Friday, November 30, 2018

If You Can't Nar-Can

I worked for a manufacturer of pharmaceuticals for 30 years of my working career. Looking back on my personal experience in that venue is a dizzying and surreal experience. I promoted several products. Some of the list are Percodan, Percocet, Hycodan, Nubain, Narcan. The first four on that list are narcotics. Two of them are Oxycodone products and the last is the polar opposite of a narcotic. It is a narcotic antagonist and reverses the illicit effects of the first four.

Against the canvas of history those narcotics were once considered the good guys. If you were in moderate to severe pain your physician could use his pen to almost instantly relieve your pain. Nowadays in the new light of some grassroots campaigning we are in the midst of the Opiate Crisis. Percodan, Percocet, OxyContin, etc. are all bad guys now with this new perspective. The Opiate Crisis drum is being beaten all across America. Who created this crisis? Physicians who prescribed opiates irresponsibly? Pharmacists who dispensed opiates irresponsibly? The manufacturers who created these products and promoted them irresponsibly? Rarely does the end user bear any responsibility for the abuse feeding this crisis! In my opinion the only thing that has been creating this crisis are those down and out individuals that choose to start down the path of opiate abuse through their irresponsible search to take them out of the main stream. I really don't want to get a job nor to go to school. I would really rather inject heroin into myself, get high and sit around and beat on my drum all day. I am the poor, poor victim here. Society, commercialism and the free enterprise system have driven us all to this crisis. I am a victim of all that. Let's institute a government centered in Socialism and all this will go away. You want to talk about some jacked up thinking.

So we have our protagonist to our story now we have to introduce an antagonist. In most stories the antagonist is a bad guy. However this one is a good guy. The brilliant scientists who worked for the same company as I did created a unique analog to the opiate molecule. Up on the carbon chain they substituted an allyl chain for the carbon. What they got was a molecule that did the polar opposite of the opiate. Whereas the opiate killed people by occupying the nerve centers along the diaphragm thus inducing respiratory depression this product competed with the opiate at the receptor site and via competitive antagonism always won the fight to occupy the receptor. You could have a patient stop breathing during balanced anesthesia. The anesthesiologist might have gotten a little heavy handed with the fentanyl. At that point the physician ordered the administration of  Narcan ( naloxone HCl). The patient would miraculously start breathing again. Thus the phrase arose in medical circles, " If You Can't Then Nar-Can" 

This morning I read an article in our local muckraker about a policeman who encountered a heroin overdose patient who had stopped breathing. His local agency had just authorized all law enforcement people to carry Narcan in their emergency kits. So he gets his name in the paper for reversing the overdose caused by an addict exercising their right to imbibe the illicit drug of their choosing, in this case a narcotic of choice.

All the while, dear reader, a new sophistry has arisen. Another psychoactive substance the use of which could send you to prison 10 or more years ago has arisen to save us all. It is Tetrahydrocannibinol (THC) the psychoactive component of marijauna. As we learn from other states first comes medical use and then recreational use. All the while those who have aided and abetted its legalization get incredibly rich. We have just elected a new Ag Commissioner who is heavily engaged in the marijuana issue and will surely add to its burgeoning adoption by a beer drinking, weed smoking, opiate consuming public.

At the bottom line as always is the almighty $$$$. The prophet Isaiah, who lived roughly 3000 years ago said it pretty well in the 5th Chapter of his book "Woe unto them that call evil good and good evil; that put darkness for light and light for darkness; that put bitter for sweet, and sweet for bitter!"

Friday, October 26, 2018

An Old Friend in Mexico Beach

October 26, 2018

I, like many others, am a hurricane Michael survivor. My family members here in Tallahassee are all safe and sound, The worst inconvenience suffered was 6 days without electricity. Which meant no cable TV, no internet, no hot water, and most of all NO A/C. With the help of generators we got by with floor fans, listening to radio, accessing the internet on cell phones charged by the generator. All is back to normal now. I am able to get back to blogging even.

