Sunday, December 18, 2011

Living life to the fullest (Christopher Hitchens)

I'm struck by the recent deaths of people who lived life the way they wanted to, regardless of consequences, and how it fits with Buddhist ideas.

One Buddhism principle is to live in the present as that's when life happens. Seems to be a Doh! but many people ignore it. Instead, they endlessly fret about the past or focus on the wonderful life they will have in the future, once retired, assuming they will live long into their retirement years.

This blog features Christopher Hitchens, who died on Dec. 15, 2011 at 62.

Hitchens smoked and drank too much and smoking likely ended his life early. He was a public man on a big stage, revered and reviled by many.

Besides his columns, he wrote 'God is not Great, How religion poisons everything' (available on Amazon), a courageous act given that he had become an American citizen. Where else in the developed world but the USA do you see a constant reference to God and religion by politicians? Such hypocrisy in the country that celebrates separation of church and state....

Some may think him selfish, squandering his life with addictions that led to his early demise. Others may hate his stand against religion. Many admire him for his intellect, writing and debating skills. Most of all, he is respected and honoured for his promotion of freedom - freedom of thought, particularly freedom from religious dogma and other such frauds.

George Bernard Shaw said, "The only service a friend can render is to hold up a mirror in which you see a noble image of yourself".

Hitch, as his buddies called him, had loving friends who held up such a mirror. Remembrances of CH:
To appreciate Hitchens and his intellect, listen to his debate with Tony Blair in 2010 in Toronto (debate proper starts at ~6:32)

and his acceptance speech of the 2011 Richard Dawkins award.

Christopher Hitchens lived life fully in the present according to his beliefs. We should all be so lucky.

Saturday, December 03, 2011

Pathologist error: Double standard for docs & lab techs?

Pathologist error happened elsewhere:

And now significant pathologist error has hit my city:
Apparently the pathologist was substituting for another doctor over the summer. According to the news item:
"Of the 126 retests completed, 51 had no discrepancies with the pathologist’s initial report, 46 had minor discrepancies and 29 had substantial discrepancies."
If the subset of biopsies already retested is representative of the 159 prostate biopsies (or 1,568 non-prostate specimens), the pathologist made serious errors on 23% of the tests examined.

For interest, in the transfusion service laboratory (TS) when it comes to ABO grouping of patients, where errors can cause serious morbidity and potentially mortality, the margin of error allowed for medical technologists during competency assessment is zero, i.e., all ABO groups must be interpreted correctly.

Anyone hired to work in the TS lab, whether as fulltime, part-time, or casual staff, would undergo orientation during which they would be oriented to the lab's policies and procedures, retrained on basic theory and practice as needed, and undergo comptency assessment before being allowed to work independently with the same arms-lenght supervision as experienced staff.

If the medical laboratory technologist had not worked in the discipline for awhile, it's guaranteed they would be retrained before being 'let loose on patients.'

QUESTIONS

#1. Did the substitute pathologist have current experience reading prostate and other biopsies? If not, was retraining provided?
My guess: No current experience otherwise there would be many tests to re-examine over multiple years. No retraining because physicians, unlike other health professionals, seem to be exempt from re-training unless they emigrate from foreign countries or were discovered - after the fact - to have made major errors.
#2. Were the substitute pathologist's assessments checked by a second pathologist or were they reported "as is"?
My guess: Reports were unchecked and reported 'as is." There are no built-in processes to check physician error, except in retrospect when things go drastically wrong.
#3. What is the root cause of this screw-up?
My guess: Pathologist shortage.  ( Lots of evidence )
Are Edmonton pathologists now so overworked and in such short supply that physicians near retirement, who may not have current experience, are hired as substitutes so others can take much needed vacations?
Contributing factors: Double standard for physicians, who do not have to undergo the competency assessment that lab technologists do AND whose work seldom, if ever, has built-in system checks designed to detect errors.
SUMMARY

1. A substitute pathologist made multiple serious errors that impact patient care.

2. So far, all that happened is that he or she retired.

3. The pathologist's name will likely not be released since quality systems (QS) is now an integral part of health care. QS is a non-punitive system designed to foster staff revealing errors in a safe environment.

