs. Gardasil would be the most expensive vaccine in history, costing patients $420 for the three-jab series and generating revenues of over $1 billion annually for Merck.83 That year, nine of the thirteen ACIP panel members and their institutions collectively received over $1.6 billion of grant money from NIH and NIAID. Systemic Conflicts of Interest Pharma and Dr. Fauci similarly rig virtually all the critical drug approval panels using this strategy of populating them with PIs who, bound by financial fealty to Pharma and NIAID funders, reliably approve virtually every new drug upon which they deliberate—with or without safety studies. From 1999 to 2000, Government Oversight Committee (GOC) Chairman Republican Congressman Dan Burton investigated the systemic corruption of these panels during two years of intense investigations and hearings. According to Burton, “CDC routinely allows scientists with blatant

The government moved aggressively to block its use. On December 24, in what seemed like a trial balloon, the South African government quietly banned the importation of ivermectin. YouTube soon scrubbed Kory’s video64 and Facebook blocked him. Then in March 2021 the US FDA, the European Medicines Association (EMA), and the WHO issued statements advising against the use of ivermectin for COVID-19. The EMA said it should not be used at all. The WHO, echoing its strategy for tanking hydroxychloroquine, said ivermectin’s use should be limited to clinical trials (the high costs of running a clinical trial and their reliance on NIH, NIAID, Gates, or pharma funding means that their results may be easily controlled). FDA issued a much firmer directive: “You should not use ivermectin to treat or prevent COVID-19.”65

After spending the day in a school vaccination clinic, a colleague of mine quipped: “Every time you add a question to a form, I want you to imagine the user filling it out with one hand while using the other to break up a brawl between toddlers.”6 Applications for government benefits might be completed under similarly chaotic circumstances. Users who have a lot else going on in their lives need to be able to apply for the service without an undue burden of time, technology, and cognitive overhead. If they’re asked for documentation, the documents need to be ones they have access to. If they need to correspond with the program, there has to be a way for them to do so even if they lack a stable mailing address. If they have family who are undocumented immigrants, they may need reassurance that applying for a program won’t get them or their relatives in trouble.

When government institutions hold more lunatics than mental institutions, know that, there's something clinically wrong with this world.

Psychologists are professionals who have a degree in psychology, which is the study of human behavior and mental processes. They specialize in understanding and treating mental and emotional disorders. Psychologists can be clinical, counseling, or research psychologists, and they may work in various settings, including private practices, hospitals, schools, and government agencies.

The stark lesson of the Holocaust is that whenever doctors join forces with government and deviate from their personal, professional, clinical commitment to do no harm to the individual, medicine can then be perverted from a healing, humanitarian profession to a murderous apparatus…What sets the Holocaust apart from all other mass genocides is the pivotal role played by the medical establishment, the entire medical establishment. Every step of the murderous process was endorsed by the academic, professional medical establishment.

Yes. We were so successful during the clinical trials in proving the efficacy of the drug we asked to fast-track the approval process. The British government was very pleased with our work and readily approved.” The boastful pride typical of Dr. Shirvani’s illustrious but tumultuous career quickly returned. It was reflected not only in his beaming face but also in his posture. He sat up like a proud parent attending their child’s graduation. James nodded his head slightly confused.

After a long multi-decade fight with the city, the 200 households of Charrúa were in 1991 granted something that would offer them the most important foundation for development they could get: certificates of property ownership. The Charrúa families didn’t earn higher incomes than those in other parts of the neighborhood, and they weren’t more educated or better connected. The difference was that they had the capacity to prove home ownership with the indisputable seal of a government. And that status opened the door to a whole host of other benefits. As taxpaying property owners, they now had standing in the community, which meant they could lobby the government for services. That led to the school and the clinic. And they could use the deeds as collateral to borrow money to invest in businesses, which is why Charrúa became a commercial center, lined with stores and small restaurants. A visitor from the tony neighborhoods of the city’s northern corridor would still see a stark lack of amenities, but to the Bolivian locals, this two-block strip is proof that at least some of their kind have made it. What does this have to do with the blockchain? Well, to answer that, let’s not focus on the comparatively lucky 200 households of Charrúa but on the hundreds of thousands of Bolivians and other slum-dwellers of Buenos Aires and shantytowns all around the developing world who don’t have a title to their home. Their communities will acknowledge them as the owners but there’s nothing official saying so, nothing that’s accepted by the government or a bank, that is. Public registry systems in low-income countries are prone to corruption and incompetence—so a poor resident of a slum in a village in Uttar Pradesh or Manila might try to get a loan with their home as collateral, but no bank would accept it.

