Three Approaches to Health Care

There are three ways of approaching less than optimal health: prevention, treatment and cure. All have their strong and weak points; all are political hot cakes at the moment.

I think most individuals and societies would agree that the best solution is to stay in good health. It is also a solution that is not always possible. It is, however, the approach that is responsible for the dramatic drop in childhood death in developed countries.

Prevention measures are generally lumped as public health. Clean drinking water, proper sewage disposal, nutritious food, clean air and immunizations all fall into this category. So do measures intended to reduce accidental injury or death (such as seat belts) and those encouraging a healthier life style. Prevention would also include such highly controversial measures as not passing on genes known to have a deleterious effect on health.

In general prevention measures are good for the population, but affect individual choice. They may also affect the bottom line of corporations with a great influence on public policy, such as the food industry.

Some of what I need for treatment of diabetes. I want a cure!

By treatment I refer to ongoing treatment — the pill (or shot) for everything or treatments such as dialysis which must be repeated regularly for the life of the patient. Certainly it is better to have a treatment than not! I am alive today thanks to insulin. But treatment is generally expensive and is often lifelong. Further, treatment of this sort almost always has undesirable side effects. In my case, insulin can produce hypoglycemia which can kill. It should be noted that some “cures,” such as organ transplants, may then produce a condition in which lifelong treatment (anti-rejection drugs) is needed.

A cure implies a return to normal health. In some cases (such as the common cold) a cure is mainly a matter of time, with supporting treatment to prevent secondary infections or ease symptoms. Some cancers are curable with surgery, especially if caught early. Broken bones or other traumatic injuries can often be cured, especially in the young. A number of conditions, however, have no cure. Research on cures is ongoing, but the profit from a true cure is usually not as great as from lifelong treatment. Given that most health research today is profit-driven, research on cures tends to take a back seat to research on treatments.

I’ll probably return to this in the future, looking at one of the three approaches at a time. For right now, how would you order the importance of the three approaches?

Jarn’s Journal, Day 672

Jarn’s Journal is the fictional journal of an alien stranded in Africa 125,000 years ago. He is being hailed as a god by the human ancestors he has discovered. His story is the remote background of the Jarnian Confederacy, the setting of my science fiction novels. The Journal to date is on my author website.

Day 672

The equinox is close, if not here. The grass is shriveling, though not yet as brown as when I arrived – that must have been a drier than normal year. Plant food is harder to find, and some of the animals are leaving. Already the shaman has asked me if I will go with them to the Gather. I wasn’t trying to read her mind, but I couldn’t help picking up what a coup it would be for her group to be accompanied by a god.

I am not a god! Why can’t I get that across?

Besides, I don’t think I can keep up with them.

They will be walking. The longest distance I’ve walked, since that first disastrous day, is from here to the camp. It takes the shaman a little over an hour. I takes me two, and I’m pretty well worn out when I get there. In fact I’ve done it only once, the time I took Songbird home. No doubt they’d carry me, but I don’t want to slow them down.

And to be very honest ….

I’m not sure I can stand the stench. They do the best they can, but water is carried from the stream, sanitation is non-existent, butchering is done in the camp … well, let us just say that any group of people that large, carrying out their life without benefit of the amenities I have in my shelter, stinks.

It wasn’t bad at first, when they had only been at the camp site a day or so. But odorous materials pile up with time.

Admit it, I’m spoiled. I like my shelter, which now has running water, modern sanitation, a comfortable bed, and smells faintly of whatever flowers or grasses I’ve brought in. I don’t want to leave it.

Now I just have to figure out how to tell the shaman no, politely. Perhaps this journal, which requires the computer in my shelter, could serve as an excuse? But I will miss having someone intelligent to talk with.