4. Alberta's College of Physicians and Surgeons releases names only if the physician is part of a disciplinary hearing open to the public.

5. Alberta's Health Quality Council will investigate. Will it provide a full public report of what happened? Who knows. I hope so, including answers to the 3 questions above.

MUSINGS

As a life-long transfusion science educator, I am often struck by how physicians are not required to meet the same standards of competence as medical laboratory technologists. Fact is, physicians who treat patients (clinicians) can prescribe transfusions in a total state of ignorance. They typically have little education in transfusion medicine.

The blood system relies on lab technologists to monitor inappropriate transfusion orders and draw them to the attention of the physicians (often hematopathologists) who serve as medical directors of transfusion services in Canada's urban centres. In smaller centres that lack technologists who are transfusion specialists, there are no checks on the incompetent ordering practices of clinicians, except in retrospect if things go dramatically wrong.

Tidbit: My experience in tranfusion service laboratories and blood centres is extensive. However, if I wanted to work in one today as a medical laboratory technologist, I would not be allowed to without providing clear evidence of continuing competency to the Alberta College of Medical Laboratory Technologists. And once on the job, I would receive extensive retraining.

If my assumptions about the substitute pathologist are true (and it's big if), would the harm to patient safety exist if pathologists had to demonstrate the same competency as I would before being let loose on patients?

Friday, August 12, 2011

Silencing USA! USA! chants (Musings on 2011 FIFA Women's World Cup)

I love soccer ('football' outside of NA) and the 2011 FIFA Women's World Cup in July was a delight to watch. Amazing how much entertaining drama such international events can generate. It's taken awhile, but I'd like to offer some musings on the tournament, particularly the play of the Japanese and American teams and my reaction to chants of USA! USA!

Germany, arguably the best women's team in the world heading into the tournament and the two-time defending champions, was favoured to win, especially playing on home turf. They had not lost a game since 1999. What a shocker to see little Japan beat them 1-0 in extra time during the quarter finals despite the added disadvantage of a strongly pro-German crowd. But the win foreshadowed what was to come in the final against the USA team, also a tournament favorite.

MUSINGS ON HEIGHT

I say 'little Japan' because most of their players are inches shorter than others, especially opponents on the German and USA teams, some of whose members are amazon-like. For example, the average height of the Japanese women is 5'4'' versus 5'7' for USA players. Japan's veteran star midfielder Homare Sawa is 5'5'', compared to the USA's prolific scorer Abby Wambach, who is 5'11''. Japan's midfielder, Aya Miyama, who scored in the final, is only 5'2''. Germany's legendary Birgit Prinz, although not a factor in the tournament, is just over 5'10''.

Being short has significant implications in soccer:
1. Short players have to run many more steps than taller opponents.

2. Short players seldom or never win challenges for the ball involving headers.

3. Short players seldom score on headers, a gold mine of goals from set plays such as corners.

4. Short players are typically much smaller overall, hence tall players can usually physically 'muscle' short ones off the ball.

5. Short players usually lack the power of taller ones and kick balls with less force and speed.

6. A short goalie is disadvantaged with a shorter reach. Tall 'keeper's' can stretch farther and protect more of the goal. Japan's Ayumi Kaihori is under 5'6'', whereas Hope Solo, the best goalie in the tournament (and arrogant at times), is 5'9''.
Yet Japan (ranked #4) beat the taller and physically stronger German and American teams.

MUSINGS ON CHANTS OF "USA! USA!"

Like many around the globe, in the final I cheered for Japan, the clear underdog. But it wasn't just a case of cheering for David against Goliath.

