Sunday, March 23, 2008

A Man Named Meester

Today I experienced the future that is definitely now. For some this is old hat, but it was new for me and I enjoyed it. I am talking about Skype, the software that allows you to make free video phone calls online with an internet connection, webcam, and microphone. For those who are interested, my skype ID is rwrapp. Now, the actual significance of this story is the history... going all the way back to 1995 and a man named Meester...

Back in 1995 I was a freshman at Horizon High School in Thornton, CO. There was a teacher there named Ray Meester who despite being a lovable old hippie-type, also happened to be quite a math teacher and technological prophet. He had the foresight in the early 90's to get technology grants to make Horizon one of Colorado's first fully networked high schools with broadband in every room and a full service internet and technology lab. Yes, I became one of the internet lab T.A.'s and built my first website using HTML in 1995.

However, I distinctly remember a conversation with Mr. Meester about the future of internet technology. He predicted that while computers would get smaller and more portable (think Mac Air), that cell phones would actually become more powerful and computer-like (think Blackberry). He also said that a time would come when he could be sitting in his canoe fishing in a mountain lake, connected wirelessly to the internet through a cell phone card in his laptop, making a video call to his math classroom to teach trigonometry while he fished. That would be Skype. He shared these thoughts with me 13 years ago in 1995!!!

Unfortunately, Mr. Meester died of cancer in November of 1997, and thus did not see these things come to pass. I mention this whole story simply because it is an amazing memory of someone who was a good friend, great teacher, and wise in many ways. This world can always use more teachers like Mr. Meester.

Thursday, March 20, 2008

A Week of Contemplation

This week, Spring Break, has been refreshing for me as we have visited Katrina's family in Ohio. Oddly, I spent most of the week working, doing baseboard and trimwork carpentry in my in-laws house. For me this is exactly what I needed. I realize that amidst the measuring, cutting, painting, and nailing I've had quite a bit of time to contemplate where I am mentally, spiritually, physically, and even politically. Let me devote a few sentences to each...

Physically I am in limbo. I have regained all of the 50 lbs I lost during the Fall & Winter of my senior year at UNC. With that comes all sorts of psychological, physical, and sleep problems. But I have also been getting back into regular exercise, finding new ways to get myself motivated, and nearing a point of commitment to nutritional change. This of course has been a lifelong battle for me, but I continue to remain interested in fighting, and someday I think I'll find the right strategy.

Mentally I'm ready to get back to school and finish this semester. The change of thought process this week to visualization, mathematics, and a little creativity has been good and I know that the summer will give me the same opportunity with my research job and masters classes. I realize that I need to somehow incorporate more alternative mental exercises than I have, even though I have kept playing my guitar, writing on occasion, etc. I also realize that I'm still not feeling attached to the baby growing inside my wife which makes me feel somehow like a bad father or husband even though I know most fathers feel this way during a pregnancy and it ultimately isn't true.

Spiritually I'm distant but not detached. That is actually a positive for me because I no longer let myself go completely. God still is in my consciousness, which means hope and joy are always present to some extent in each day in my life regardless of whatever other depression may exist. Faith and Med School are not mutually exclusive but finding the right conditions for both to thrive is a challenge for me.

Politically I've realized that I'm angry and disenchanted. What started for me as hope for change, an unstoppable wave or societal revolution has now become mired in the same political sewage that sits stagnant across the floodplain that is our American 2 party system. What was a sure thing for the Democratic party has self-destructed behind the efforts of a candidate too self-absorbed to realize they've been beaten, dragging down the candidate who could secure the future generation for the party, and that candidate allowing themselves to be drawn off-topic by these efforts. The Clinton's are the political equivalent of Mike Tyson, the heavyweight fighter who won't retire or go away when they can no longer win, and Obama has become Evander Holyfield, the person known for getting his ear bit off by the Clintons... Al Gore lost because he was too attached to Clinton politics. Now, somehow Obama has allowed himself to become attached to Clinton politics. Maybe his speech on race will be a good first step back out of the mire.

I think it is time for me to focus on my spiritual, physical, and mental needs... letting the political cards play themselves.

