Tuberculosis in Britain 2012
World TB Day today
Yesterday, on the BBC Radio 4 Today programme, Professor Mike Kelly reminded us about the scandal of over 9,000 cases in the UK last year, a 5% rise.
The interviewer, James Naughtie, had a great opportunity to ask why. Is telling people to eat, drink and smoke less, and exercise more, distracting public health doctors from their traditional role, preventing and treating infectious diseases?
Instead he wondered if the coalition government’s NHS Reform bill had distracted them! Listen here.
Balanced broadcasting? My elbow!
Jim Thornton
Ocmulgee river from Juliette to Macon, Georgia
Starting at the Whistle Stop Cafe
Twelve years ago I launched my canoe in the Ocmulgee river at Juliette dam and paddled down nearly to Macon (rhymes with bacon). My late father, wife, children, and a family friend Lesley came too. A great paddle.
Fannie Flagg’s lesbian novel Fried Green Tomatoes at the Whistle Stop Cafe was filmed in Juliette.
Juliette bridge crosses the river just upstream of the dam
Here’s the present Whistle Stop Cafe and other pictures of the dam
These pictures of Juliette and the old disused mill are from before Hollywood came to visit.
We launched from just below the dam on the left bank.
After the first few rapids (shoals) below the dam, the river was easy and in less than an hour we’d found an island to camp on for the night.
We lay awake in our tents and listened to the coal trains inch past.
Next day we paddled on. Turtles plopped off their warm stones into the water as we rounded every bend. We didn’t see any alligators.
On the right bank we passed the water abstraction station for the the nearby Robert Scherer power plant.
This is allegedly the largest single point source for CO2 in the United States. But it also produces 32 megawatts of power for nearby Atlanta. It’s situated a few miles from the river on the artificial Lake Juliette created by damning a small tributary Rum Creek, and topped up with water from the Ocmulgee.
Island – pass either side
Dames Ferry – Highway 18 bridge
Shoals below
Rum creek joins right.
We landed here at Pope’s Ferry. A good access point.
The total distance was no more than 10 or 12 miles. Wobbles on some of the shoals, but no-one fell in.
Jim Thornton
Toll roads
Their time has come
Toll roads “Free” roads Private roads
David Cameron’s tentative suggestion yesterday to encourage new roads, or the upgrading of old ones, in return for letting the builders levy tolls, has provoked the usual howls of outrage. Why? It has something for everyone.
Businessmen make money, taxpayers get a break, drivers get better roads, and pricing discourages wasteful trips and time spent in traffic jams – Nick Clegg’s green friends should rejoice most of all. Automated electronic charging makes even tollbooth queues a thing of the past.
The idea is a no brainer for trunk roads, but it should be extended to all roads. Let local communities, even the residents of single streets, own their roads and charge to drive or park on them. Most would spend less on maintenance than remote councils do, which would save energy, slow local traffic and help the environment. Traffic would keep moving because a few people would find it worthwhile to tart up a through road, or build a bypass, and charge for it. Click here for more.
Most objections come from socialists who think the state should run everything, and from drivers who fear paying more. Fortunately the former are an endangered species and the latter are mistaken. There is no need for the overall costs of travel to rise. High fuel tax is a crude way to pay for the pollution drivers impose on others. Road pricing, varied by time and route is more efficient, and the increased visibility of tolls, while making them unpopular, paradoxically makes people more aware of them and brings pressure for reduction. Supporters of low tax should encourage visible taxes.
The main objection has been transaction costs. Until recently it would have been prohibitively expensive to collect the tolls on all but the largest roads. But technology and the internet have changed all that. The time for letting government give us the roads they think we want has passed. This is one policy Cameron and Clegg can genuinely both support. Keep on guys.
Jim Thornton
Didn’t do it. It wasn’t true
Test cases not always what they seem
In the landmark Lawrence v. Texas case where the US Supreme court ruled in 2003 that anti-sodomy laws were unconstitutional, Lawrence hardly knew Garner, the other guy. They were dressed and in different rooms on the night in 1998 when the police barged in looking for someone waving a gun. In fact Lawrence never actually did the deed for which he was charged (Review of Flagrant Conduct by Dale Carpenter, Norton, New Yorker March 12, 2012). But he was gay, and the police got confused by an explicit gay cartoon of James Dean on the wall!
Normally Lawrence and Garner would have pleaded not guilty, but campaigners needed a test case, and they were the only people, in the 12 years since the Supreme Court had previously considered anti-sodomy laws, who had actually been arrested! So, in return for admitting the offence he hadn’t committed, Lawrence got high-powered legal support all the way to the top. And the law got changed.