During the tournament, as in most international sports events, whenever the USA plays, chants of USA! USA! are bound to arise. Many American fans attended the 2011 FIFA tournament, not just American tourists, but also due to the presence of the US military in Germany. Since 1984 and the Los Angeles Olympics I've detested these chants.

It began when watching a volleyball game. I forget if it was men or women but the USA was playing a team from a small Pacific Island nation. As you can imagine, it was a rout, with the USA team being so much better. Yet the American fans in LA constantly chanted USA! USA! and never once cheered or clapped when the outclassed opponents from the tiny island nation made a good play.

The Yanks in the LA crowd seemingly had no sense of fair play and no appreciation for the game. Like bullies, they relished in the beating up of a runt, exhibiting chauvinistic patriotism, where only winning matters.

That's what USA! USA! has reminded me of ever since, including in the German FIFA women's tournament. (I won't go into the sickening feeling generated by over-the-top political use of USA!USA! by mostly right wing supporters at American political rallies, as if only Republicans and Tea Partiers are patriotic.)

For fun, this is a Canadian crowd chanting USA! USA! to recognize the great effort of the US women's hockey team in winning the silver medal at the Vancouver 2010 Olympics. It's during the medal ceremony after Canada beat them in the gold medal  game.

KUDOS to the YANKS

The pro-American crowd's USA! USA! chants aside, there are many admirable things about the US women's soccer team. Some that impressed me:

1. Abby Wambach is a class act.
Not only did she show sportsmanship throughout all the games, give interviews after the games that acknowledged opponents, e.g., after the USA won over France in the semi-final, she noted that France played better than the USA at times (No kidding! France outshot the USA 25 to 11.)
I was especially impressed that, even after the USA lost the gold medal game to Japan, which was a heartbreaker to Americans, Abby still showed good sportsmanship to those Japanese players who, like her, had won awards. She lent a helping arm to guide them into posing for photos, a joy to behold.
2. Besides Wambach, the team has many excellent players, including Megan Rapinoe. I've never seen anyone better at delivering corners. In the game against the talented Brazil squad, she saved the USA with a perfectly placed pass to Wambach, whose header tied the game at the 122'' minute mark (into injury time at the end of overtime).

Singing 'Born in the USA' after the win over Columbia was a bit much, but she has overcome setbacks and comes from a working class family who sacrificed for her.

3. Despite the high stakes, the final against Japan was a friendly match, with players on both sides, taking time to say 'sorry' and check on opponents after bringing them down by accident or on purpose. Nice to see, especially from Americans, who so often are focused on win-win-win at all costs. Both Japan and the US soccer teams showed great sportsmanship.

4. US coach, Pia Sundhage, a Swede, is a delight. After each game she always took time to praise her players and assistant coaches, and give credit to opponents.
5. The American team played its heart out in the final and had many chances to put the game out of reach early on. If they had scored on their opportunities, they would have won and been deserving winners. But they didn't.

You could say the Americans 'choked' in not capitalizing on their chances and then fell totally apart in the penalty kicks. Or you could say that Japan created their own miracle by never giving up and playing well throughout the tournament.

BOTTOM LINE

As a sports fan I rejoiced when the wee Japanese courageously came back to tie the game twice in the final with the USA and then win on penalty kicks.

Congratulations to Japan - Prior to the World Cup Japan and the USA had played 25 games, with Japan winning none (22 US wins and 3 ties). But on the days it counted they beat Germany and the USA without the advantages of height and power, not even the support of the spectators. Japanese players have the right stuff, the stuff of champions.

They are most deserving winners. Did I mention the Japanese team also won the tournament's Fair Play Award? They played the fairest of any team, getting just five yellows and one red card. After every game, they showed this banner to the delight of the crowds:
This summary of the tournament says it all:
What did it take? Skill, skill, and more skill. And most of all, heart. The Japanese gave 100%+ game in and game out against great odds. They didn't know the meaning of 'quit.' Their exemplary attitude, perseverance, and skilled play silenced USA! USA!

As always, comments are most welcome.

