MEDICINE

GENERIC DRUGS

Katherine Eban believes generic drugs are important for global health because of affordability and accessibility. One wonders if anyone who reads or listens to “Bottle of Lies” will take generic drugs if they can afford the original FDA approved product.

Books of Interest
Website: chetyarbrough.blog

Bottle of Lies (The Inside Story of the Generic Drug Boom)

Author: Katherine Eban

Narrated By: Katherine Eban

Katherine Eban (Author, American Rhodes scholar with a MPhil from University of Oxford.)

“Bottle of Lies” is a history of duplicity and dishonesty in the generic drug industry. It is a damning dissection of the lure of money at the expense of human life. On the one hand, affordability, healthcare savings, global health, and the value of regulation are made clear in “Bottle of Lies”. On the other, Katherine Eban shows how the lure of capitalism and greed creates an incentive to evade regulation and kill innocent people seeking drug treatment for their illnesses.

Katherine Eban reveals the history of an India drug company named Ranbaxy that was founded by two brothers, Ranbir Singh and Gurbax Singh.

In 1937, these two entrepreneurs recognized the economic opportunity of creating a drug manufacturing operation with lower labor costs in India to capture the market in drugs nearing their patent expiration dates. They were focused more on organizational cost cutting and the money that could be made than the efficacy of the drugs they could produce. The company was sold in 1952 to their cousin Bhai Mohan Singh. This cousin transformed Ranbaxy to a pharmaceutical giant, but his experience was in construction and finance, not pharmaceuticals. However, his son Parvinder Singh joined the company in 1967 and was a graduate from Washington State University and the University of Michigan with a master’s degree and PhD in pharmacy.

Parvinder Singh (1944-1999, became the leader of Ranbaxy in 1967.)

Eban argues Parvinder Singh looked at his father’s business as a scientist with a pharmaceutical understanding and a desire to produce lower cost drugs for the world for more than a source of wealth. Parvinder appeared to value quality, transparency, drug efficacy, and long-term credibility for Ranbaxy. Parvinder recruited talent who believed in lowering costs and maintaining the efficacy of drugs the company manufactured. However, Parvinder dies in 1999 and the executives who took over the company focused on maximizing profit rather than the efficacy of the drugs being produced. Parvinder’s leadership is succeeded by Brian Tempest who expands the company by navigating the regulatory restrictions on generic drug manufacture. Tempest tries to balance profitability with global health efficacy of generic drugs. Parvinder’s son, Malvinder Singh eventually becomes the CEO of the company. He returned control to the Singh family. The corporate culture changed to what its original founders created, i.e., a drug producer driven by profit. Malvinder was not a scientist.

Malvinder Singh (Born in 1973, Grandson of Bhai Mohan Singh and son of Dr. Parvinder Singh.)

Under Malvinder, Eban shows the company turns from science to economic strategy to increase revenues of Ranbaxy. Internal checks on the efficacy and testing of their drugs is eroded. Criticism from regulators and whistleblowers are either ignored or sidelined by company management. Peter Baker Tucker’s role in exposing Ranbaxy is detailed in Eban’s history. With the help of Dinesh Thakur, an employee of Ranbaxy, Tucker bravely exposed the company’s fraud. (Thakur received $48 million compensation as a whistleblower award.) Tucker is an FDA investigator who reviewed Ranbaxy’s internal documents that revealed their fabricated data about their drug manufacturing process.

Peter Baker Tucker (aka Peter Baker, former FDA investigator.)

Ranbaxy is sold to a Japanese company called Daiichi Sankyo in 2008. Eban explains that Malvinder concealed critical information about FDA investigations and data fraud in the company’s sale. Malvinder and his brother, Shivinder Singh, are arrested in 2019 and remain in custody in 2021, facing multiple fraud accusations.

Sun Pharma acquires the remnants of the Ranbaxy-Sankyo’ sale.

