Time to Call Your Doctor

I was so relieved to learn that, in the wake of the Vioxx debacle, Merck's board has acted decisively to financially reward senior executives should the once revered company turn into a house of cards.  I am sure those who have lost loved ones, or who themselves face the potential of Vioxx induced heart attacks, were equally heartened to hear of their thoughtful largesse.  Reading the Merck news over breakfast turned out to be somewhat of a serendipitous coincidence.  Just the night before, I found myself once again being irritated by the ever growing number of prescription drug commercials that, thanks to a compliant FDA, have become impossible to avoid.  While watching an episode of the British mystery Walking the Dead on BBC, I was urged to treat my stomach with Nexium (proven better), rhymed into reducing my cholesterol with Crestor (recently identified as a potential future Vioxx) and, get this, consider a hip replacement with a specific Titanium/ceramic prostheses even though I had no need of such surgery. 

I've spent the last thirty plus years in the branding and marketing business, so I understand the important role advertising plays in building sales for consumer products.  As a professional, I appreciate what it can do and the often inventive executions that emanate from the many talented people in the agency world.  As a consumer, I'm like everyone else, disdaining many of the commercials I see while probably being totally susceptible to their sales pitch.  That's OK when it comes to household cleaners, soft drinks or automobiles.  I'm not sure the same can be said of prescription drugs, and the more I see of those ads the greater my concern.  In 2003, just six years after the FDA relaxed its rules, the pharmaceutical industry spent $3.2 Billion on prescription drug advertising.  Studies suggest that for every dollar spent, more that four dollars are returned in revenue.  That means that in 2003, advertising generated more than $12 Billion in drug sales.  The power of persuasion.  The thing that bothers me is that a basic role of advertising is to induce trial, make us purchase something that we may not have considered before and that we may not need.  Trial is benign when it comes to a new brand of soap or ice tea, but not for a drug that by definition is going to modify the way our body is functioning, often with dangerous side effects. One has to assume that part of that $12 Billion incremental business comes at the expense of competitive pharmaceuticals appropriately prescribed, but it would be naïve to think that some of it, perhaps a significant share, doesn't fall into the category of unnecessary medication.

The fact is that patients are, as the ads usually suggest, calling their doctor "today" to ask whether taking this or that wouldn't be a great idea.  Sadly, the harassed physicians often take the path of least resistance.  How many people are popping Celebrex when Aspirin or another conventional analgesic would suffice?  How many functional males are pushing their doctors to prescribe Viagra or the like when these drugs are meant to assist only the dysfunctional?  And what, from a social perspective, is this $3.5 Billion expenditure doing to further increase the mounting cost of these and other medications?  In a country where we get exercised about someone smoking a joint to alleviate nausea induced by chemotherapy, it seems quite hypocritical that we allow the hawking of prescription drugs as if they were some kind of innocuous confection.  While I certainly have to take responsibility for my own health and do, I don't quite see telling my doctor what drugs are appropriate as part of that task.  Last I checked he, not I, was the one with a medical diploma on the wall.  I'll accept being asked to rush out to the supermarket or down to my car dealer by some actor on TV, but not when and if to call my doctor.  Something about that just doesn't sit well.

We blame the fast food industry for contributing to our national obesity.  All that superfluous fat is taking its toll.  It's time we started blaming the pharmaceutical industry and the FDA for making us a nation that over medicates.  It may take years to know the full extent of damage wrought by Vioxx, once the most heavily advertised prescriptive drug, but we already know it has done harm.  Perhaps I should call my doctor today and ask him why he and his colleagues are not raising their voices against this dangerous trend, this invitation to drug abuse?  Perhaps you should call your physician with the same question.

The Reds

History sure has its ironies, and here is one nobody seems to have picked up on.  Anyone old enough to remember the Cold War and most especially the horrendous 1950's has a vivid association with the designation "Red".  To paraphrase that sage Kermit the Frog, "it wasn't easy being Red" in those days when Joe McCarthy and his ultra conservative friends labeled them, or anyone the least bit sympathetic, as "Commies".  Everyone knew that a movie called "Reds" was going to be about Communists and it was commonplace to speak disparagingly of Red China.  So it is especially ironic that today Red States should refer to the Republican (and conservative at that) dominated sections of the country.  How did their language guru Frank Luntz let that happen?  The people he has so influenced on the right pride themselves on discipline especially in co-opting powerful descriptors, "Pro-Life" for anti-abortion activists or the "Death Tax" to discredit the inheritance taxes they want to repeal to name only a few.  One really has to laugh a little that they find themselves in linguistic bed with the much maligned enemy over which they obsessed for most of the last century.  What's worse, they aren't merely "Pinko" sympathizers (read liberals), they are Reds.

