Medical Illustrator Quotes

Genetic tests,” as Eric Topol, the medical geneticist described it, “are also moral tests. When you decide to test for ‘future risk,’ you are also, inevitably, asking yourself, what kind of future am I willing to risk?” Three case studies illustrate the power and the peril of using genes to predict “future risk.

We cannot incarcerate ourselves out of addiction. Addiction is a medical crisis that—when it comes to nonviolent offenders—warrants medical interventions, not incarceration. Decades later, data unequivocally illustrates that this war has been a massive failure. It has not only failed to reduce violent crime, but arrest rates—throughout its tenure—have continuously ascended even when crime rates have descended.

Ultimately the judge threw Moore’s suit out of court, saying he had no case. Ironically, in his decision, the judge cited the HeLa cell line as a precedent for what happened with the Mo cell line. The fact that no one had sued over the growth or ownership of the HeLa cell line, he said, illustrated that patients didn’t mind when doctors took their cells and turned them into commercial products. The judge believed Moore was unusual in his objections. But in fact, he was simply the first to realize there was something potentially objectionable going on.

And there is one thing that I really, really like to have company for. Watching TV. I'm not particularly needy in relationships, I actually demand a fair amount of space. But I really like to be in bed with another human being and watch TV. That's as intimate and reassuring and tender as it gets for me. I find dating exhausting and uninteresting, and I really would like to skip over the hours of conversation that you need just to get up to speed on each other's lives, and the stories I've told a million times. I just want to get to the watching TV in bed. If you're on a date with me, you can be certain that this is what I'm evaluating you for—how good is it going to be, cuddling with you in bed and watching Damages I'm also looking to see if you have clean teeth. For me, anything less than very clean teeth is fucking disgusting. Here's what I would like to do: I would like to get into bed with a DVD of Damages and have a line of men cue up at my door. I would station a dental hygienist at the front of the line who would examine the men's teeth. Upon passing inspection, she(I've never met a male hygienist, and neither have you) would send them back to my bedroom, one at time, in intervals of ten minutes, during which I would cuddle with the man and watch Damages. Leaving nothing to chance, using some sort of medical telemetry, I would have a clinician take basic readings of my heart rate and brain waves, and create a comparison chart to illustrate which candidate was the most soothing presence for me. After reviewing all the data from what will now be known in diagnostic manuals throughout the world as the Silverman-Damages-Nuzzle-Test, I will make my selection.

Until fairly recently, every family had a cornucopia of favorite home remedies--plants and household items that could be prepared to treat minor medical emergencies, or to prevent a common ailment becoming something much more serious. Most households had someone with a little understanding of home cures, and when knowledge fell short, or more serious illness took hold, the family physician or village healer would be called in for a consultation, and a treatment would be agreed upon. In those days we took personal responsibility for our health--we took steps to prevent illness and were more aware of our bodies and of changes in them. And when illness struck, we frequently had the personal means to remedy it. More often than not, the treatment could be found in the garden or the larder. In the middle of the twentieth century we began to change our outlook. The advent of modern medicine, together with its many miracles, also led to a much greater dependency on our physicians and to an increasingly stretched healthcare system. The growth of the pharmaceutical industry has meant that there are indeed "cures" for most symptoms, and we have become accustomed to putting our health in the hands of someone else, and to purchasing products that make us feel good. Somewhere along the line we began to believe that technology was in some way superior to what was natural, and so we willingly gave up control of even minor health problems.

The ten-o' clock breakfasters began to appear: nervous, little men, morose, preoccupied, who wiped their plates with crusts of bread; rude, massive women who, like primitive idols dug out of the soil, had grown rotten in the years; flowery dandies with repulsive faces, reminding him uncomfortably of illustrations in medical tracts.

The stack of her medical files that confronted me at the nurses’ station was about four feet high, taller than the shrunken little girl herself. Laura’s story, like that of the children of Waco, helped us learn more about how children respond to early experience. It illustrates how the mind and body cannot be treated separately, reveals what infants and young children need for healthy brain development and demonstrates how neglecting those needs can have a profound impact on every aspect of a child’s growth.