Though Eban does not focus on what happens after the sale to the Japanese company, it is sold at a loss to Sun Pharmaceutical Industries and Singh family’s ownership is sued by Sankyo for hiding regulatory issues of the company. Daiichi received a $500 million settlement but effectively lost money on their investment. Eban, in “Bottle of Lies” offers a nuanced indictment of generic drug manufacturer and sale.

Eban believes generic drugs are important for global health because of affordability and accessibility.

Quality and drug efficacy must be insured through international regulation. Eban endorses unannounced inspections, routine testing of the drugs, and strict legal enforcement against poor manufacturing systems. Without transparency and oversight of all drug manufacturing, human lives are put at risk.

This is quite an expose, but it ends with criticism of inspections of China’s drug manufacturing capabilities.

The inspections of foreign companies that manufacture generic drugs, like those she refers to in her book, are conducted by similar inspectors who do not know the culture or language of the countries in which generic drugs are being produced. The FDA was paying their inspector in India $40,000 per year at the time of Ranbaxy’s investigation. It is by instinct, not interrogation, that malfeasance is detected. Too much is missed when one cannot talk to and clearly understand employees of manufacturing companies.

It seems America has two choices: one is to increase the salaries of FDA inspectors and require that they know the language of the countries in which they are working and two, set up a system of random reverse engineering of generic drugs allowed in the United States. This not to suggest all other FDA regulations would not be enforced when a generic drug is proposed but that site reviews would be more professionally conducted. One wonders if anyone who reads or listens to “Bottle of Lies” will take generic drugs if they can afford the original FDA approved product.

GOTHIC TALE

The climax of “Modern Gothic” is where myth enters Moreno-Carcia’s story. The fundamental truths of colonization are revealed in her creative story while its denouement is an entertaining explosion of imagination.

Books of Interest
Website: chetyarbrough.blog

Mexican Gothic

Author: Silvia Moreno-Garcia

Narrated By: Frankie Corzo

Silvia Moreno-Garcia (Author, Mexican/Canadian novelist, editor and publisher.)

Moreno-Garcia’s “Mexican Gothic” is a chilling story of colonization, eugenics, ecological contamination, mystical beliefs, and control of society by men. The author chooses the name of Doyle as an English family that exploits the Mexico’ silver mining industry in earlier centuries. A dynasty is created by generations of Doyle’s. They created a colonial manor called “High Place” from which to rule a crumbling empire. As colonizers they capitalize on Mexico’s silver deposits by exploiting native Mexicans’ land and labor to grow their mining operation. The wealth of local citizens is lost to the English foreigners who keep wages low to increase the wealth of the Doyle family.

**Over generations, the Doyle men married local women that were related to each other. A common practice of royalty before the twentieth century.**

They wished to maintain the genetic purity of the Doyle bloodline by having future Doyles marry genetic descendants of Mexican women that had been their wives. This is not greatly different than the experience of royal marriages in European cultures. The consequence of that marriage tradition is that recessive genetic mutations become more prominent in offspring. Children were more susceptible to diseases like cystic fibrosis and had higher incidents of developmental and cognitive disorders. This is one of many threads of meaning in “Mexican Gothic” because one of these descendants becomes a murderer of Doyle family members and the current Doyle generation seems socially dysfunctional. Added to that dysfunction is the Doyle family’s diminishing wealth.

An arranged marriage is a lynch pin to the story.

The heroine, Noemi, is the daughter of a wealthy Mexican family. She is sent to investigate a letter that was received by her father from a young woman that marries a Doyle. She is a cousin of Noemi’s. The marriage is arranged in part because of her father, and he feels something is wrong and wants Noemi to visit the Doyle family to find what the mysterious letter means. Soon after Noemi arrives, she begins to have hallucinatory dreams. Listener/readers find the hallucinations are because of spores that are in the bedroom of the deteriorating Doyle house. A clever thread of meaning in Moreno-Garcia’s story is ecological contamination that comes from colonization. As one nation colonizes another, it inevitably brings different plants and animals that are not indigenous to the country they are colonizing. The author notes a fungus is growing in the Doyle household that may have come from the original colonizers.