Saturday, March 8, 2008

My Baby's First Story

Last night I read my baby its very first story. In my mind I know that the baby, our first child, cannot actually hear my words at 16 weeks in the womb. But deep down part of me wants and needs to bond with my child, and to begin sharing my world with him or her (we are not finding out the sex). The story that I read is called, "The Crippled Lamb" by Max Lucado. It tells the story of a little white lamb with spots of black wool and a crippled leg. These differences cause the lamb to be left out by the other lambs. It also causes him to be left behind in a stable when the shepherds take the flock to the next valley to graze. He feels so left out and lacking in purpose. While in that stable, a young couple arrives and the woman gives birth to a little baby. The night is cold and the baby begins to cry. The little lamb realizes his wool can keep the baby warm, so he cuddles up to the baby, who then stops crying. The mother thanks the little lamb for taking care of God's son Jesus. The little lamb finally realizes that God had a grand purpose for the problems that left him at that stable.

I did not know what this story was about before I read it to my baby. It seems like possibly the most appopriate and powerful first story a soul, a new life can hear!

God bless my friends!

Type rest of the post here

Thursday, March 6, 2008

Phenomenal Articles

Check them out!

A Response to Parable Comments

I have received a couple of good, critical comments to my posting entitled 'A Parable to Ponder'. I encourage you to read that parable and those comments, and then review this response to those comments. It is understandable that my zeal for the cessation of direct-to-physician marketing and gifting by pharmaceutical companies may have come across as an opposition to pharmaceutical companies as a whole. That is not my position and I will explain further, and respond to other comments as you read on...

I was asked to remain open-minded about Pharma and learn more about their role and influence in medicine before jumping to conclusions. You all should know that I firmly believe the pharmaceutical industry has produced amazing medicines and devices that have saved millions of lives and improved the quality of life more millions more, including myself. I would hate to see what this world would look like without the products this industry has put forward. Pharma has created the Partnership for Prescription Assistance to help poorer patients receive medicines in this country. My issue with Pharma lies in their violation of medical ethics. When a company deals in medical products and has a mission statement stating that you want to improve patient's lives as much as possible, they have put themselves under the constraints of medical ethics. Therefore you violate medical ethics and your stated mission by:
-Intentionally trying to influence physician's to prescribe your product more than a competitor by giving them free gifts.
-Saying you are helping educate physicians but providing research data that only SUPPORTS the product, providing data that only compares the product to placebo and not others in the same drug class
-Saying you are giving free samples for distribution to poorer patients but only providing free samples of the newest, most expensive Tier 3 drugs that a poorer patient would never be able to afford.
-Advertising to consumers with coupons for __# of days free of a medicine if your doctor will prescribe it for you.

So many great resources relating to these issues can be found at Different companies participate in these practices to different degrees, but the practices are highly prevalent in every major Pharma company like Wyeth, Pfizer, Amgen, etc.

Physicians are ALSO a part of this medical ethics violation. By accepting free gifts no matter how small, you are creating a conflict of interest. Find the time and take it to do your own research. Don't even risk the appearance of a potential ethical violation. Don't accept the gifts. This is the mission of PharmFree. To help physicians and future physicians see the conflict for what it is, and to change their personal behavior. My personal opinion is that a pharm rep could come to my future office leave their research data and free samples at the front desk and leave. I will not see them. I will review the data as a part of a larger literature review, and I will only give the samples to the patients who will benefit most from that drug AND cannot afford it, but will also educate them on how to get prescription assistance.

Another commentor posted a thought about eliminating all Pharma marketing. I do not think this is feasible. Remember that these companies are operating in a unique business arena where they can only hope to get physicians to write prescriptions. They do not have many options within their federal regulation constraints to get the word out about complex products that they have invested billions of dollars and 7-15 years of research and development in. I believe that direct-to-consumer advertising does get patients to see their doctors more for conditions that need to be treated, while also generating a fair share of hypochondriac syndromes. I also think in a minority of cases these patients put pressure on the doctor to prescribe the medication they heard about. That is pressure doctors should be able to resist through good communication and patient education based on the physician's personal research. Yes Doctors also see the ads on T.V., but in this case they do not have the subconscious drive for reciprocity of the gifts back to the Pharma company. This is a tougher issue because, as I said before, we need Pharma to survive and progress in this world. Ultimately we just need to find a way to get both Pharma and Physicians to interact ethically so that patients get the most possible benefit and Pharma survives economically.