Despite all the admiration M. Swann might profess for these figures of Giotto, it was a long time before I could find any pleasure in seeing in our schoolroom (where the copies he had brought me were hung) Charity devoid of charity, that Envy who looked like nothing so much as a plate in some medical book, illustrating the compression of the glottis or uvula by a tumour in the tongue, or by the introduction of the operator's instrument, a Justice whose greyish and meanly regular features were the very same as those which adorned the faces of certain good and pious and slightly withered ladies of Combray whom I used to see at mass, many of whom had long been enrolled in the reserve forces of Injustice. But in later years I understood the arresting strangeness, the special beauty of these frescoes lay in the great part played in each of them by its symbols, while the fact that these were depicted, not as symbols (for the thought symbolized was nowhere expressed), but as real things, actually felt or materially handled, added something more precise and more literal to their meaning, something more concrete and more striking to the lesson they imparted.

different subject. The story of the serotonin hypothesis for depression, and its enthusiastic promotion by drug companies, is part of a wider process that has been called ‘disease-mongering’ or ‘medicalisation’, where diagnostic categories are widened, whole new diagnoses are invented, and normal variants of human experience are pathologised, so they can be treated with pills. One simple illustration of this is the recent spread of ‘checklists’ enabling the public to diagnose, or help diagnose, various medical conditions. In 2010, for example, the popular website WebMD launched a new test: ‘Rate your risk for depression: could you be depressed?’ It was funded by Eli Lilly, manufacturers of the antidepressant duloxetine, and this was duly declared on the page, though that doesn’t reduce the absurdity of what followed. The test consisted of ten questions, such as: ‘I feel sad or down most of the time’; ‘I feel tired almost every day’; ‘I have trouble concentrating’; ‘I feel worthless or hopeless’; ‘I find myself thinking a lot about dying’; and so on. If you answered ‘no’ to every single one of these questions – every single one – and then pressed ‘Submit’, the response was clear: ‘You may be at risk for major depression’.

The evolution of the gluten-free diet illustrates how attempts to control consumption are swiftly countered by modern market forces, just one more example of the challenges inherent in our dopamine economy. There are many other modern examples of previously taboo drugs being transformed into socially acceptable commodities, often in the guise of medicines. Cigarettes became vape pens and ZYN pouches. Heroin became OxyContin. Cannabis became “medical marijuana.” No sooner have we committed to abstinence than our old drug reappears as a nicely packaged, affordable new product saying, Hey! This is okay. I’m good for you now.

The history of another country, one Americans don’t much like comparing themselves with, illustrates the grave dangers of yoking political ideology to dubious science. In the 1930s under Joseph Stalin, the quack “scientist” Trofim Lysenko, who promoted himself through party newspapers rather than rigorous experiments, rose to prominence and took control of Soviet biological, medical, and agricultural research for several decades. Lysenko used his power to prosecute an ideologically driven crusade against the theory of genetics, which he denounced as a bourgeois affront to socialism. In short, his political presuppositions led him to embrace bogus scientific claims. In the purges that followed, many of Lysenko’s scientist critics lost their jobs and suffered imprisonment and even execution. By 1948 Lysenko had convinced Stalin to ban the study of genetics. Soviet science suffered immeasurable damage from the machinations of Lysenko and his henchmen, and the term “Lysenkoism” has since come to signify the suppression of, or refusal to acknowledge, science for ideological reasons. In a democracy like our own, Lysenkoism is unlikely to take such a menacing, totalitarian form. Nevertheless, the threat we face from conservative abuse of science—to informed policymaking, to democratic discourse, and to knowledge itself—is palpably real. And as the modern Right and the Bush administration flex their muscles and continue to battle against reliable, mainstream conclusions and sources of information, this threat is growing.