The penultimate theme in “Modern Gothic” is the creation of myths that compound the horrific events that occur in the Doyle house.

From the history of murders in the Doyle household, to hallucinatory dreams, to incestuous relationships, to the gloom and doom of the story, to a myth about the age of the Doyle patriarch, Moreno-Garcia offers a climax to her story that vivifies reader/listener’s imagination. The climax of “Modern Gothic” is where myth enters Moreno-Carcia’s story. The fundamental truths of colonization are revealed in her creative story while its denouement is an entertaining explosion of imagination.

AI & HEALTH

Like Climate Change, AI seems an inevitable change that will collate, spindle, and mutilate life whether we want it to or not. The best humans can do is adopt and adapt to the change AI will make in human life. It is not a choice but an inevitability.

Books of Interest
Website: chetyarbrough.blog

Deep Medicine (How Artificial Intelligence Can Make Healthcare Human Again)

Author: Eric Topol

Narrated By: Graham Winton

Eric Topol (Author, American cardiologist, scientist, founder of Scripps Research Translational Institute.)

Eric Topol is what most patients want to see in a Doctor of Medicine. “Deep Medicine” should be required reading for students wishing to become physicians. One suspects Topol’s view of medicine is as empathetic as it is because of his personal chronic illness. His personal experience as a patient and physician give him an insightful understanding of medical diagnosis, patient care, and treatment.

Topol explains how increasingly valuable and important Artificial Intelligence is in the diagnosis and treatment of illness and health for human beings.

AI opens the door for improved diagnosis and treatment of patients. A monumental caveat to A.I.s potential is its exposure of personal history not only to physicians but to governments and businesses. Governments and businesses preternaturally have agendas that may be in conflict with one’s personal health and welfare.

Topol notes China is ahead of America in cataloging citizens’ health because of their data collection and AI’s capabilities.

Theoretically, every visit to a doctor can be precisely documented with an AI system. The good of that system would improve continuity of medical diagnosis and treatment of patients. The risk of that system is that it can be exploited by governments and businesses wishing to control or influence a person’s life. One is left with a concern about being able to protect oneself from a government or business that may have access to citizen information. In the case of government, it is the power exercised over freedom. Both government and businesses can use AI information to influence human choice. With detailed information about what one wants, needs, or is undecided upon can be manipulated with personal knowledge accumulated by AI.

Putting loss of privacy and “Brave New World” negatives aside, Topol explains the potential of AI to immensely improve human health and wellness.

Cradle to grave information on human health would aid in research and treatment of illnesses and cures for present and future patients. Topol gives the example of collection of information on biometric health of human beings that can reveal secrets of perfect diets that would aid better health during one’s life. Topol explains how every person has a unique biometric system that processes food in different ways. Some foods may be harmful to some and not others because of the way their body metabolizes what they choose to eat. Topol explains, every person has their own biometric system that processes foods in different ways. It is possible to design diets to meet the specifications of one’s unique digestive system to improve health and avoid foods that are not healthily metabolized by one’s body. An AI could be devised to analyze individual biometrics and recommend more healthful diets and more effective medicines for users of an AI system.

In addition to improvements in medical imaging and diagnosis with AI, Topal explains how medicine and treatments can be personalized to patients based on biometric analysis that shows how medications can be optimized to treat specific patients in a customized way. Every patient is unique in the way they metabolize food and drugs. AI offers the potential for customization to maximize recovery from illness, infection, or disease.

Another growing AI metric is measurement of an individual’s physical well-being. Monitoring one’s vital signs is becoming common with Apple watches and information accumulation that can be monitored and controlled for healthful living. One can begin to improve one’s health and life with more information about a user’s pulse and blood pressure measurements. Instantaneous reports may warn people of risks with an accumulated record of healthful levels of exercise and an exerciser’s recovery times.

Marie Curie (Scientist, chemist, and physicist who played a crucial role in developing x-ray technology, received 2 Nobel Prizes, died at the age of 66.)