Tallahassee was spared. Had the storm veered 50 miles east that would not be the case. We would have lost significant infrastructure. Many homes would have been destroyed just like those to the west of us. Tallahassee was bruised but there were towns that were killed or at least placed on the critical care list.

Ground zero was Mexico Beach Florida. That town is about 90 miles from us. I have an old friend that lives there. She has been my friend since 1972 when I first moved to Tallahassee. Ironically enough, I moved to Tallahassee in June of that year in the midst of a hurricane. It was Hurricane Agnes.

This old friend of mine is the El Governor motel. I discovered her early in my first year as a traveling salesman. It sits right on the beach adjacent to the beautiful Gulf of Mexico. I had to overnight in my job to work the western part of my territory. I elected to make the El Governor as my overnight spot. From there I could access Panama City, Port St Joe, Apalachicola, Marianna, Blountstown, Carrabelle.

I met a wonderful, beautiful girl in my 20's and married her. We were blessed with children. We could not wait to introduce them to our friend in Mexico Beach. We were within her walls 4 times on the average in a given year. Spring breaks from school, summer vacations there, birthdays, special events. We would many times stay there in a 4 bedroom town home. Friends of the family, boy friends, girl friends of our kids accompanied us there. From there we could access Captain Andersons restaurant, Angeloes restaurant, Miracle Strip in Panama City, theaters in the malls, etc. Ultimately we introduced her to grandchildren and enjoyed so much family time there. Lazy, sun-filled, happy leisure days there on her decks and swings, cabanas, pool and lovely rooms with cooking and refrigeration in our rooms.

I saw a video of her on You Tube after hurricane Michael. It broke my heart. It was like seeing an old friend who had been in a terrible accident and was in intensive care. I don't know if she will live on. However, my hope is that she will.

I seem to keep learning the same lesson over and over. Nothing ever remains the same. Old friends get sick and some even die and move on from our association. I look in the mirror and see an old man who has lost his hair, his looks, his teeth, etc. The only thing that remains clear is that our spirits pretty much remain the same. The difference over time is the amalgamation of experiences, associations, love, joy, family, etc. Those intangibles that you cannot put in the bank, hold in your hand, wear on your body are the well springs of a life well lived. The winds of war, storms, illness, grief, sadness can beat on us from time to time. We human beings are greater than anything that can inconvenience us or make life difficult. What we are, are angels fallen from the presence of God into the storm of life. The British poet, John Milton taught us concerning that in his poem Paradise Lost. A myriad of experiences gives us wisdom and awareness. At the end we stand in the memories of many like the El Governor being weighed in what is considered as life experience. We should live our lives in a fashion that makes us worthy of reflection. Turn aside from anger, terse words, acts of inpropriety. Let us instead live our lives in a fashion that is expected of an angel.

Thank you to my old friend the El Governor. She has been a respite for my family amidst the storms of life. I am hoping that you survive this death blow you have been dealt.

Tuesday, August 7, 2018

Dental Dilemma

7 August 2018

Does anyone out there know of a good, ethical dentist? I am sure that they abound, however this has been an illusive search for me covering about four years. You see I had a great dentist for 40 years. He up and retired 4-5 years ago. He sold his practice to an unknown practitioner. Just before he left he told me that I needed to see a specialist because one of my pearly whites had died and I needed special consultation. This started the dilemma that plunged me into a dental black hole.

The specialist I was referred to is an old friend. I've known him for about 30 years. I used to call on him and sell him an injectable pain reliever when I was repping for a pharmaceutical company. I made an appointment and got an assessment on the tooth that was in trouble. Before anyone ever fired up a drill I was in the red about two hundred bucks for x-rays and other diagnostics. The conclusion was " Yep, Lee that tooth is dead as a hammer." We need to extract it then look at whether we need to do an implant. Cost of an implant? About $5,000.