Society would have much to gain from decriminalization. On the immediate practical level, we would feel safer in our homes and on our streets and much less concerned about the danger of our cars being burgled. In cities like Vancouver such crimes are often committed for the sake of obtaining drug money. More significantly perhaps, by exorcising this menacing devil of our own creation, we would automatically give up a lot of unnecessary fear. We could all breathe more freely. Many addicts could work at productive jobs if the imperative of seeking illegal drugs did not keep them constantly on the street. It’s interesting to learn that before the War on Drugs mentality took hold in the early twentieth century, a prominent individual such as Dr. William Stewart Halsted, a pioneer of modern surgical practice, was an opiate addict for over forty years. During those decades he did stellar and innovative work at Johns Hopkins University, where he was one of the four founding physicians. He was the first, for example, to insist that members of his surgical team wear rubber gloves — a major advance in eradicating post-operative infections. Throughout his career, however, he never got by with less than 180 milligrams of morphine a day. “On this,” said his colleague, the world-renowned Canadian physician Sir William Osler, “he could do his work comfortably and maintain his excellent vigor.” As noted at the Common Sense for Drug Policy website: Halsted’s story is revealing not only because it shows that with a morphine addiction the proper maintenance dose can be productive. It also illustrates the incredible power of the drug in question. Here was a man with almost unlimited resources — moral, physical, financial, medical — who tried everything he could think of and he was hooked until the day he died. Today we would send a man like that to prison. Instead he became the father of modern surgery.

More to the point, one cannot understand The Holocaust without understanding the intentions, ideology, and mechanisms that were put in place in 1933. The eugenics movement may have come to a catastrophic crescendo with the Hitler regime, but the political movement, the world-view, the ideology, and the science that aspired to breed humans like prized horses began almost 100 years earlier. More poignantly, the ideology and those legal and governmental mechanisms of a eugenic world-view inevitably lead back to the British and American counterparts that Hitler’s scientists collaborated with. Posterity must gain understanding of the players that made eugenics a respectable scientific and political movement, as Hitler’s regime was able to evade wholesale condemnation in those critical years between 1933 and 1943 precisely because eugenics had gained international acceptance. As this book will evidence, Hitler’s infamous 1933 laws mimicked those already in place in the United States, Britain, Norway, Sweden, Finland, and Canada. So what is this scientific and political movement that for 100 years aspired to breed humans like dogs or horses? Eugenics is quite literally, as defined by its principal proponents, an attempt at “directing evolution” by controlling any aspect of human existence that affects human heredity. From its onset, Francis Galton, the cousin of Charles Darwin and the man credited with the creation of the science of eugenics, knew that the cause of eugenics had to be observed with religious fervor and dedication. As the quote on the opening pages of this book illustrates, a eugenicist must “intrude, intrude, intrude.” A vigilant control over anything and everything that affects the gene pool is essential to eugenics. The policies could not allow for the individual to enjoy self-government or self-determination any more than a horse breeder can allow the animals to determine whom to breed with. One simply cannot breed humans like horses without imbuing the state with the level of control a farmer has over its livestock, not only controlling procreation, but also the diet, access to medical services, and living conditions.

Some examples from the American experience in Iraq help illustrate the contradiction between the physical and moral levels: The U. S. Army conducted many raids on civilian homes in areas it occupied. In these raids, the troops physically dominated the civilians. Mentally, they terrified them. But at the moral level, breaking into private homes in the middle of the night, terrifying women and children, and sometimes treating detainees in ways that publicly humiliated them (like stepping on their heads) worked powerfully against the Americans. An enraged population responded by providing the Iraqi resistance with more support at each level of war, physical, mental, and moral. At Baghdad’s Abu Ghraib prison, MPs and interrogators dominated prisoners physically and mentally – as too many photographs attest. But when that domination was publicly exposed, the United States suffered an enormous defeat at the moral level. Some American commanders recognized this when they referred to the soldiers responsible for the abuse as, “the jerks who lost us the war.” In Iraq and elsewhere, American troops (other than Special Forces) quickly establish base camps that mirror American conditions: air conditioning, good medical care, plenty of food and pure water. The local people are not allowed into the bases except in service roles. Physically, the American superiority over the lives the locals lead is overwhelming. Mentally, it projects the power and success of American society. But morally, the constant message of “we are better than you” works against the Americans. Traditional cultures tend to put high values on pride and honor, and when foreigners seem to sneer at local ways, the locals may respond by defending their honor in a traditional manner – by fighting. After many, if not most, American military interventions, Fourth Generation war has tended to intensify and spread rather than contract.