Topol offers a number of circumstances where AI has improved medical diagnosis and treatment. He notes how AI analysis of radiological imaging improves diagnosis of body’ abnormality because of its relentless process of reviewing past imaging that is beyond the knowledge or memory of experienced radiologists. Topol notes a number of studies that show AI reads radiological images better than experienced radiologists.

One wonders if AI is a Hobson’s choice or a societal revolution.

One wonders if AI is a Hobson’s choice or a societal revolution greater than the discovery of agriculture (10000 BCE), the rise of civilization (3000 BCE), the Scientific Revolution (16th to 17th century), the Industrial Revolution (18th to 19th century), the Digital Revolution (20th to 21st century), or Climate Change in the 21st century. Like Climate Change, AI seems an inevitable change that will collate, spindle, and mutilate life whether we want it to or not. The best humans can do is adopt and adapt to the change AI will make in human life. It is not a choice but an inevitability.

LSD

Some academics considered Timothy Leary a visionary thinker who pioneered consciousness expansion, psychedelic therapy, and transhumanism. Others argue he lacked scientific rigor.

Books of Interest
Website: chetyarbrough.blog

The Acid Queen (The Psychedelic Life and Counterculture Rebellion of Rosemary Woodruff Leary)

Author: Susannah Cahalan

Narrated By: Susannah Cahalan

Susannah Cahalan (Author, journalist for the New York Post)

Susannah Cahalan has written a titillating story of the 60s and 70s and Americans burgeoning experimentation with illicit drugs. It focuses on Rosemary Woodruff Leary, the fourth wife of the LSD guru, Timothy Leary. Leary’s first wife committed suicide, his second seemed a rebound companion, his third is to Nena von Schlebrugge, and then Rosemary who eventually becomes his lover, fourth wife, and supporter during their 9 years of marriage. His last marriage was to Barbara Chase in 1978 which lasted for 14 years until 1992. Leary died in 1996 at the age of 75.

Timothy Leary’s time with Rosemary is filled with mutual infidelity but with freely given support by Rosemary of a diminishing intellectual who promoted hallucinogens and their mind-altering effects. The handsome Leary became a significant influence on the use of hallucinogens like LSD and psilocybin as tools for expanding human consciousness. He believed psychedelics could unlock deeper levels of self-awareness, creativity, and spiritual enlightenment. An interesting point about LSD and other hallucinogens is how they have become useful drugs for modern treatment of psychological dysfunctions like schizophrenia and PTSD. On the other hand, Cahalan shows indiscriminate use of LSD can diminish social propriety and become an escape from or harmful distortion of consciousness.

Putting aside the value of hallucinogens, “The Acid Queen” is about the life of Rosemary Woodruff Leary.

Rosemary was born in 1935. Growing into a beautiful woman, she was drawn into the counterculture movement of the 60s and 70s in her travels to San Francisco, Southern California, and New York. Her beauty opened doors of opportunity for Rosemary. She became an airline stewardess until retirement in her early 30s that were required by age limits of airlines in those years. Cahalan infers Rosemary’s attractiveness and free-spirited beliefs led her to use sex as a useful way of getting what she wanted through relationships with men. She joined the beatnik generation because it fit her style of living. This is a generation that rejected mainstream American culture with an interest in artistic self-expression, non-conformity, and spirituality. This was in the 1950s and early 60s.

Rosemary meets Timothy Leary in 1965.

Leary’s use of LSD as a transformative experience fit into Rosemary’s lifestyle. She became one of Leary’s devoted followers. They married in 1967. Art Linkletter’s daughter died in 1969 by suicide and blamed it on LSD. Not surprisingly, the conservative President, Richard Nixon, called Leary “the most dangerous man in America”. In 1968 Timothy Leary was arrested in Laguna Beach, California and charged with marijuana possession. He was tried in 1970 and sentenced to 1o years in prison. He escaped prison with the help of the Weather Underground but was recaptured in 1973. His sentence, in conjunction with his former conviction, was extended to 20 years. He was released in 1976, after 3 years, when he cooperated with authorities by offering information on the counterculture movement.