Sunday, June 05, 2011

CBC 'brown noses' PM Harper

Why did CBC broadcast Jian Ghomeshi's 30-minute interview with Stephen Harper about the PM's love of hockey before the 2nd game of the Vancouver-Boston series? It gave the 'pygmy PM' a kazillion $ worth of free publicity. Was it to ingratiate CBC with Harper who threatens to axe Canada's national broadcaster?

Friday, April 29, 2011

Left shift spawns Henny Pennys

The rise in the polls of Jack Layton and the NDP in the run up to Canada's 2011 federal election has made Henny Pennys of those whose world order is threatened. Witness 'Layton as PM a frightening scenario,' an editorial in the Calgary Herald, reprinted in the Edmonton Journal.

However, contrary to the editorial's headline, the sky does not fall in when the NDP forms governments. Unfortunately, facts do not stop Tory spin doctors and their surrogates from using the politics of fear.

When Gary Doer, Canada's ambassador in Washington, was premier of Manitoba (1999-2009), he won two successive re-elections, each time with increased majorities, and consistently introduced balanced budgets. Saskatchewan's NDP government (1991-2007) also showed fiscal responsibility with 11 consecutive balanced budgets. In 2005 the federal Dept. of Finance released a report on federal and provincial budgets over the past 22 years that showed that NDP governments had the best fiscal track-record among all parties.

Older readers may recall that in 1962 Saskatchewan's doctors screamed like 'chicken little' and went on strike claiming that 'socialized medicine' would be so intolerable as to leave the province without doctors. By 1965 most doctors supported medicare and the model was implemented across Canada within 10 years.

Stephen Harper's Conservatives are expert practitioners of the politics of fear and practice a "course, vicious brand of politics" (to quote Maclean's editor Andrew Coyne). Indeed it's their stock and trade. Witness their focus on crime and building more prisons, despite the fact that crime, including serious crime, is declining in Canada.
On May 2 Canadians should not reward those who twist facts and try to scare us into voting for them. The sky is not falling in. Have courage. We should not believe everything we are told by the Henny-Pennys of this world. Otherwise the fox will have us all for lunch.

Harper on Gretzky: He didn't come back for you...

Stephen Harper's Tories create nasty attack ads that hurl personal insults at Michael Ignatieff and distort reality for their partisan goals. One ad implies that spending time living and working outside Canada is unpatriotic ("He didn't come back for you." - Robert Fulford's take). Nothing about Liberal policies, just a personal slur. That's our PM, folks.

I wonder if hockey fan Harper would toss that accusation at Wayne Gretzky (aka 'The Great One'), who has lived in the USA since 1988? Gretzky, the great traitor, he didn't come back for you.

People's Republic of Albertastan

Updated: 6 May 2015 (Fixed broken links)
Albertans tend to vote overwhelmingly Conservative to the point where the province is sometimes derisively called Albertastan. The name is a take-off on the many one-party "stan" states in central Asia, mostly former Soviet republics.

Sadly, many Albertans take the view that people who do not vote Conservative are not only misguided but also dangerous and unpatriotic. Such intolerant views would be at home in the former USSR where 'dissidents' were treated as pariahs. Such citizens think that it's intolerable that Alberta has one non-Tory seat, Edmonton-Strathcona, ably represented by Linda Duncan. They don't comprehend that democracy means respecting the views of all and that diversity of opinion is a strength.

Intolerance and related 'group think' can bully people into voting Conservative. Others may vote Conservative because they want to vote for the winning side or to vote as they perceive their bosses vote. Some Albertans may vote on a single issue such as the economy, believing that only a Tory government can keep it strong. Such voters conveniently forget that the Liberals left Harper with a solid economy and surplus and that our sound banking system, not Stephen Harper, protected us from the worst of the recent recession. I've heard many Albertans say they would like to support another party, but it seems hopeless given that one vote cannot change anything here.