Beyond One-Way ANOVA The approach described in the preceding section is called one-way ANOVA. This scenario is easily generalized to accommodate more than one independent variable. These independent variables are either discrete (called factors) or continuous (called covariates). These approaches are called n-way ANOVA or ANCOVA (the “C” indicates the presence of covariates). Two way ANOVA, for example, allows for testing of the effect of two different independent variables on the dependent variable, as well as the interaction of these two independent variables. An interaction effect between two variables describes the way that variables “work together” to have an effect on the dependent variable. This is perhaps best illustrated by an example. Suppose that an analyst wants to know whether the number of health care information workshops attended, as well as a person’s education, are associated with healthy lifestyle behaviors. Although we can surely theorize how attending health care information workshops and a person’s education can each affect an individual’s healthy lifestyle behaviors, it is also easy to see that the level of education can affect a person’s propensity for attending health care information workshops, as well. Hence, an interaction effect could also exist between these two independent variables (factors). The effects of each independent variable on the dependent variable are called main effects (as distinct from interaction effects). To continue the earlier example, suppose that in addition to population, an analyst also wants to consider a measure of the watershed’s preexisting condition, such as the number of plant and animal species at risk in the watershed. Two-way ANOVA produces the results shown in Table 13.4, using the transformed variable mentioned earlier. The first row, labeled “model,” refers to the combined effects of all main and interaction effects in the model on the dependent variable. This is the global F-test. The “model” row shows that the two main effects and the single interaction effect, when considered together, are significantly associated with changes in the dependent variable (p < .000). However, the results also show a reduced significance level of “population” (now, p = .064), which seems related to the interaction effect (p = .076). Although neither effect is significant at conventional levels, the results do suggest that an interaction effect is present between population and watershed condition (of which the number of at-risk species is an indicator) on watershed wetland loss. Post-hoc tests are only provided separately for each of the independent variables (factors), and the results show the same homogeneous grouping for both of the independent variables. Table 13.4 Two-Way ANOVA Results As we noted earlier, ANOVA is a family of statistical techniques that allow for a broad range of rather complex experimental designs. Complete coverage of these techniques is well beyond the scope of this book, but in general, many of these techniques aim to discern the effect of variables in the presence of other (control) variables. ANOVA is but one approach for addressing control variables. A far more common approach in public policy, economics, political science, and public administration (as well as in many others fields) is multiple regression (see Chapter 15). Many analysts feel that ANOVA and regression are largely equivalent. Historically, the preference for ANOVA stems from its uses in medical and agricultural research, with applications in education and psychology. Finally, the ANOVA approach can be generalized to allow for testing on two or more dependent variables. This approach is called multiple analysis of variance, or MANOVA. Regression-based analysis can also be used for dealing with multiple dependent variables, as mentioned in Chapter 17.

A recent RAND Corporation report illustrates these points precisely, finding that preventable medical errors in hospitals result in tens of thousands of deaths per year; preventable medication errors occur at least one and a half million times annually; and, on average, adults receive only 55 percent of recommended care, meaning that 45 percent of the time, our doctors get it wrong.

The actual Beryl was written by Sangye Gyamtso, regent to the fifth Dalai Lama.  It was based on the Tantras, but Gyamtso did something that had never been done before, something that would change medicine forever: he commissioned drawings, based on the cures in the Beryl, depicting all aspects of human anatomy, all the flora and fauna used in the cures, and directions on their application. “This makes the Blue Beryl the first illustrated medical ‘how to’ manual ever written.  It’s a beautifully illustrated encyclopedia with diagnoses and treatments.  It actually showed the reader, using pictures and text, which herbs to combine and in what quantities.

Death entered the medical miracle of the twentieth century already camouflaged. But in scientifically advanced nations, it now takes place in hospitals or nursing homes, out of view, a medical failure rather than a natural process. And, to 'protect' our children, rarely does it make an appearance within their beautifully illustrated picture books.