Cahalan shows how Rosemary followed and supporter Leary in his escape from prison and how their relationship fell apart.

It is somewhat unclear from Cahalan’s story about why Rosemary gave up on Leary. One may have been because of his and her self-absorption or their penchant for attachment to others for the support they believe they deserved. Cahalan’s story of Rosemary is interesting because of her association with Leary. Though Rosemary is self-educated, she appears to have limited formal education with her claim to fame largely based on the men with whom she became intimately involved.

In contrast, Timothy Leary earned a B.A. in psychology from the University of Alabama in 1943, a master’s degree in psychology from Washington State University in 1946, and a Ph.D. in psychology from the University of California, Berkeley in 1950.

Leary had many intimate women friends and five wives. He had two children, a girl born in 1947 and a boy born in 1949, with his first wife, Marianne Bush. Leary’s daughter died at age 42. She hung herself with her shoelaces tied to a jail bar while waiting to be charged for shooting her boyfriend. His son Jack, at 25 years of age, is noted in a NYT’s article in 1974. The article clearly implies Jack had become estranged from his father.

“The Acid Queen” is a sad story of two self-absorbed people who had exciting and tragic lives.

Timothy Leary had fame and fortune. Rosemary Woodruff Leary had beauty and tenacity. Neither seem paragons of virtue and both seem much less than they could have been. The underlying message of “The Acid Queen” is we need to be more connected to the world, less self-absorbed, and more other-directed. (Easy to say or write, but unlikely to be.)

Some academics considered Leary a visionary thinker who pioneered consciousness expansion, psychedelic therapy, and transhumanism.

Timothy Leary showed himself to be a charismatic and persuasive speaker. However, critics argue he lacked scientific rigor and had little foresight or objectivity about the effects of drugs on consciousness. Rosemary may have been “The Acid Queen” but never achieved the sobriquet of “Queen of Hearts”.

A government designed to use public funds to pick winners and losers in the drug industry threatens human health. Only with the truth of science discoveries and honest reporting of drug efficacy can a physician offer hope for human recovery from curable diseases.

Books of Interest
Website: chetyarbrough.blog

Rethinking Medications (Truth, Power, and the Drugs You Take)

By: Jerry Avorn

Narrated By: Jerry Avorn MD

Jerry Avorn (Author, professor of medicine at Harvard Medical School where he received his MD, Chief Emeritus of the Division of Pharmacoepidemiology and Pharmacoeconomics)

Doctor Avorn enlightens listener/readers about drug industry’ costs, profits, and regulation. Avorn explains how money corrupts the industry and the FDA while encouraging discovery of effective drug treatments. The cost, profits, and benefits of the industry revolve around research, discovery, medical efficacy, human health, ethics, and regulation.

Drug manufacture is big business.

Treatments for human maladies began in the dark ages when little was known about the causes of disease and mental dysfunction. Cures ranged from spirit dances to herbal concoctions that allegedly expelled evil, cured or killed its followers and users. The FDA (Food and Drug Administration) did not come into existence until 1930, but its beginnings harken back to the 1906 Pure Food and Drug Act signed into law by Theodore Roosevelt. The FDA took on the role of reviewing scientific drug studies for drug treatments that could aid health recovery for the public. The importance of review was proven critical by incidents like that in 1937, when 107 people died from a Sulfanilamide drug which was found to be poisonous. From that 1937 event forward, the FDA required drug manufacturers to prove safety of a drug before selling it to the public. The FDA began inspecting drug factories while demanding drug ingredient labeling. However, Avorn illustrates how the FDA was seduced by Big Pharma’ to offer drug approvals based on flawed or undisclosed research reports.

Dr. Martin Makary (Dr. Makary was confirmed as the new head of the FDA on March 25, 2025. He is the 27th head of the Department. He is a British-American surgeon and professor.)