Private equity surrounds you. When you visit a doctor or pay a student loan, buy life insurance or rent an apartment, pump gas or fill a prescription, you may—wittingly or not—be supporting a private equity firm. These firms, with obscure names like Blackstone, Carlyle, and KKR, are actually some of the largest employers in America and hold assets that rival those of small countries. Yet few people understand what these firms are or how they work. This is unfortunate because private equity firms, which buy and sell so many businesses you know, explain innumerable modern economic mysteries. They explain, in part, why your doctor’s bill is so expensive and why your veterinary clinic seems to be in decline. They explain why so many stores are understaffed or closing altogether. They explain why there are ever fewer companies in America and why those that remain are selling ever lower-quality products. In fact, despite their relative anonymity, private equity firms are poised to reshape America in this decade the way in which Big Tech did in the last decade and in which subprime lenders did in the decade before that. And as we will explore, they’re all doing it with the government’s help.

With a break in the mother-child bond among siblings, each child might express his or her disconnection with the mother differently. One child might become a people pleaser, fearing that if he’s not good, or he makes waves, he’ll lose connection with people. Another child, believing that connection is never hers to have in the first place, might become argumentative and create conflict to push away the people close to her. Another child might isolate and have little contact with people at all. I’ve noticed that if several siblings have breaks in the mother-child bond, they’ll often express anger or jealousy, or feel disconnected from one another. For example, an older child might resent the child born later, perceiving that the younger child received the love that he or she did not get. Because the hippocampus—that part of the brain involved in creating memories—isn’t fully operational until after the age of two, the older child may not consciously remember being held, fed, or cuddled by the mother, but remembers the younger child receiving their mother’s love. In response, the older child, feeling slighted, can unconsciously blame the younger child for getting what he or she did not. And then, of course, there are some children who don’t seem to carry any family trauma at all. For these children, it’s quite possible that a successful bond was established with the mother and/or father, and this connection helped to immunize the child from carrying entanglements from the past. Perhaps a window of time opened in which the mother was able to give more to one particular child and not the others. Perhaps the parents’ relationship improved. Perhaps the mother experienced a special connection with one child, but couldn’t connect deeply with the others. Younger children often, though not always, seem to do a bit better than first children, or only children, who seem to carry a bigger portion of unfinished business from the family history. When it comes to siblings and inherited family trauma, there are no hard and fast rules governing how each child is affected. Many variables, in addition to birth order and gender, can influence the choices siblings make and the lives they lead. Even though it may appear from the outside that one sibling is unscathed by trauma, while another is encumbered, my clinical experience gives me a different perspective: Most of us carry at least some residue from our family history. However, many intangibles also enter into the equation and can influence how deeply entrenched family traumas remain. These intangibles include self-awareness, the ability to self-soothe, and having a powerful internal healing experience.