Technology Index

The Perversity of Inanimate Objects 1 4/10/10
Insulin Pumps 5/20/10
Wars With Word 5/28/10
The Perversity of Inanimate Objects 2 6/4/10
Float Chair (fictional) 6/24/10
Tricycles are not Bicycles 8/8/10
Why Temperature Remembered doesn’t match the Record 4/5/11
Does Banking Software Work? 4/21/11
My New Toy – an iPad 2 5/12/11
Before Computers 6/5/11
How do you Eat a Salad? 4/28/12
Battery Woes 5/12/12
Printer Woes 6/14/12
Adult Proof 9/8/12
Digital Cameras 9/29/12
Who Needs a Nightcap? 9/3/13

Quotes from Anne McCaffrey

All of the past week’s quotes but the last are from The Rowan, by Anne McCaffrey.

“Especially guard the guardian” Part of Yegarani’s prediction about the Rowan, which Lusena interprets as guarding the Rowan from the excesses of Siglen.

“Someday it would be nice to have something who loved me!” The Rowan, expressing a wish for something other than the cupboard love of her barque cat, or reaction to her Talent.

“Old horrors could indeed grab you at the most unexpected moments.” The Rowan, when a rough sea triggers the fears planted by her earlier experience trapped in a hopper caught in a landslide.

“Love isn’t as strong as it’s supposed to be.” Peter Reidinger III, Earth Prime, when his idea of breaking the Rowan’s fear of space travel by her love for Jeff Raven fails.

“One is forced to put away childish things.” The Rowan is remembering, with deep regret, the pukha she had as a child.

“Why have a dog and bark yourself?” One of Siglen’s sayings. In this case, the Talents have spotted an alien invader and must convince the Fleet that it is a real threat.

“I know what it’s like to be used that way.” Sue Ann Bowling, Tourist Trap. Flame, trying to explain to Penny the difference between being used as a slave and the mutual love she and Roi share.

Prehistoric Predators (DVD Review)

No, they’re not dinosaurs. These critters are much more recent than the 60 million years since dinosaurs walked the Earth. In fact, our own species may be in part responsible for their demise. They were the top predators of Ice Age North America, and while the cause of their extinction is still subject to debate, they died out, along with their prey, shortly after humans first migrated into the Americas.

The DVD has National Geographic programs on three animals: the saber-toothed cat, the dire wolf, and the short-faced bear. Fossils of all three are found in the La Brea tar pits, and the excavations at La Brea are repeatedly discussed on the DVD. It is subject to the usual bias of this series: good interviews with scientists; poor quality animation clips which are repeated over and over. Another problem is that the science is posed on a “proof” basis when in fact science works by disproof. In general the narrator speaks of “proof” when the scientist involved has shown that his or her hypothesis as not been disproved. This is a very common problem with National Geographic science DVDs.

All three animals hunted the same mega-herbivores: bison, horse, and mammoth. In the same habitat they selected somewhat different prey. Camel and (for the short-faced bear) ground sloth may also have been on the menu, but all three predators were specialized to go after very large prey.

The saber-toothed cat was no more a tiger than it was a house cat. Its weight was in the same range as the modern lion, but it was far stockier and more muscular, with a short tail which reduced its agility at a run. It probably was much more of a wrestler than the modern large cats, and a fair part of the program is devoted to the question of how it used its saber-like but brittle canines for killing. It’s not as obvious as it seems; those oversized canines would have slid off the rounded belly of a prey animal. Nor was its skull constructed for a hard bite. But I have a feeling that it may have used its momentum more than the video clips suggest in pulling down a large animal. (I suspect also that any mammoths it killed were young, very old, or injured. I have a highly unsuccessful saber-tooth attack on a mammoth calf with its mother close by in Tourist Trap.)

The dire wolf closely resembled the modern gray wolf, but was considerably larger and sturdier, with greater bite strength. It probably ran in larger packs than modern wolves, but is thought to have had a very similar hunting style. I suspect the video clips show a far more immediate pulldown of prey than actually occurred. With very large herbivores thick on the ground, the dire wolf would have been an advantage over the gray wolf. When only smaller game became available, the faster, lighter, more behaviorally flexible gray wolf survived and the dire wolf did not.