Tomorrow is Thanksgiving the holiday that is truly ours as opposed to yours and mine.  It's a time when we're not Jews, Christians, Moslems or non-believers, but Americans; perhaps we're not Democrats or Republicans either.  I love Thanksgiving and in large measure because, unlike the synthetically neutralized "holiday season" ahead, it is truly shared by all.  The changed meaning of Red reminds me that history has its ebb and flow, its ups and downs.  It gives me some hope that this distressing time isn't necessarily destined to be forever.  That thought alone makes me thankful.

And I guess one should also be thankful for today's Reds and the many things wrought under their dominion.  We're at war, and not a single one of us has yet had to pay a dime for it.  Indeed, they've cut our taxes so that we can indulge ourselves by buying more, not sacrifice by doing with less.  Not to worry, the kids for whom we have, after all, done so much will pay the bills; even better so will their still unborn offspring.  Countless thousands have died or been wounded, physically or psychologically, and notwithstanding that among them are many of our own sons and daughters, the President tells us that it's better happening over there than over here.  That should make us thankful, shouldn't it?  There is melting at both polar caps and an ever growing thirst for finite energy in a fast developing world (most significantly in the old Red China), but the garage under my New York City building is filled with SUVs.  I am so thankful on this holiday that my urban neighbors and their relatives in suburbia can still have those guzzling Hummers, Escalades and Navigators to transverse the rugged pavement of Amsterdam Avenue, Central Park West and the Garden State or Merritt Parkways. 

Life is good, undeniably good, so why am I so depressed this Thanksgiving?  I must really be a poop.  The latest polls show that a majority of Americans think the years ahead will be better than those immediately past.  I guess that's not surprising since a majority of them voted Red.  Maybe I should get with the program, not feel so Blue.  Now what happened to those rose colored glasses?  They must be around here somewhere.

An Old Friend in New Clothing

Visiting the Museum of Modern Art, was among my earliest childhood memories, perhaps predating school.  It was there that I was introduced to some of the great paintings and sculptures that have moved me, given me joy and a lifelong passion for art.  I remember the treat of eating lunch with my parents out on the penthouse terrace of the Edward Durell Stone building or walking up and down the interior staircase that is forever etched in my brain.  I remember seeing Picasso's Guernica, housed temporarily there when the artist was on the outs with his native Spain.  Perhaps I wasn't a pre-schooler the first time I came to MoMA, but my sons most certainly were and there is no doubt that the experience also left a lasting imprint.

I had the great pleasure of previewing the new MoMA last evening.  If its previous expansions sometimes struck a dissonant chord -- seemingly more appendages than integrated parts, this reincarnation is a cohesive exhilarating symphony.  Unlike other efforts, the 2004 MoMA is really new from top to bottom.  Perhaps behind the walls are skeletal remains of the old but, aside from the sculpture garden, you would be hard pressed to identify them.  What you will find is elegant and ample space.  Whether typography or painting, the visual always thrives on the air around it, and the new MoMA provides plenty of that.  You never feel the sense of being crowded or confined and happily neither are the paintings or sculptures.  The architecture doesn't shout with any egocentric "look at me".  Rather it reveals, and in a very intriguing way.  On each floor one can peek over railings or through "windows" and get a glimpse of what was seen or is about to be seen on another level, not to mention the city which it embraces rather than hides.  The walls are filled with old friends, but somehow even those appear as if never seen before.  The new MoMA is visually fresh and more importantly it provides, even demands, a fresh look.