...we might try to assuage our loneliness and fears by sleeping with partners we don't love or respect -- sometimes men who won't even remember our names -- as we use sex addictively to fill the emotional hole. But we never walk away from sex Scott free. Sex is more personal to us than to men, and there's a reason for that. The results of preliminary research suggests that when we have orgasms, our bodies release oxytocin, the same chemical that's produced during breast-feeding, and that heightens feelings of bonding. As [Niravi] Payne explains in The Language of Fertility, which is coauthored with Brenda Richardson, her work is based on research that validates thoughts and beliefs can affect functioning in cells, tissues and organs. In recent decades, scientists have learned that much of human perception is based not on information flowing into the brain from the external world, but on what the brain based on previous experience, expects to happen next. That means if we unconsciously believe that sex is "shameful" or something to be feared, that belief can be reflected in our reproductive organs by throwing our hormonal functioning, which regulates pregnancy, or in our immune system, which governs our ability to maintain a pregnancy, or even in our menstrual flow, which if malfunctioning can lead to fibroid tumors. Like all feelings, sexual feelings are energy, and when energy is suppressed, it builds and burst out in destructive ways. Clinical psychologist Darlene Powell Hopson has said she teaches her clients an invocation that in, part, she learned from fellow author Iyanla Vanzant: 'Dear God, I love you and being your child. You made me a sexual being and I want to experience closeness and fulfillment with my partner. My soul yearns for the pleasure and satisfaction of being spiritually and physically intimate with my partner....Please continue to remain with me and in me, forever.

THERMOGRAPHY Misinformation abounds as to the true nature of breast cancer and what causes it. With so much public focus on breast cancer awareness, very little attention is given to breast health, which we know is governed by things like clean eating, routine detoxification, energy balance, and stress reduction, among other things. These other things include not blasting radiation at the breasts in the form of mammograms, which only exacerbate breast cancer risk. Dr. Martin Bales, L.Ac., D.A.O.M., a licensed acupuncturist and certified thermologist at the Center for New Medicine in Irvine, California, has for years been administering one of the best-known alternatives to mammograms: thermograms. As its name suggests, thermography utilizes the power of infrared heat—hence the root word “therm”—to detect physiological abnormalities indicative of a possible breast cancer diagnosis. Dr. Bales’s father first pioneered the technology in the late 1970s with the development of the world’s first all-digital infrared camera, which was used for missile detection purposes during wartime. Its capacity to track the heat signature of missiles was applied to the field of medicine in the 1980s, which eventually gave way to thermographic medical devices. Dr. Bales opined during a recent interview: “In the early eighties, a group of doctors approached my father and said, ‘You know, we’ve heard the body—obviously with its (blood) circulation—we can diagnose a lot of diseases by seeing where there’s hot spots and where there’s cold.’ He said, ‘Okay, I’ll make a medical version for you.’” And the rest is history: thermography machines that identify hot spots in the breasts later hit the market, and select doctors and clinics offer it as a safe, side effect–free alternative to mammograms. “The most promising aspect of thermography is its ability to spot anomalies years before mammography,” says women’s health expert Christiane Northrup, M.D., about the merits of thermography. “With thermography as your regular screening tool, it’s likely that you would have the opportunity to make adjustments to your diet, beliefs, and lifestyle to transform your cells before they became cancerous. Talk about true prevention.

No, thanks. No breakfast,” Elly said. “I got a call. I need to go down to the clinic. I was wondering if you could help me figure out how the shower works? I don’t want to end up spraying myself.

given how insurance and drug companies, managed care and government spending cuts have made quality psychotherapy totally out of reach for most people. This means that just when we know what to do for the victims of trauma, there are very few teaching hospitals and clinics that treat poor women in feminist ways.

As had been true at Palin rallies, reporters at Tea Party events caught attendees comparing me to animals or Hitler. Signs turned up showing me dressed like an African witch doctor with a bone through my nose and the caption OBAMACARE COMING SOON TO A CLINIC NEAR YOU. Conspiracy theories abounded: that my healthcare bill would set up “death panels” to evaluate whether people deserved treatment, clearing the way for “government-encouraged euthanasia,” or that it would benefit illegal immigrants, in the service of my larger goal of flooding the country with welfare-dependent, reliably Democratic voters.