The third of the predators, the short-faced bear, may not have been a predator so much as a scavenger, stealing kills from the other large predators. It was a very large bear, larger than the largest of the modern grizzlies, such as Kodiak bears. Its legs, however, were relatively long and slender, and it seems to have built for efficiency of gait rather than speed. It probably had an exceptional sense of smell (modern grizzlies have a better sense of smell than bloodhounds) so it was actually well adapted for stealing the kills of other predators. Certainly grizzlies today steal wolf kills if an opportunity occurs. But as I said, possibility or even probability is not scientific proof.

As an introduction to these three Pleistocene predators, this DVD is definitely worth watching. But don’t take everything it says too literally.

North Pole Weather, 1/16/12

Sunrise will be 10:29 and sunset 3:37 for 5 hr 12 minutes of daytime today, almost 6 minutes more than yesterday. The sun is now getting 4.4° above the horizon, almost 9 solar diameters. I haven’t seen sunlight on the walls yet, but I think I did just see a spark through the trees yesterday. I can see sunlight on the treetops across the road.

Yes, it’s been clear again – and cold, even by local standards. The indoor-outdoor thermometer has been stuck on LL (below 40 below) for a couple of days now, as of Sunday. It’s supposed to cloud over and get warmer today. I hope!

Not much snow here lately; we’re on the other side of the Alaska Range from Cordova. In fact, the snowpack has settled more than it has grown – I’d say 18” now, and no new snow in sight.

But the seed catalogs are arriving. I have five now, and I’m drooling over them. Park’s even has both of my favorite beans for Alaska back: Gina and Rocdor. Both bear early and well in our cold climate, though this year I’m going to start them a little earlier. Hope they don’t peak during Summer Arts Festival!

Six Sentence Sunday

It’s Sunday again, and I’m still posting consecutive bits from the second chapter of Rescue Operation (working title.) Tod’s the youngest of a group of teenaged “freedom fighters” who’ve been captured by slavers. To look at previous snippets, click “Six sentence Sunday” under the “Writing” tab.

At least not for him.

The twins had learned long since to split up when their father was after them, and to communicate their intentions to each other without words.  With luck, they could confuse their father to the point that they both got away, and at the worst, he had only one of them to abuse.  Tod didn’t think either of them had much of a chance, but he caught Tammy’s eye and gave the signal to split up.

She shook her head slightly.

He repeated the signal, more emphatic this time.

Visit the other Six Sentence Sunday authors by clicking the logo.

Alaska Winter Weather: Cordova and Nome

Alaska’s been in the news this week, but the AP reports are a little misleading. We’re not in the midst of a snow apocalypse all over the state. Here in Fairbanks, we could use more, and we have plenty of fuel. Both the storms and the fuel shortage are localized.

Many people, including news broadcasters, simply do not realize the sheer size of our state. We can have massive snowstorms in one part of the state while another part is dry and frigid and yet another part is sunny, or raining. It is certainly true that the areas surrounding Anchorage, including Valdez and Cordova, are having a snow emergency. It is also true that Nome missed its usual fall fuel delivery due to an unseasonable storm, and a Russian tanker and a Coast Guard icebreaker have just arrived to deliver fuel.  But the two areas of trouble are over 650 miles apart, and under the influence of quite different weather systems.

Cordova and Valdez, and to a lesser extent Anchorage, are all in areas where the ocean water is unfrozen and mountains run right down to the sea. If you see Alaska as a sourdough looking west, this region is just east of the diamond-shaped peninsula jutting south from under his chin. The relatively warm ocean water evaporates readily, providing the energy needed for storms. When the storms are steered into the coast, the snowfall (or at times rainfall) can be intense. This has happened a lot more often than usual this winter, and the area around Prince William Sound has more snow than they can cope with. But the same weather patterns that overwhelm the coastal areas with snow put central Alaska in a precipitation shadow.

The problem in Nome is quite different, being due to sea ice: its lack when a massive storm battered the city and prevented the normal barge delivery of winter fuel, and its presence now. There are no roads to Nome, though there are some in it. Neither is there any sort of fuel pipeline or long-distance power line. Electricity and heat are dependent on fuel oil, which is normally delivered by barge before the sea freezes up. A violent storm prevented that last fall, and now the landfast sea ice is blocking any normal barge delivery. Air delivery is possible, but only as a last resort – it’s expensive!