I remember when Yoshio Taniguchi was awarded the MoMA project.  It wasn't that the man wasn't qualified.  He had created nine museums (models of which can be seen as part of the opening exhibits).  But some MoMA loyalists had hoped for a Frank Gehry sculpture-edifice or a Frank Lloyd Wright layer cake – something that would stand out against the cityscape.  It was around the time when everyone was rhapsodizing about Bilbao.  As to Wright's Guggenheim, it's the only museum that I really hate.  To be sure the building is striking, though it still seems out of place in its 5th Avenue context, but that narrow ramp simply isn't conducive to viewing art, especially larger canvases.  I haven't seen Bilbao yet, but its notoriety caused me to think a great deal about the role of museum architecture.  I have been to the new Tate in London, a spare warehouse of a place and to the Getty in LA, like the new MoMA an elegant but visually understated building.  In both cases, the architects seemed more interested in showcasing the works inside (even though the Getty collection disappoints) than in asserting their own signature.  Far be it for me to discount the sheer architectural brilliance of Gehry or Wright both of whom I admire greatly, but I am in the Taniguchi and company school.  I don't want a museum's architecture to distract me but to facilitate the best possible viewing of all those collected treasures.  For that reason alone, I love the new MoMA, can't wait to return and hope you'll get there soon to share my pleasure.

You won't be Missed

Colin Powell won't be part of the last (that has a nice sound) Bush administration and it won't matter one bit.  The man who four years ago joined a President with an assumed weak mandate was widely regarded as the Walter Cronkite of American public life.  If Bush unnerved many of us, and Cheney scared us half to death, Powell promised to be the saving moderating voice.  And, given the trust most of the country had in him, we wrongly assumed his views would prevail, at least most of the time.  These many years later Walter Cronkite is still missed, still trusted.  Colin Powell is unlikely to benefit from a similar legacy.

Powell it turns out, photo ops at the ranch notwithstanding, was a pretty weak player in the Administration from day one.  Despite tours in Viet Nam and leading the military at NATO and at home, he turned out to be inept in the trenches.  Draft evader Dick and "oh things happen" Rummy beat him at every turn.  The only time it seems that they passed him a bone was when it was clear that he would embarrass himself, not to mention his country, and forever tarnish his reputation before the UN and the world community. 

Walter Isaacson points out in a Times Op Ed that George Marshall, another General turned statesman, is Powell's hero.  Marshall didn't step aside when he disagreed with Truman and Powell followed his example even in the face of both foreign policy and military missteps.  Good soldiers both of them.  Marshall at least has left the Western World with concrete accomplishments – think about Europe without the life-regenerating Marshall Plan.  The Powell Doctrine has already been trashed, if it were ever really employed.  No, my guy is the late Cyrus Vance who quit Jimmy Carter's cabinet after the aborted attempt to rescue the hostages in Iran.  He did so on principle (remember that antiquated concept), something that seems to have eluded the general.  Soldiers may salute the Commander and Chief, but apparently Mr. Powell forgot that Secretary of State is a civilian diplomatic post, not another military assignment.

Some people will try to put a good face on the Powell tenure, speaking of the frustrations and valiant behind-the-scenes efforts.  They see his UN appearance as a tragic moment, an aberration in an unblemished career.  All of this doesn't cut it.  People who have reached Powell's level (achieved with considerable systematic planning and personal ambition) don't get free passes.  If George Bush squandered the good will that followed 9/11, Powell squandered what may well have been the myth of his public career.  Good bye Colin Powell, you won't be missed.  Don't get me wrong, Condi won't be welcomed.

A Death in the Family

A break from the global to the personal, the canine.  In 1968 we were blessed with our first son, dutifully named and reared in the traditional way.  Wonderfully, he would have nothing of it and early on established his individuality including rebranding himself Tommy DOG.  His path ever since has been one of boundless creativity and originality, facing and meeting challenges, some of them steep, and in the end conquering.  He is among the most inventive and industrious people I know, and among the most loving.  He life is music, fanciful sculptures – some of them working instruments – and collecting.  It is also revolves around a true love of dogs.

In full disclosure his father is not a dog person, and further is guilty of depriving his children of a canine companion in our New York City apartment when they were growing up; until only recently, a home I shared with Tommy DOG.  Eleven years ago, my house mate announced that he had decided to purchase a puppy, a Rottweiler no less.  It wasn't something I had contemplated nor necessarily welcomed, but his money and certainly his home as well as mine.  Into are lives came Otis.  She, and I'm sure you were thinking he, was named after the elevator that carries us up and down each day.  Did I tell you he is an original?