I nod. Pull out a chair and try to gather my thoughts. No small feat for me these days. I take a deep breath and try again. “What is … the treatment goal for people with … with what I …” Knight leans across the table toward me. “Bipolar disorder type I.” “Yeah.” “Okay … well, we want to stop the extreme mood changes. Bring down the ceiling on the mania, bring up the floor on the depression.” Knight uses his hands to illustrate the shrinking space. “Put more time between the episodes. And make the medication regimen as tolerable as possible. Stability. That’s what we’re aiming for.

Snow published his findings and the maps that illustrated them in his major work of 1855 On the Mode of Communication of Cholera, which is now widely considered the foundational text of epidemiology as a discipline. During Snow’s lifetime, although the book kept the emerging germ theory in public view, it failed to persuade the medical profession. Anticontagionism and miasmatism persisted as orthodoxy with regard to cholera.

A Reiki Healing Course involves placing the hands on or just above various parts of the body to promote health. Living beings are believed to have energy control that enhances their health and vitality. What is Reiki Early in the 20th century, Reiki, a spiritual technique, was developed in Japan. It entails applying hands-on healing methods to channel and transfer energy in order to encourage mental, emotional, and spiritual recovery. Reiki is a combination of the Japanese terms "rei" which means Universal, and "ki," which means Energy, which both imply "life force energy." It is the belief of Reiki practitioners that by channelling this energy, they may harmonise and restore the body's natural energy flow, thereby fostering healing and well-being. A Reiki session involves the practitioner placing their hands on or near the recipient's body and channelling energy through a sequence of hand postures. Throughout the treatment, the receiver usually lies down or sits comfortably while remaining completely clothed. Although reiki is viewed as a complementary therapy, conventional medical care is frequently combined with it. Although there isn't any scientific proof that Reiki works, many people find it to be a calming and helpful practice. Methods of Teaching Reiki Scientific Method Energy Healing Method Quantum Method How Reiki Interact With Our Life There are many ways that reiki can improve our life. Here are a few illustrations: Reducing stress and fostering relaxation: Reiki is renowned for its capacity to foster calm and lower tension. We can feel more relaxed and at ease through Reiki by balancing our body's energy and encouraging calm.

The likes of you and I cannot “give” to the federal government, as under the Federal Acquisition Regulations this is considered to be a risk for exerting undue influence. But the CDC has established a nonprofit “CDC Foundation.” According to the CDC’s own website [419]: Established by Congress as an independent, nonprofit organization, the CDC Foundation is the sole entity authorized by Congress to mobilize philanthropic partners and private-sector resources to support CDC’s critical health protection mission. Likewise, the NIH has established the “Foundation for the National Institutes of Health,” currently headed by CEO Dr. Julie Gerberding (formerly CDC director, then president of Merck Vaccines, then chief patient officer and executive vice president, Population Health & Sustainability at Merck and Company—where she had responsibility for Merck’s ESG score compliance). Dr. Gerberding’s career provides a case history illustrating the ties between the administrative state and corporate America. These congressionally chartered nonprofit organizations provide a vehicle whereby the medical-pharmaceutical complex can funnel money into the NIH and CDC to influence both research agendas and policies.

Any joke or humorous incident has the following form. You narrate a story step-by-step, leading your listener along a garden path of expectation, and then you introduce an unexpected twist, a punch line, the comprehension of which requires a complete reinterpretation of the preceding events. But that’s not enough: No scientist whose theoretical edifice is demolished by a single ugly fact entailing a complete overhaul is likely to find it amusing. (Believe me, I’ve tried!) Deflation of expectation is necessary but not sufficient. The extra key ingredient is that the new interpretation must be inconsequential. Let me illustrate. The dean of the medical school starts walking along a path, but before reaching his destination he slips on a banana peel and falls. If his skull is fractured and blood starts gushing out, you rush to his aid and call the ambulance. You don’t laugh. But if he gets up unhurt, wiping the banana off his expensive trousers, you break out into a fit of laughter. It’s called slapstick. The key difference is that in the first case, there is a true alarm requiring urgent attention. In the second case it’s a false alarm, and by laughing you inform your kin in the vicinity not to waste their resources rushing to his aid. It is nature’s “all’s okay” signal.