In the 2008 election 58.8% of Canadians voted (province by province results). Conservatives won 37.6% of the votes, with 62.4% voting for other parties. In our 'first past the post' system, Conservatives "won" and formed a minority government with the support of only 22% of voters.

So, if you are an Albertan thinking of voting Green or Liberal or NDP, you are not alone. Indeed you are in the majority nationally. Your vote matters as much as those who vote Conservative.
To paraphrase Rick Mercer's recent 'vote rant' that spawned the vote mobs on university campuses:
  • If you're 18 or older and breathing, and you want to scare the hell out of those who run this country, do the unexpected and what people around the world are dying to do: Vote. Especially vote for the party of your choice, the one that best represents your views on a range of issues.

Canada's PM pushes asbestos for votes

On 26 April 2011 articles in many Canadian and foreign papers reported that Canadian PM Stephen Harper had a campaign stop in Asbestos, Quebec in which he supported allowing Quebec's asbestos industry to export its product abroad:
The World Health Organization estimates that more than 107,000 people die of exposure to asbestos annually. Quebec's asbestos industry employs 500-800 people. And we wonder why Canada's reputation around the globe is in shreds. Harper supports Canada as an immoral exporter of death to poor countries.

Is there anything our PM won't do for a vote? Do Canadian jobs trump killing others? Anyone who votes Conservative needs to know what Harper stands for. And why was there no mention of Harper's Quebec campaign stop to support asbestos exports in the Edmonton Journal? Aren't newspapers supposed to keep citizens informed about the activities of the government?

Monday, January 24, 2011

The Facebook dilemma

A friend recently asked why I left Facebook (FB). Many have written about their FB dilemma, and why they leave, join, leave, join. Several things bother me about FB - here's a few:

1. Privacy: Ongoing privacy issues with its app developers (they get your info then can sell it to others). FB keeps backing off when caught but the young geeks in charge really do not get the privacy issue and I do not trust them.

2. Advert magnet: FB's core business is to create communities to whom advertising can be targetted. It can do this since FB knows a great deal about its users. I'm against this insidious practice in principle.

Truest quote I've heard about FB was on CBC radio awhile ago. About free social media sites like FB,  a social media expert said , "If it's free, what they are selling is YOU."

3. Quasi-voyerism: FB is supposed to be a social medium, but, like mailing lists, most people lurk and make few, if any, posts. No communication, no interaction, just a kind of harmless 'voyeurism', presumably getting pleasure from glimpsing the lives of others. The volume of genuine personal interaction among the 'friends' compared to deadening silence (or total drivel) is low.

4. Friends - really?  Once on FB, you get many friend requests from people who in no way are your friends. Indeed, some barely know you and some you may not have even gotten along with that well. It's hard to refuse a 'friend' request because you know the person will not understand, may be hurt, and just wants to touch base with a colleague or acquaintance.

Yet it's ridiculous to give virtual strangers access to your daily activities, thoughts, and feelings, assuming you use FB as a true social medium. I do not like dealing with this dilemma time and time again.

5. Posing: FB lends itself to posing and posers. Naturally, all users tend to reveal the parts of themselves they want others to see, i.e., their admirable selves, their bragging points, etc. FB is somewhat akin to those Christmas cards with long updates that some people send in which their kids are practically Nobel prize winners and they are happily planning their annual family get together in the hills of Tuscany. It's all harmless, but the hypocrisy tends to get to me.

6. Time waster: FB can easily become a huge time waster as you scroll through the drivel to get to the gems. Since our time on earth is finite, time on FB must be assessed against other activities. In most (not all) cases, FB loses. To me, few, if any, important things in life happen in front of a computer screen.

That said, now that I've left, I truly miss interacting on FB with my friends. The choice to opt out of FB was not an easy one. Most people just go with the prevailing flow (500 million users and growing), but I've never been good at that. I often think of returning but have resisted so far.
 
Currently, I'm trying a new experiment with twitter. Follow me here: http://twitter.com/bogeywheels