From her unlikely name (he added to it, but rarely used Pricilla) to her disposition, Otis mirroring her master was a contradiction in terms.  While part of a breed known for its potential ferociousness, Otis decided that she was a lap dog.  Her favorite spot of course was on my comfortable leather couch which ultimately self destructed from years of her loving licking and lying about.  Over the years, knowing my general disposition toward dogs, TD would say to me, "admit it, you like her."  Who couldn't like, even admire, Otis?  Given the subjects I usually write about, I might add that some of the human Rottweilers out there could learn a thing or two from this powerful beast who opted for peace rather than war, gentility rather than confrontation.

Otis' disposition didn't come out of the blue.  It was responsive to extraordinary love and gentleness of her adopted "parent".  From the start, she knew unquestioned love and respect.  She wouldn't have been what she was without Tommy DOG.  But that is only half the story.  He would not have been who he is today without her which is what makes this a beautiful and a powerful metaphor.  I've tried to be a good parent to my two sons and hope that some of their innate character and value systems reflect what they were exposed to at home.  But what I may have given to them – and hopefully will continue to give for some time – pales in comparison to what they have given to me.  I'm sure their mother feels the same way, and hopefully so do you if you are a parent.  Tommy DOG saw Otis as his child and, as he told friends and family in his email announcing her death last evening, "nothing has given me more pleasure and personal satisfaction then raising my Rottweiler from a pup".  He is a different person today than he was eleven years ago, and Otis is part of that difference.

"My life with her has been full and gratifying and I wouldn't have traded it for anything in the world," he said in his email.  I feel the same about my life with Tommy DOG.  Fortunately, I don't have to deal with it as a memory but as a living and wonderful work-in-progress.  We'll all miss Otis and I'll always be proud of him.

The Moral Minority

78% of the electorate did not consider morality the number one issue facing the nation.  Listening to the pundits you would think a significant majority placed it above the combined woes of terrorism, Iraq and the economy which simply is not at the case.  What one journalist characterized on C-Span as "most voters" was in fact 22% that selected morality, which any seasoned researcher knows is an ambiguous descriptor, in exit polls.  Morality, widely used as a code word for the religious right's social agenda, may have polled higher than any other single option but let's not get carried away with ourselves.  Probably more revealing is that after this long campaign there is no national consensus about what is our most urgent problem.  Perhaps even the famously focused Mr. Rove was unsuccessful in providing singular focus, but more likely it's another indication of how complicated are the problems we face going into Bush's second term (even writing those words hurts).  In this world, even the public has to "walk and chew gum at the same time".

I don't for a minute want to minimize the powerful role played by the religious right in this and the 2000 elections.  With their help, the country has been tilting conservative for a long time, most especially on the so-called cultural issues.  The next few months are likely to prove particularly troubling to many of us the President starts paying off his campaign debts, "spending his political capital".  Hold on to your seats, it's likely to be a rough ride.  But the lockstep analysis notwithstanding, we're looking at a influential moral minority not a majority of the population.  Moreover, I simply don't see the religious resurgence now taken as a truism in our media.  The fact remains that in this purportedly deeply religious country less that half of us belong to a church or synagogue.  More telling is that among the affiliated, no more, and often much less, than 40% of them attend religious services with any regularity.  If you don't believe me, stop in at your local house of worship any weekend and do a head count.  I say stop in, because most of you who read this, affiliated or not, also attend only occasionally, if at all.

Without question, religion is playing a huge role in this troubled time, and it is largely its extreme right that holds center stage.  Whether the fundamentalist fanatics who are blowing up the innocent in the name of God or their more docile counterparts who are trying to impose their ideology on the body politic, we find ourselves captives of their designs.  The religion whose face we see in the daily media is pretty unattractive if not frightening.  But to a great degree, we are not merely captives of it, but accomplices.  We complain that Moslem moderates have not raised their voices against the militants who are using their religion to justify violence, and rightly so.  But where are the moderate religious voices, the counterpoints to no less fanatical Fundamentalist Christians and Ultra-Orthodox Jews who want to impose their morality, their world view, on us?  When will the majority and the mainstream religious leaders wake up and challenge this notion that morality belongs only to the fringe or, for that matter, only to believers?  When will we stop being cowed by the hype and offer an alternative, more compelling, view?