However, we need to send you over to another specialist and have him look at it because it looks like it is cracked. He is able to make a a better assessment that I can. Off to see dentist #3. He x-rayed the tooth in question ( not sure why he couldn't look at the other guy's x-rays). Conclusion: Yep, that tooth is dead and needs to be extracted. Well, I asked, can you extract it? Oh no. You will need to go back to dentist #2 to get that done. He is better equipped for the job. Oh, and incidentally, your dentist of 40 years is very out of touch and needed to have retired.  $180 dollars please. That was when I realized how much I loved my old dentist. He was NOT out of touch. He used to teach at the university. My whole family used him. He was a great guy and took care of all of us very efficiently.

In the meantime I had done two things. I procurred some dental insurance. Heretofore, I had always found dental insurance to be a poor investment. Because I had healthy teeth the benefits never added up to the premiums I had to pay. Secondly I began seeing a general dental practitioner. Dentist #4 was the son of a good friend who had just set up practice. Over the course of a year I paid out $900 in dental insurance premiums and they had in turn paid for two cleanings totaling $400. Net loss $500. So the sum total of contributions to the dental folks here in Tallahassee $880. That does not include the $900 in dental insurance premiums. I am in the tank almost $1900. And I still have the dead tooth which no one has done anything about.

Upon seeing dentist #4 with all the incumbent diagnostics fed to him from the specialists he told me that my tooth was sure enough dead and needed to be extracted. I asked him simply and innocently could he please extract it? His reply was oh no, no, no. You need to go back to see dentist #2. He is the best equipped to do the extraction. Incidentally ( no pun intended) this tooth has not caused me the first nano-second of discomfort. At this point, I am getting pretty disgusted and disillusioned about the practice of dentistry at least here in Tallahassee.

I began a search for another dentist. I found one and contacted their office. Sure, they would be glad to see me. I made the appointment in the summer of 2017. They told me they would put me on a waiting list. I finally got an appointment for January of 2018. I also cancelled my dental insurance since it seemed to be the pariah I had always believed it to be. They limited their total coverage to $1500 in a year. That cost me $900. I seldomly was going to require much more than a cleaning year in and year out. Except for this rogue tooth that no one seemed to want to address. It was pretty much of a wash to just self insure. So here am I at dentist #5

My appointment comes. I get a cleaning and an assessment along with a treatment plan. Your tooth is dead and needs to be extracted. What a revelation. Appointment made for extraction and lo and behold it was done. Plans made for a bridge to be put in place. Cost = $2500. I am not happy but at least I finally found someone who would DO SOMETHING !!

Now the bridge is in place and I am pretty satisfied. Still no pain but the dead tooth is gone. The pain comes in the form of a bill for $4,000. Call to dentist #5's office. Hello my treatment plan said the cost was $2500. Oh, we are sorry but you do not have dental insurance. I respond, yes that is correct, I advised you of that on day one. If you do not have insurance then we have to charge you more. I respectfully inquire " What are you talking about ?" Oh you see we offer a discount to patients with dental insurance. I do not comprehend. The treatment plan clearly says $2500. Now this new wrinkle in the convoluted world of dentistry comes into play. A new fight begins.

Now I have to engage Florida Agency for Healthcare Administration and my attorney to determine what kind of a worm hole I have been dropped into now. So now on to dentist #6. I repeat my opening question. Does anyone out there know of a good ethical dentist?

Saturday, May 26, 2018

PFC James Clayton Reed (Repost)


My thoughts are turned this Memorial Day weekend to my first cousin, Jimmy Reed. He is one of 3 children born to my aunt Delores and Uncle Clay who lived in Los Angeles, California, light years from where I lived in West Virginia and later Montgomery, Alabama. We shared some happy childhood experiences. We did not see each other often but when we went to visit them or vice versa it was for extended periods of time. I remember him as being funny and entertaining. He was my younger brother's age almost exactly. They could always make me laugh.