Rather like Roe v Wade in 1973 where the Supreme Court declared laws restricting abortion unconstitutional. A Texan woman named Norma Leah McCorvey had claimed to have been raped when she sought the abortion of her third pregnancy. When her request was turned down she found her way to two campaigning lawyers who claimed on her behalf, under the pseudonym Jane Roe, that the law was unconstitutional. Long before the case got near the Supreme Court, MacCorvey had not just admitted inventing the rape, but had delivered the baby. But by then no-one was interested, the case had a life of its own and the rest is history. Later still McCorvey claimed to have been exploited by the pro-choice lawyers and she joined campaigns for the law to be overturned.
Funny how the facts so often get lost in the legal process.
Jim Thornton
3rd and 21st Century Woman
“The Thunder, Perfect Mind” & “I’m a Bitch”
In 1945 a sealed earthenware jar of papyrus codices was found at Nag Hammadi in Egypt. It had been buried in about AD 350 when the texts it contained, mainly gospels which had failed to make it into the New Testament, were proclaimed heretical.
It also contained this poem, The Thunder, Perfect Mind, probably written in cosmopolitan Alexandria a hundred years or so before it was buried. It could have been yesterday.
Here’s an extract. Full text here.
For I am the first and the last.
I am the honored one and the scorned one.
I am the whore and the holy one.
I am the wife and the virgin.
I am the mother and the daughter.
I am the members of my mother.
I am the barren one
and many are her sons.
I am she whose wedding is great,
and I have not taken a husband.
I am the midwife and she who does not bear.
I am the solace of my labor pains.
I am the bride and the bridegroom,
and it is my husband who begot me.
I am the mother of my father
and the sister of my husband
and he is my offspring.
I am the slave of him who prepared me.
I am the ruler of my offspring.
But he is the one who begot me before the time on a birthday.
And he is my offspring in due time,
and my power is from him.
I am the staff of his power in his youth,
and he is the rod of my old age.
And whatever he wills happens to me.
I am the silence that is incomprehensible
and the idea whose remembrance is frequent.
I am the voice whose sound is manifold
and the word whose appearance is multiple.
I am the utterance of my name.
[…]
For I am knowledge and ignorance.
I am shame and boldness.
I am shameless; I am ashamed.
I am strength and I am fear.
I am war and peace.
Give heed to me.
I am the one who is disgraced and the great one.
Give heed to my poverty and my wealth.
Do not be arrogant to me when I am cast out upon the earth,
and you will find me in those that are to come.
And do not look upon me on the dung-heap
nor go and leave me cast out,
and you will find me in the kingdoms.
And do not look upon me when I am cast out among those who
are disgraced and in the least places,
nor laugh at me.
And do not cast me out among those who are slain in violence.
But I, I am compassionate and I am cruel.
Be on your guard!
Do not hate my obedience
and do not love my self-control.
In my weakness, do not forsake me,
and do not be afraid of my power.
Although only translated in the 1970s, it has already featured in Prada adverts, in Umberto Eco’s Foucault’s Pendulum, and has inspired many songs. I wonder if Alanis Morisette had read it when she wrote I’m a Bitch.
I hate the world today
You’re so good to me, I know
But I can change
Tried to tell you
But you look at me like maybe I’m an angel underneath
In a sentence sweet
Yesterday I cried
Must have been relieved to see the softer side
I can understand how you’d be so confused
I don’t envy you
I’m a little bit of everything
All rolled into one
I’m a bitch I’m a lover
I’m a child I’m a mother
I’m a sinner I’m a saint
I do not feel ashamed
I’m your hell I’m your dream
I’m nothing in between
You know, you wouldn’t want it any other way
So take me as I am
This may mean, you’ll have to be a stronger man
Rest assured that, when I start to make you nervous
And I’m going to extreme’s
Tomorrow I will change and today won’t mean a thing
[chorus]
Just when you think
You got me
Figure out the seasons all ready changing
I think it’s cool, you do what you do
And don’t try to save me
[chorus]
I’m a bitch, I’m a tease
I’m a goddess on my knees
When you’re hurt
When you suffer
I’m your angel undercover
I’ve been numb
I’m revived
Can’t say I’m not alive
You know I wouldn’t want it any other way
For some reason Alanis Morisette never recorded, or even sang, I’m a Bitch. Meredith Brooks made it a hit.
Primary Mothercare again
Look inside
Every 12 hours the equivalent of two jumbo jets crashing and killing everyone on board – that’s the worldwide death toll from childbirth. Not just on that terrible day in 1977, when two 747s collided in the world’s worst aircraft accident in Tenerife, but day in, day out. One every minute.