This past week we’ve been watching a Russian tanker and a Coast Guard icebreaker try to get to Nome, and Friday morning they finally arrived.

Luckily, the current weather forecast for Nome should allow them to offload their fuel, while Cordova is facing a brief period of sunshine. Fairbanks, on the other hand, is facing 40 below temperatures.

Disproof of global warming? No. Remember what I said about the warm water evaporating lots of vapor into the air, and the latent heat of the vapor fueling the storms? It’s hard to connect single weather events with climate, but global change is just as likely to have had a hand in causing the storms.

Jarn’s Journal Day 625

This is an entry from the (fictional) Journal of Jarn, an alien stranded on Earth some 125,000 years ago, during the interglacial preceding the one we are in. His stranding ultimately led to the Jarnian Confederation, the setting for my science fiction novels Homecoming and Tourist Trap. The setting is Africa, in the southern hemisphere. The Journal to date is also posted on my author website.

Day 625

I think I am beginning to have some handle on the seasons of this planet, and how they affect the nomads. The rains come a little before the southern solstice. It takes a few days for the flush of new growth, which is followed by the herd animals and the nomads and other predators who hunt them. Not that there aren’t some predators, and animals they prey on, year round, but the migratory herds are far more numerous.

I teleported to the nomads’ camp today. The shaman asked me about the fish trap Songbird had made after seeing a picture on my computer, and after I answered I asked the shaman why the nomads did not stay in one place as some of the lions and wild dogs do.

“We follow the food,” she said, and I was reminded of my own early struggles to find things I could eat. I could teleport to where food was abundant, once I found where that was. These people could not. But the shaman continued. “Also, we go to meet with other clans. The young people find mates at the Gather, and it is a good place to trade ideas. But if we stayed there, as you stay at your shelter, there would not be enough food.”

I was reminded of what Songbird had said, when I first asked her why her parents had left her, and the questions I had then about the role of the shamans. “If mates come from different clans, what determines which clan they stay with?”

“That depends on what they want, on the sizes of the two clans, and on the food supply. Sometimes there is a question, and then the shamans of the two tribes decide together. If a clan is too large there is a problem finding food; if it is too small it cannot fight off predators. Our clan could be a little larger, especially with the fish traps you have shown us. That is an idea we will share.

All I had done was observe that the trap in the picture worked because fish could not swim backwards. Songbird worked out how to make the trap and set it where it looked like the natural vegetation of the stream. “Give Songbird the credit,” I urged.

She giggled. “You make us think, and from that comes new things.”

Do not interfere. How can I stop interfering?

Poems and Songs

Here’s an index of the poems, songs and song parodies I’ve posted.

Poems
The Bargain 5/17
Cat and Man 6/22/10
Love Song 7/26/11
Old Gods 4/28/11
Haiku 5/26/11
Things my Dogs have Taught Me 6/16/11
Thunderstorm 6/30/11
Sheep 7/7/11
Calypso 7/14/11
On an Exhibition of Photographs by Barry McWayne: 1932-2010  7/23/11
Readiness 8/4/11
The Place Where You Go to Listen 8/18/11
Sunrise 8/25/11
Skyscape 10/13/11
Rain Clouds 10/27/11
To the Poet, from His Cat 11/3/11
Dreams 3/6/12

Songs (not parodies)
Apart 8/1/10

Songs (parodies)
White Christmas 11/23/10
O Christmas Tree 11/25/10
Here Comes Ice Fog 12/1/10
Plate Tectonics Carol 12/3/10
Where have All the Glaciers Gone 12/7/10
Arctic Haze 12/10/10
Climate Change 12/14/10
Snow Carol 12/16/10
O Permafrost 12/21/10
There Were Three Quarks 12/23/10
The Greenhouse Carol 1/1/10
The Twelve Days of Christmas 1/5/11
The Glacier March 12/1/11
Let it Snow 12/15/11
Merry Christmas and a Snow Carol (audio) 12/25/12