A perplexing aspect of Long COVID is that numerous sufferers undergo a plethora of medical tests, which typically return results that are either 'within normal limits' or unusually abnormal, eluding easy explanation. On the surface, everything might look ostensibly normal, or biomarkers may display only slight variations. This diagnostic uncertainty leaves us grappling with a fragmented understanding of the condition, akin to a scene from "The Simpsons" where Mr. Burns is diagnosed with the fictional Three-Stooges Syndrome, humorously illustrating the dilemma of too many symptoms trying to manifest simultaneously, much like the Stooges attempting to pass through a door at the same time.

10. What realities are captured in the story of Lou Sanders and his daughter, Shelley, regarding home care for an aging and increasingly frail parent? What conflicts did Shelley face between her intentions and the practical needs of the family and herself? What does the book illustrate about the universal nature of this struggle in families around the globe? 11. A key concept that emerges from the author’s interviews is “home.” Much more than just the place where you go to bed at night, home evokes a set of values and freedoms for many as they face old age. As you consider the life you want lead in old age, what does home mean to you? 12. Reading about Bill Thomas’s Eden Alternative in Chapter 5, what came to mind when he outlined the Three Plagues of nursing home existence: boredom, loneliness, and helplessness? What do you think matters most when you envision eldercare? 13. What can be learned from the medical treatment choices that were made in the final days of Sara Monopoli’s life? 14. What are your feelings about hospice care? When is the appropriate time to introduce hospice in the treatment of those with life-threatening illness?

we medical men, my dear lady, have no time to stop for conventionalities when life is in the balance. If Major de Vigne were anywhere in this country I would make him come and quiet my patient by a sight of him; all she does is to sob quietly, and murmur that man’s name to herself, and if we cannot get at the mind we cannot work miracles with the body. Any shock would be better than this dreamy lethargy; there is no knowing to what mischief it may not lead. I shall tell her he is gone to the Crimea!

But these are extreme cases. They only serve to illustrate that whenever reality reinforces a child’s fantasied dangers, the child will have more difficulty in overcoming them. This is why, on principle, we avoid any methods of handling a child which could reinforce his fantasies of danger. So, while parents may not regard a spanking as a physical attack or an assault on a child’s body, the child may regard it as such, and experience it as a confirmation of his fears that grown-ups under certain circumstances can really hurt you. And sometimes, unavoidably, circumstances may confirm a child’s internal fears. A tonsillectomy may be medically indicated. It can be disturbing to a small child because his fears of losing a part of his body are given some justification in this experience where something is removed from him. We cannot always avoid the situation in which a child’s fears are confirmed in some way in reality but where it is within our control, as in the realm of everyday parent-child relationships and methods of handling, we try not to behave in such a way that a child need feel a real danger. There

The role of endorphins in human feelings was illustrated by an imaging study of fourteen healthy women volunteers. Their brains were scanned while they were in a neutral emotional state and then again when they were asked to think of an unhappy event in their lives. Ten of them recalled the death of a loved one, three remembered breakups with boyfriends and one focused on a recent argument with a close friend. Using a special tracer chemical, the scan highlighted the activity of opioid receptors in the emotional centres of each participant’s brain. While the women were under the spell of sad memories, these receptors were much less active.6 On the other hand, positive expectations turn on the endorphin system. Scientists have observed, for example, that when people expect relief from pain, the activity of opioid receptors will increase. Even the administration of inert medications—substances that do not have direct physical activity—will light up opioid receptors, leading to decreased pain perception.7 This is the so-called “placebo effect,” which, far from being imaginary, is a genuine physiological event. The medication may be inert, but the brain is soothed by its own painkillers, the endorphins.