Well here I am turning 65 in two days. I had a thirty year career with DuPont and got to travel a lot. I was able to carry some important assignments for DuPont and achieved some degree of recognition. I met a wonderful girl and we fell in love and raised 3 children. We have 7 grand children. I used to coach softball and baseball, volunteer in scouting, work in PTA, go on family vacations and just generally have had a great life.

Jimmy died just west of Khe Sanh during operation Purple Martin March 20,1969. That was just a little more than 30 days before his 19th birthday. He was a member of the D Company, First Battallion, Third MarDiv, USMC. He died that day along with 2nd Lt. Mike McCormick of Wellston, Ohio; LCpl Max Baer of Goshen, Ind; LCpl Steve Byars, Lakeland, Florida; LCpl Ernest Elders of Shelby, NC; PFC Norman Beck of Rockford, Il.; PFC Jeffrey Forry, Marion, OH and PFC Larry Knox of Harrisonville, MO.

I graduated from college in 1969 and rode a student deferrment to avoid military service. I also pulled a 344 as my draft lottery number. Were it not for those two happenstances I well could have had my name engraved onto that war memorial wall in Washington, DC. I have been there and was able to find Jimmy's name on that wall. It is a somber and eloquent memorial fitting as a requiem for those who gave their lives on various battlefields of the Vietnam war. For whatever purpose that war served I honor his memory this Memorial Day. I wish I could pick up the phone and call him and tell him a joke or two but that opportunity was nullified by the winds of war. His Mother, my aunt Delores, has grieved every day for her fallen son for 42 years now.

It is pure irony how some of us end up pursuing the military option. Today we have a totally volunteer military. You press the statistics on the makeup of our armed forces and you will see a lot of people who just seemed to have no other option than to join the military. The impetus is largely economic with job prospects being what they are. In mine and Jimmy's youth the draft was rampant. The selective service boards were steaming at full speed. In my case, had I not been a student it was a certainty that I would have been drafted into the miltary.

I recall that in those days you would report for a college class and two or three of the people that had been in the class the day before would be gone. You had to maintain a class standing to keep your draft exemption of 2-S. In order to do that you had to be in the upper 1/4th of your freshman class in academic performance. Fail to do that and you were draft fodder. Sophomores had to be in the upper 1/2 and Juniors in the upper 3/4. If you made it to be a senior then they left you alone. Along about my freshman year they administered the selective service standardized test. The guys at Harvard made the claim that the students in the bottom 3/4 of their freshman classes were superior to the upper 1/4 of the freshman class at State College X. So the selective service came up with the standardized test and administered it to us all in the second semester of my 1st year. You either had to maintain your academic standing or have scored 75% or better on the test. I remember scoring a 78 and my worries were ended.

There was also a point at which I was thinking I needed to drop out of college. I checked with the draft board and I was told the day after I did I would be reclassified 1-A and almost certainly drafted into the military. I do not know of Jimmy's circumstances but while I was studying Mark Twain in English 301 he was most likely doing basic training at Paris Island. Talk about worlds apart.

When I ponder the freedoms under which I live and also ponder the 58,220 war dead from the Vietnam war, the 405,399 from WW2 and the 116,516 from WW1 I feel guilty and appreciative at the same time. I do believe that those fallen willingly sacrificed their lives so that we could continue to breathe the free and unfettered air of liberty. I have to ask myself what sort of life have I led to justify the single death of my cousin Jimmy, not to mention the 100's of thousands of war dead who made similar sacrifices.

I suppose I have made small sacrifices but the bumper sticker I read once that said "All gave some but some gave all" makes me realize what an investment we all have in our freedom. Just about every American can tell a similar story as mine about my cousin, Jimmy. I contemplate why he had to lay down and die that day in Vietnam. It was because he felt the call to duty and like others of his family before him felt the obligation to serve. Pure and simple.

