Saturday, August 27, 2016

The EpiPen -- A First World Problem -- Nothing About The Bakken -- August 27, 2016

I can't believe what a great mood I'm in.

I've come to terms with the keystoning of the Dakota Access Pipeline (maybe the Native Americans are "right"); the Clinton Foundation (it's all about "pay for play" and what's wrong with that? Paul Ryan never followed up on the Democratic fund raising from the House floor this past year); and, the huge debt and deficit Obama will leave us with (it will be worse when Hillary gets into office; and Warren Buffett seems not to be worried).

Example of irony: the Dakota Access Pipeline keystoned in Dakota by the Lakota. 

Maybe I will get back to those issues later but I doubt it.

Right now I'm enjoying the "Review" section of today's Wall Street Journal. Our older granddaughter wants to be a marine biologist (although lately, there are indications, this may be changing); her father, a US Navy submarine veteran and avid sailor, has hopes of sailing around the world. So, it was with great joy and surprise I saw Angus Phillips review of Tristan Gooley's How To Read Water, a 400-page book at $19.95. (At Amazon.com: $13.95 and free shipping.) The link is here. Yes, I just ordered it and will have it in two days. [The most grating response to any question is the one I generally get at Barnes and Noble: "We don't have it in stock but we can order it." Well, so can I. From Amazon. And a whole lot cheaper.] [Update: I put the Amazon.com order in earlier this morning, just before I went biking. I just received an e-mail saying my order had shipped -- less than six hours later -- posted 4:10 p.m. same day.]

Earlier this week our 10-year-old granddaughter says she wants to "read" Shakespeare so she can understand "what he's all about." She is now reading the plays re-written in "modern" English, in prose, but using original Shakespeare dialogue. So, I was intrigued to a see a long review of Shakespeare's first folio, also in today's "Review." Fascinating. Reading the review suggests there may not be much new that we don't already know, but perhaps it's updated for a more enjoyable read. The link is here. It has an Oxford imprint so I assume it is very, very good, but I doubt I will get it. If the author doesn't weigh in (correctly) on the "true" William Shakespeare, I lose my interest fairly quickly.

On page 2 of the first section of the WSJ today: Suburbs Divide on Development. I might have missed this story but my wife caught it. There's a fair amount of ink devoted to our area north of DFW, specifically the city of Flower Mound. The link is here. This is not stated in the article, but this is a truism that cannot be forgotten: most land appreciates faster than inflation; most homes don't.

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The EpiPen Story

Holman W. Jenkins, Jr. has a great opinion piece on the $600 hammer EpiPen. He provided the obvious answer. Why pay $600 for an American two-pack of EpiPens, when you can get them for about $100 each in Canada (the internet will work just fine)?  By the way, it would be an interesting science project to see exactly how widely used EpiPens really are. In my 30+ years being in the business of medicine, I have never seen a layperson use an EpiPen. I've worked with school nurses for decades and I've never seen a school nurse (or even heard of a school nurse) using an EpiPen. Anyway, here's a Canadian site offering EpiPens for about $160/pen which is probably the "standard" price in Canada.

By the way, the EpiPen story gets crazier the more one looks at it. The standard EpiPen delivers 0.3 ml of 1:1000 epinephrine. One can buy a 1-ml amp (enough for three doses) of epinephrine for $4.49.

Three doses is one more dose than the standard 2-pack epinephrine provides. Three doses for $4.49 vs two doses for $600.

Syringes and needles are virtually free: every insulin-dependent diabetic has ample supplies of syringes and needles, and most jurisdictions provide the homeless and drug addicts with syringes and needles for free, it seems. Whatever the expense, it has to be nominal. The challenge of administering epinephrine in an emergency is not the "physical" action but the "mental" action. The "mental" action is recognizing an emergency; recognizing that it is an allergic reaction; knowing that epinephrine is needed; and knowing where that epinephrine is. Snapping open an ampule, "drawing up" 0.3 ml in a standard little syringe, and then using one's own fist to push the needle into the thigh (by holding onto the syringe) and using one's own thumb to push in the plunger is the entirety of the "physical" action. This is not rocket science. If one has the time to complete the "mental" action, one has ample time to complete the "physical" action. Emergency room physicians do not use EpiPens; they use syringes, generally handed to them by nurses or technicians.

Meanwhile, there's a heroin overdose epidemic in the Rust Belt. It seems like there is an easy way to stop a heroin overdose epidemic. 

Perhaps more later. Going biking.

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Southlake Public Library

Later. It's about a 30-minute ride from my hovel to the Southlake Library. I generally ride to this library or the Grapevine Public Library every day; they are both about the same distance from home. The Southlake ride is more urban, more fun. The Grapevine ride is a bit more rural or industrial, and more utilitarian.

There is a half-mile stretch of road on the Southlake route that has been under construction (widening from two lane to four lane) for quite some time. It is a bit sporty competing with F-150's where there is no shoulder. For the most part (99.9% of the time) the drivers have been wonderful. Today, they've opened up the new road to the extent that I have almost two full lanes of asphalt to myself. For the next stage of construction, it just so happens it's going to be a lot easier to navigate, at least heading north.

The books today: I will continue Matt Ridley's Genome (previously posted) and will begin Bill Bryson's The Road to Little Dribbling: Adventures of an American In Britain, c. 2015. I've already read a bit of it and for any American who has lived in Great Britain for any length of time, it's a must read.

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23 Pairs Of Chromosomes

From Matt Ridley's Genome:
It is actually rather surprising that human beings do not have twenty-four pairs of chromosomes. Chimpanzees have twenty-four pairs of chromosomes; so do gorillas and orang utans. Among the apes we are the exception.

Under the microscope, the most striking and obvious difference between ourselves and all the other great apes, is that we have one pair less. The reason, it immediately becomes apparent, it not that a pair of ape chromosomes has gone missing in us, but that two ape chromosomes have fused together in su.

Chromosome 2, the second biggest of the human chromosomes, is in fact formed from the fusion of two medium-sized ape chromosomes, as can be seen from the pattern of black bands on the respective chromosomes.

Pope John-Paul II, in his message to the Pontifical Academy of Sciences on 22 October 1966, argued that between ancestral apes and modern human beings, there was an "ontological discontinuity" -- a point at which God injected a human soul into an animal lineage.

Thus can the Church be reconciled to evolutionary theory. Perhaps the ontological leap came at the moment when two ape chromosomes were fused, and the genes for the soul lie near the middle of chromosome 2.
The gene for drumming in on the X chromosome (if you don't believe, watch the sequence beginnign at 3:00):

10-Year-Old Owns The Drums

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