Sharon Ellis has proven to be a skilled, perceptive, and flexible medical illustrator. When I first recruited her into this project after admiring her work online, she had no familiarity with yoga, but before long, she was slinging the Sanskrit terms and feeling her way through the postures like a seasoned yogi.

Without Lydia’s partnership, this book would still be lingering somewhere in the space between my head and my hard drive. Sharon Ellis has proven to be a skilled, perceptive, and flexible medical illustrator.

Addiction is a human problem that resides in people, not in the drug or in the drug’s capacity to produce physical effects,” writes Lance Dodes, a psychiatrist at the Harvard Medical School Division on Addictions. It is true that some people will become hooked on substances after only a few times of using, with potentially tragic consequences, but to understand why, we have to know what about those individuals makes them vulnerable to addiction. Mere exposure to a stimulant or narcotic or to any other mood-altering chemical does not make a person susceptible. If she becomes an addict, it’s because she’s already at risk. Heroin is considered to be a highly addictive drug — and it is, but only for a small minority of people, as the following example illustrates. It’s well known that many American soldiers serving in the Vietnam War in the late 1960s and early 1970s were regular users. Along with heroin, most of these soldier addicts also used barbiturates or amphetamines or both. According to a study published in the Archives of General Psychiatry in 1975, 20 per cent of the returning enlisted men met the criteria for the diagnosis of addiction while they were in Southeast Asia, whereas before they were shipped overseas fewer than 1 per cent had been opiate addicts. The researchers were astonished to find that “after Vietnam, use of particular drugs and combinations of drugs decreased to near or even below preservice levels.” The remission rate was 95 per cent, “unheard of among narcotics addicts treated in the U.S.” “The high rates of narcotic use and addiction there were truly unlike anything prior in the American experience,” the researchers concluded. “Equally dramatic was the surprisingly high remission rate after return to the United States.” These results suggested that the addiction did not arise from the heroin itself but from the needs of the men who used the drug. Otherwise, most of them would have remained addicts. As with opiates so, too, with the other commonly abused drugs. Most people who try them, even repeatedly, will not become addicted. According to a U.S. national survey, the highest rate of dependence after any use is for tobacco: 32 per cent of people who used nicotine even once went on to long-term habitual use. For alcohol, marijuana and cocaine the rate is about 15 per cent and for heroin the rate is 23 per cent. Taken together, American and Canadian population surveys indicate that merely having used cocaine a number of times is associated with an addiction risk of less than 10 per cent. This doesn’t prove, of course, that nicotine is “more” addictive than, say, cocaine. We cannot know, since tobacco — unlike cocaine — is legally available, commercially promoted and remains, more or less, a socially tolerated object of addiction. What such statistics do show is that whatever a drug’s physical effects and powers, they cannot be the sole cause of addiction.

At the summit, there are statues illustrating pilgrims from the past. Often there is an Englishman here; he spends his summers helping pilgrims. He sells cans of soft drinks and gives away tea; he also has some basic medical supplies to help pilgrims suffering from blisters. The

Ah! said the doctor, in his most complacent manner, "here is the opportunity I have long been waiting for. I have often desired to test and taste the indian mode of cooking. What do you suppose this is?" holding up the dripping morsel. Unable to obtain the desired information, the doctor, whose naturally good appetite had been sensibly sharpened by his recent exercise á la quadrupède, set to with a will and ate heartily of the mysterious contents of the kettle. "What can this be?" again inquired the doctor. He was only satisfied on one point, that it was delicious - a dish fit for a king. Just then Gurrier, the half-breed, entered the lodge. He could solve the mystery, having spent years among the Indians. To him the doctor appealed for information. Fishing out a huge piece and attacking it with the voracity of a hungry wolf, he was not long in determining what the doctor had supped so heartily upon. His first words settled the mystery: "Why this is dog." I will not attempt to repeat the few but emphatic words uttered by the headily disgusted member of the medical fraternity as he rushed from the lodge.

resistance to medical research illustrates an important point regarding the status of experts and the cultural acceptance of progress. The modern medical vision of the body, as an inert and physical specimen, is not intuitively appealing.