May we take a little time to really remember those who sacrificed their lives and well being to keep us safe and free this Memorial Day weekend. God bless you Jimmy. You were way too young to die. I hope to see you again someday, if I am worthy, and shake your hand and say thank you in person. I hope that you will see someone standing in front of you who you can feel justified your sacrifice. I need to work to become such.

Thursday, April 5, 2018

Sun burned Tonsils and the Masters

I took up golf later in life. Through the influence of a good friend who was a great athlete and gifted golfer my wife gave me clubs for Christmas in 1984. I played HS football, basketball and baseball and was always good enough to make the squads and was always a starter, first team and decent player. The various sports I participated in came pretty easily to me. Later on, I took up racquetball through the influence of a friend who flew big jets for Air Florida. I beat him consistently from the very beginning. I could never determine whether I was that good at the sport or if he was that bad. I am pretty sure it was the latter.

That brings me to golf. At 38 years of age I picked up a club for the first time. I am right handed so of course my wife bought me left handed clubs. However, that was OK because I always batted left handed in baseball and softball.I went to the range with my friend and pounded a couple of hundred balls. Mostly, I hit them very badly. It seemed that strength, swinging hard and getting angry when you missed a ball were all things to be avoided. 33 years later I still have not progressed much beyond that. I have scored 80 four times in the 33 years I have played. I scored a 77 on one course, one time out of hundreds of rounds. The best my handicap ever got was a 12.

Golf is a very funny game. The harder you try at it the worse you get. You basically have to play the game and swing the club as if you don't care about the result. About ten years into playing I took five lessons from a local Pro who is a wonderful teacher. He tried to talk me  into playing rightie. It was not worth the effort to switch. I heard many sayings about golf over the years. Most of them are not repeatable in mixed company. The one that I heard that was the most amusing and I think applicable was: " Golf is like sex. You do not have to be an expert at either to enjoy them."

I earned my living within the pharmaceuticals industry working 30 years for DuPont. It was a wonderful career and I enjoyed every minute of it. I worked my way up from Sales Rep to Government Affairs manager. As the GAM I was responsible for lobbying 3 states and staying involved with Professional Associations in medicine and pharmacy. When an issue heated up I would hire consultants to help me work compromises that would protect our business. These consultant/lobbyists became my friends. The money we paid them was decent for 3 months work surrounding the legislative session.So renewing the contract year to year was a lifeline for them all.

That brings me to the point of my post today. One of the consultants I had hired invited me to attend the Masters with him in 1999. I jumped at the opportunity. We played a round of golf on the way up and spent the night in Macon and then on into Augusta the next morning. I was in love with the game of golf at this point. Here I was attending the Masters on a beautiful spring day in April. After all the blood letting to find a parking place we gained admittance and there I was standing on the most famous course in the world. The place was overwhelming. I was very much like a Muslim making a pilgrimage to Mecca and walking around just soaking it all in.

Everywhere you looked there was nothing but the greenest grass you have ever seen. Azaleas were in full bloom. There was not a weed anywhere in sight. The greens were absolutely magnificent and the most lovely you have ever seen anywhere. Surprisingly the food and keepsakes, ie: hats, shirts, balls, etc. were very affordable. After eating a hot dog and some chips I was advised that I should find a space along one of the par three holes and get ready to watch the par three tournament. I did so. Sat down and prepared to watch the tournament. The onions I had eaten on my hot dog were laying sort of hard on my palate. I decided that I wanted to spit and I turned my head to do so. However, before I did the thought entered my head that " this is hallowed ground. This is Augusta National. You cannot spit on this ground." I forewent spitting and sipped my Diet Coke and got ready for the tournament. Such is the effect that that place has on golfers.

I was not prepared. I knew that they played a 72 hole tournament, however, the fact that on the Wednesday practice round they played this little par three tourney that was mostly just fun had eluded me. The professionals had their families including their young children playing down the fairways with them. But it was the who's who of golf that caused me to revere the moment. There parading down the fairway were all the greats of golf. Nicklaus, Palmer, Trevino, Sarazen, Byron Nelson, Crenshaw, Player, Singh, etc. I could have almost reached out and touched them.