We live in dangerous times and the religion that presents itself most vigorously is a huge part of the problem.  If we continue on this course of silent acquiescence don't expect our kids, already largely absent, to sign up for faithful duty.  Who can blame them?

2000 All Over Again, Not!

Much time will be spent in the coming days weeks and perhaps years analyzing the election of 2004.  In the final analysis, I believe this election proves that being for something and someone trumps being against.  The stark fact is that, while many of us happily voted for John Kerry, few felt any real passion for him.  It isn't as simple as saying we don't like him, for in fact most of us both like an admire him.  But, to use a popular expression of the kids, "he's not to die for."  With the possible exception of Howard Dean, none of the Democrats evoked real passion among their supporters and I doubt if any could have done better including John Edwards who somehow disappeared from the screen during this campaign.  People still vote for Presidents on both sides and even mediocre running mates don't amount to meaningful dragging anchors if Number One is up to his game.  Howard Dean evoked passion, but scared the hell out of the establishment that saw success only in the middle.  But more important, his campaign was largely against and his wipe out in the primaries should have been seen as a significant sign for the perils that lay ahead.  That said, I still don't think Kerry had voter passion going for him rather than against Bush which probably made the margin of difference.

Make no mistake about it; The United States has become a conservative country dominated politically by a right religious tilt.  Political tides change, but that's where we are as the lingering votes are sorted out in 2004.  The frustrating thing about 2000 was that the country as a whole saw no great difference between Bush and Gore (speak about passionless candidates).  When the Supremes cast their vote, many Democrats were saying that it really wasn't a big deal.  What could a mandate-free President do?  Right.  This election was vastly different.  Everyone saw two distinct candidates and two distinct ideologies.  Nobody thought or thinks it won't make a difference, particularly on domestic issues over which in the final analysis President's have the most control.

John Edwards is fond of saying there are two Americas, those who have and those who need.  That may be true, but politically the two Americas don't divide over possessions but over ideology and regionalism.  We Liberals, a term that I use broadly to define the heart of the Democratic Party, are cultural pluralists who are uneasy when our personal and particularly our religious predilections are brought into the public discourse, much less used to determine public policy.  The Conservatives, read Republicans, feel just the opposite.  We Liberals are coastal (which has become somewhat of a cliché but is nonetheless true) and excursions into the heartland are, language and Shopping Malls aside, more akin to visiting a foreign country than a next door neighbor.  The reverse is equally true.  We don't talk to each other, because we don't really speak a common language.

If the religious-cultural thing, what Conservatives like to call values (a term that they have co-opted much as they have "life') is so important than we might look at what role that played in planting the seeds of this election.  This time around I don't think it was abortion, but rather the decision made by the Massachusetts Supreme Court on Gay Marriage, one with which I happen to concur.  More than inclusion of this issue on the ballots of half a dozen states was the unspoken homophobic rage that still exists in our society, particularly in the heartland.  The fact that John Kerry is so much a son of Massachusetts where it all started should not be underestimated.  His remark about the Vice President's daughter which I don't think was either calculated or malicious nevertheless underscored this connection and was even unnerving to many of his supporters.  The induction of an openly Gay Episcopal Bishop, also from New England, didn't help.  Homosexuality in this conservative environment is like Color was (and sadly still very much is) in earlier times.

This was a bad day for Liberals.  I think it was also a bad day for science and, considering the illness of the Chief Justice and an aging Court, a potentially bad day for Choice.  I shudder to think that we are headed once again for back alley abortions.  All of this brings us to religion which may be the bottom line of this election.  Not merely is America considered the most religious of Western countries, functionally we have become a right tilting Christian country which, lip service to the contrary notwithstanding, is increasingly intolerant of other points of view.  Taking an international perspective, this is a very ominous development.  In fact, I would contend that we are moving rapidly toward replacing the Communist Menace that we lost in the Soviet Union's demise with the Moslem Menace.  Perhaps George Bush didn't literally mean Crusade when he said it, but there is no question that for some democracy is simply a code word for a certain religious belief.  That is not good for either the country or the world.  The record of holy wars and their impact upon the world, not to mention on minorities caught in the cross fire, is not pretty.  We dare not let that happen.