When there are too many physician-patient interactions, the amplitude gets turned up on everything,” he says. “More people with non-fatal problems are taking more medications and having more procedures, many of which are not really helpful and a few of which are harmful, while the people with really fatal illnesses are rarely cured and ultimately die anyway.” So it may be that going to the hospital slightly increases your odds of surviving if you’ve got a serious problem but increases your odds of dying if you don’t. Such are the vagaries of life.

Your Personal Economic Model One tool we use when discussing the best course of action to secure your financial future is the Personal Economic Model®. Just as a medical doctor would use an anatomical model to convey medical concepts, we use the following model to convey financial concepts. This model offers a visual representation of the way money flows through your hands. On the left, you will notice the Lifetime Capital Potential tank, which illustrates that the amount of money you will control during your lifetime is both large, as well as finite. Most people are shocked to see how much money can flow through their hands in their lifetime. Once earned, your money flows directly to the Tax Filter where the state and federal governments take tax dollars owed from your paycheck. The after tax dollars are then directed to either your Current Lifestyle or your Future Lifestyle. Your management of the Lifestyle Regulator determines where these dollars go. Regulating the cash flow between your current lifestyle desires and your future lifestyle requirements may be the most important financial decision you will ever make. Here’s why. Each and every dollar that is allowed to flow through to your Current Lifestyle is consumed and gone forever. The goal is to accumulate enough money in the Savings and Investment tanks so that when you retire, the dollars in those tanks can be used to pay for your future lifestyle requirements. Retirement planning seems hard for most people to do but it is not rocket science. The best position, position A, would be to have enough in the tanks so that you can live in the future like you live today adjusted for inflation and have your money last at least to your life expectancy. That’s a win, but the icing on the cake would be to accomplish that with little to no impact on your present standard of living, and that is exactly what we strive to help our clients to do. Working with us can help you with the following: Optimize the balance between your Current and Future Lifestyles Identify inefficiencies in your current personal economic model (where are you losing money) Design, implement, and execute a plan to secure your financial future Limit the impact on your Current Lifestyle dollars (maintain your current standard of living)

In the introduction to my 2001 best-selling book Beyond Prozac, I wrote that within so-called developed societies, much emotional and psychological distress has for decades been re-packaged as ‘mental disorders’. I wrote that I would refer to ‘mental illness/mental disorders’ within inverted commas, to illustrate ‘my disquiet at the widespread acceptance of these terms without debate about what the terms mean and what might be better words to use’.[3] I added that the experiences themselves were real and valid in their own right. This situation continues to this day. None of the psychiatric diagnoses have any scientific validity.[4] Throughout this book series therefore, I also use inverted commas when referring to these commonly accepted concepts. I do this to signify that these are not what they are claimed to be; they are not verified medical illnesses.

Cost-effectiveness analyses can be undertaken from a number of different perspectives. The choice of the study perspective is an important methodological decision because it determines which costs and effects to count and how to value them. The appropriate perspective depends on the objective of the study, the context, and the relevant decision makers. As indicated above, we recommend that analysts conduct Reference Case analyses from both the healthcare sector and societal perspectives (Recommendations 2–5). Other perspectives may, however, be relevant for specific decision makers. To illustrate, we briefly consider four perspectives potentially relevant to the analysis of health interventions: the payer perspective, the healthcare sector Reference Case perspective, the healthcare sector with time cost perspective, and the societal Reference Case perspective. Although we note two additional perspectives here, the remainder of this book will focus on the healthcare sector and societal Reference Case perspectives. The payer perspective includes the consequences that a specific payer considers relevant. This perspective will be more or less narrow depending on whether the payer is private or public. For a US private commercial payer (insurer), for example, costs might include reimbursement for medical care paid for by the insurer and consequences for patients covered by the insurer.

In the early 1980s, the authors of this book first heard about a medical practice that involves integrating music into the treatment of both biomedical and psychological disorders. At the time, we thought the field now called music therapy was a new mode of treatment and a new occupation. As the preceding examples illustrate, many other cultures have long recognized the connection between music and healing and have integrated the performance arts into their treatments.