Saving them won’t be easy. In 1990 the UN set one of its Millenium Development Goals, MDG 5A to be precise, to reduce maternal mortality by three quarters by 2015. Few believe it will be hit.
Saving mothers lives takes more than vaccination and clean water. It needs anti-biotics, anti-convulsants, blood transfusion and safe surgery. That means transport systems, trained staff and functioning hospitals. Training means books – lots of them. Complete, but written in simple language. That’s where Primary Mothercare and Population comes in.
My scanner is poor quality, but the following extracts give you a peek inside. Four hundred detailed, easy to read, fully illustrated pages.
Read more here. Help me get it where it’s needed. Send an email to jimgthornton@hotmail.co.uk and I’ll send you a free copy.
Jim Thornton
Joining UK biobank
Waiting to become a data point
A couple of years ago I responded to an invitation to join UK Biobank, one of the largest health research cohorts ever assembled. I’m normally sceptical about health cohorts – they cost a bomb and never seem to come up with much, apart from the Lancet’s “Friday Health Scares”, or pseudo-justifications for public health enthusiasts various nanny state agendas. But my curiosity was piqued by Biobank. I’d been aware of its development over many years, and it is large enough to test some interesting hypotheses.
First impressions were favourable. Although I’d failed to make a proper appointment they fitted me in, the survey was clear and unambiguous, my blood pressure was checked properly, and there was almost no waiting for all the blood tests and other assessments. Everything was efficiently bar coded and automated, and I was out of the door in 30 minutes clutching my profile – “waist measurement borderline”. I felt guilty for having halved my reported alcohol intake and doubled the number of people I said I’d had sex with!
Now I’m one of 500,000 people in their forties and fifties who get occasional requests to describe what we ate and drank in the preceding 24 hours – I try to answer truthfully now – and waiting to annoy the next generation as a data point on a “Friday Health Scare”.
Jim Thornton
WOMAN trial featured in the Lancet
On International Women’s Day
Click here to read about the trial and about Dr Utako Okamoto, who with her husband Shosuke Okamoto discovered the antifibrinolytic drug, tranexamic acid.
Ripe-tomato.org featured theWOMAN trial here, and here, and here. It’s one of the most important trials currently recruiting in obstetrics. And my hospital, Nottingham University Hospitals NHS Trust, is one of the top recruiting sites in the UK.
Jim Thornton
“A little useful weeding”
How views change
A revealing quote in the recent biography of HG Wells, Another Kind of Life by Michael Sherborne. It’s 1914, and Wells has written The War That Will End War, the first of a series of articles that would later cause him embarrassment. Sherborne reminds us he was not alone in his naivety.
Another writer, working as a language teacher in France, had written to his mother at the same time about the effect of the war on the working classes;
“The guns will effect a little useful weeding.”*
Four years later the same writer composed his most famous poem.
What passing-bells for these who die as cattle?
Only the monstrous anger of the guns.
Only the stuttering rifles’ rapid rattle
Can patter out their hasty orisons.
No mockeries for them; no prayers nor bells,
Nor any voice of mourning save the choirs, —
The shrill, demented choirs of wailing shells;
And bugles calling for them from sad shires.
What candles may be held to speed them all?
Not in the hands of boys, but in their eyes
Shall shine the holy glimmers of goodbyes.
The pallor of girls’ brows shall be their pall;
Their flowers the tenderness of patient minds,
And each slow dusk a drawing-down of blinds.
Wilfred Owen wrote Anthem for Doomed Youth while in hospital in Edinburgh after being wounded. A few months later he returned to the front where he was killed one week before the armistice.
Wells and Owen’s pre-war views were not unusual. Many regarded Edwardian Britain as ripe for some selective culling – until they saw what it involved.
Jim Thornton
* Quoted in Jon Stallworthy, Wilfred Owen: The War Poems (London 1994), p. xxiv
A Chinese Arnolfini
Decadence during the Cultural Revolution
Shi Guowei’s pastiche of the famous Arnolfini Wedding by Van Eyck, was exhibited recently at the Albemarle Gallery in London.
The Arnolfini depicts a rich merchant’s traditional marriage. Everything in the painting says wealth, status, formality, a serious contract being entered into. The woman appears pregnant but isn’t – it was the fashion then. The mirror symbolises virginal purity.
In Shi Guowei’s Wedding Invitation the woman is a red guard, and really pregnant. Whatever else stopped during the Cultural Revolution fornication carried on. The kicked-off high heels mean the same in China and the West. The loyal alert dog is replaced by a lazy cat, the mirror by a clock, a symbol of death. The bare bulb and peeling wall tell their story. Look closely. Is the clock not even straight?
This is subversive art.
Jim Thornton
Ripe-tomato.org 