I spent the day traipsing around the course. My mouth hanging open and savoring every moment. That is why I ended up with sun burned tonsils. I don't think I would ever go back. There are far too many people there nowadays and the parking is impossible. The best way to watch any golf tournament is on the television. However, that one day I sat in the presence of the demi-Gods who had perfected the game. It was a sight to behold.

Tuesday, March 13, 2018

Tylenol and School shootings

It has been almost a month since the Parkland, Florida Stoneman Douglas school shooting. The fallout has been a game changer on numerous fronts. The assault rifle has found fewer and fewer friends. The 2018 legislative session was turned on its ear towards gun control leaving many important issues laying in it's wake that were never taken up. Acne scarred adolescents were propelled into the limelight by the event as long as they were to parrot the talking points of those on both the right and the left. You could see them lined up endlessly on either CNN or Fox News on the nightly shows. The NAR, which teeters on the cusp of being public enemy number one or the salvation of mankind with their far reaching stance on the second amendment was seen in an endless stream of public discourse. They have now launched a law suit against the state's efforts to raise the age for lawful gun purchase. Mental health advocacy has seen a bit of the spotlight since we do not seem to be able to adequately sift out these threats hiding in personalities too endless to inventory.

I have 7 grandchildren that attend the public schools here in Leon county. I have always felt that they were safe here. I had occasion to consult with a gentleman named John Hunkiar sometime back on the purchase of a home. He was recruited out of the Miami police department where he was in charge of surveillence and controlling the gangs. He assumed the job of chief of security for Leon County schools. The brief time I spoke with him I got the impression that he was a capable and tough cop. I see no other reason to doubt that he is well capable of protecting my grandchildren with the help of many well trained and capable people.

I also think  back to a time when I made my living as an executive in the pharmaceuticals business. In 1982, in Chicago, 7 innocent people died after ingesting Tylenol capsules. Tylenol is a trusted brand name for acetominophen (APAP). Millions of people, adults and children , have ingested hundreds of millions of doses for headache, muscle aches and fever over many, many years worldwide.

It was determined that some maniac had decided to substitute potassium cyanide in place of the APAP in several individual boxes of the drug and replaced on market shelves. 7 innocent people lost their lives because of this maniacal and mercenary act. A few years later the same thing happened with the gelatinous form of Tylenol. Three lives were lost from that episode. They never caught, arrested or prosecuted anyone in relation to this crime. They did elevate product tampering to a federal crime making it easier to prosecute anyone caught from then on.

Johnson and Johnson, the manufacturer of Tylenol reacted swiftly and capably. They immediately recalled the product at a cost of $100 million. They seized the day and saved other lives by their action. As a result of that and the reaction of the FDA today we have a tamper resistant seal on every consumer product that you can imagine. The problem was solved swiftly and effectively. There was no emotional argumentation about need to curtail the sale of headache medication. 36 years later more people are swallowing Tylenol than ever before.

Ironically we also see an opiate bill coming out of this recent Florida legislative session that makes it illegal for you to have pain for more than 7 days. The wisdom of the legislators took on this issue with less debate. All focus shifted in the direction of  the school shootings. .

There is a plausible and practical solution to making our schools safer. Much like we made our airports safer post 9/11. School marshals alla Sky marshals could be a good approach. Taking politics off the table and emotion off the street we could fix this problem. If Johnson and Johnson made firearms they would solve the problem for us. The manufacturers of firearms, all represented by NRA, are unwilling to step up to the plate.

Do you think it has anything to do with the realm in which these two businesses are active? The pharmaceuticals business is directed towards extending and enhancing life. The gun business is mostly about protecting people from one another to the extent of taking life.

One thing for sure honesty and law abidedness has certainly not been attained by the passing of any bill, law or ordinance at any level so far.