Even before the first Soviet tanks crossed into Afghanistan in 1979, a movement of Islamists had sprung up nationwide in opposition to the Communist state. They were, at first, city-bound intellectuals, university students and professors with limited countryside appeal. But under unrelenting Soviet brutality they began to forge alliances with rural tribal leaders and clerics. The resulting Islamist insurgents—the mujahedeen—became proxies in a Cold War battle, with the Soviet Union on one side and the United States, Pakistan, and Saudi Arabia on the other. As the Soviets propped up the Afghan government, the CIA and other intelligence agencies funneled millions of dollars in aid to the mujahedeen, along with crate after crate of weaponry. In the process, traditional hierarchies came radically undone. When the Communists killed hundreds of tribal leaders and landlords, young men of more humble backgrounds used CIA money and arms to form a new warrior elite in their place. In the West, we would call such men “warlords.” In Afghanistan they are usually labeled “commanders.” Whatever the term, they represented a phenomenon previously unknown in Afghan history. Now, each valley and district had its own mujahedeen commanders, all fighting to free the country from Soviet rule but ultimately subservient to the CIA’s guns and money. The war revolutionized the very core of rural culture. With Afghan schools destroyed, millions of boys were instead educated across the border in Pakistani madrassas, or religious seminaries, where they were fed an extreme, violence-laden version of Islam. Looking to keep the war fueled, Washington—where the prevailing ethos was to bleed the Russians until the last Afghan—financed textbooks for schoolchildren in refugee camps festooned with illustrations of Kalashnikovs, swords, and overturned tanks. One edition declared: Jihad is a kind of war that Muslims fight in the name of God to free Muslims.… If infidels invade, jihad is the obligation of every Muslim. An American text designed to teach children Farsi: Tey [is for] Tofang (rifle); Javed obtains rifles for the mujahedeen Jeem [is for] Jihad; Jihad is an obligation. My mom went to the jihad. The cult of martyrdom, the veneration of jihad, the casting of music and cinema as sinful—once heard only from the pulpits of a few zealots—now became the common vocabulary of resistance nationwide. The US-backed mujahedeen branded those supporting the Communist government, or even simply refusing to pick sides, as “infidels,” and justified the killing of civilians by labeling them apostates. They waged assassination campaigns against professors and civil servants, bombed movie theaters, and kidnapped humanitarian workers. They sabotaged basic infrastructure and even razed schools and clinics. With foreign backing, the Afghan resistance eventually proved too much for the Russians. The last Soviet troops withdrew in 1989, leaving a battered nation, a tottering government that was Communist in name only, and a countryside in the sway of the commanders. For three long years following the withdrawal, the CIA kept the weapons and money flowing to the mujahedeen, while working to block any peace deal between them and the Soviet-funded government. The CIA and Pakistan’s spy agency pushed the rebels to shell Afghan cities still under government control, including a major assault on the eastern city of Jalalabad that flattened whole neighborhoods. As long as Soviet patronage continued though, the government withstood the onslaught. With the collapse of the Soviet Union in late 1991, however, Moscow and Washington agreed to cease all aid to their respective proxies. Within months, the Afghan government crumbled. The question of who would fill the vacuum, who would build a new state, has not been fully resolved to this day.

I was supposed to start a clinic here. I had everything ready to go and then that girl disappeared from your school. I got scared. The threats came in their little baggies. I shut everything down because I was scared. The anger in this country, it is not like Ayiti. I used to think it was gone. Or neutered. But it is here. It is a matter of who gets to be angry and who gets to seek vengeance or claim justice. The anger here is not the kind that starts revolutions, it is the kind that wages wars. We fight other countries, the news, the politicians, all fight fight fight and bicker bicker bicker. There are lines and systems—rules of engagement. In Ayiti, the government and the people have an uneasy deal. They cross each other often. When I lived there, it made me edgy. The way things are here, people go so far out of their way to smile to your face and stab you in the back. Even with the language: English. You have to put together so many words to be understood. That is not even being heard, just understood.” Her eyes go back to the deer. She

Unfortunately, the government refused to permit any access to birth control information through government-funded programs. That left the work of family planning to private clinics, such as the one at which Margaret volunteered. Since there was only one in all of London, the demand was much higher than the clinic could meet.

To put it bluntly, domestic programs without committed advocates or politically valuable constituents were vulnerable. Long-term mental healthcare had long been the province of state governments, not the federal government. The Nixon administration had no interest in micromanaging local clinics and hospitals or in sustaining a payment structure, like Medicaid, in which the federal government would be on the hook for 40 to 50 percent of matching funds.