What Dr. Avorn reveals is how the FDA has either failed the public or been seduced by drug manufacturers to approve drugs that have not cured patients but have, in some cases, harmed or killed patients. It will be interesting to see what Dr. Marin Makary can do to improve FDA’s regulation of drugs. Avorn touches on court cases that have resulted in huge financial settlements by drug manufacturing companies and their stockholders. However, he notes the actual compensation received by individually harmed patients or families is miniscule in respect to the size of the fines; not to mention many billions of dollars the drug companies received before unethical practices were exposed. Avorn notes many FDA’ research and regulation incompetencies allowed drug companies to hoodwink the public about drug companies’ discovered but unrevealed drug side-effects.

A few examples can be easily found in an internet search:

1) Vioxx (Rofecoxib), a pain killer, had to be withdrawn from use in 2004 because it was linked to increased risk of heart attacks and strokes. It was removed from the market in 2004.

2) Fen-Phen (Fenfluramine/Phentermine), a weight-loss drug had to be taken off the market in 1997 because of severe heart and lung complications.

3) Accutane was used to cure acne but was found to be linked to birth defects and had to be withdrawn in 2009.

4) Thalidomide was found to cause birth defects to become repurposed for treatment of certain cancers.

5) A more recent failure of the FDA is their failure to regulate opioids like OxyContin that resulted in huge fines to manufacturers and distributors of the drug.

Lobbyists are hired by drug companies to influence politicians to gain support of drug companies. In aggregate, this chart shows the highest-spending lobbyists in the 3rd Qtr. of 2020 were in the medical industry.

Dr. Avorn argues Big Pharma’s lobbying power has unduly influenced FDA to approve drugs that are not effective in treating patients for their diagnosed conditions. Avorn infers Big Pharma is more focused on increasing revenue than effectively reviewing drug manufacturer’ supplied studies. Avorn argues the FDA has become too dependent on industry fees that are paid by drug manufacturers asking for expedited drug approvals. Avorn infers the FDA fails to demand more documentation from drug manufacturers on their drug’ research. The author suggests many approved opioids, cancer treatment drugs, and psychedelics have questionable effectiveness or have safety concerns. Misleading or incomplete information is provided by drug companies that makes applications an approval process, not a fully relevant or studied action on the efficacy of new drugs.

Avorn is disappointed in the Trump administrations’ selection of Robert Kennedy as the U.S. Secretary of Health and Human Services because of his lack of qualification.

The unscientific bias of Kennedy and Trump in regard to vaccine effectiveness reinforces the likelihood of increased drug manufacturers’ fees that are just a revenue source for the FDA. Trump will likely reward Kennedy for decreasing the Departments’ overhead by firing research scientists and increasing the revenues they collect from drug manufacturers seeking drug approvals.

Trump sees and uses money as the only measure of value in the world.

It is interesting to note that Avorn is a Harvard professor, a member of one of the most prestigious universities in the world. Harvard is being denied government grants by the Trump administration, allegedly because of Harvard’s DEI policy. One is inclined to believe diversity, equity, and inclusion are ignored by Trump because he is part of the white ruling class in America. Trump chooses to stop American aid to the world to reduce the cost of government. American government’s decisions to starve the world and discriminate against non-whites is a return to the past that will have future consequences for America.

Next, Avorn writes about the high cost of drugs, particularly in the United States. Discoveries are patented in the United States to incentivize innovation, but drug companies are gaming that Constitutional right by slightly modifying drug manufacture when their patent rights are nearing expiration. They renew their patent and control the price of the slightly modified drug that has the same curative qualities. As publicly held corporations, they are obligated to keep prices as high as the market allows. The consequence leaves many families at the mercy of their treatable diseases because they cannot afford the drugs that can help them.

Martin Shkreli, American investor who rose to fame and infamy for using hedge funds to buy drug patents and artificially raise their prices to only increase revenues.

The free market system in America allows an investor to buy a drug patent and arbitrarily raise its price. Avorn suggests this is a correctable problem with fair regulation and a balance between government sponsored funding for drug research in return for public funding. Of course, there are some scientists like Jonas Salk in 1953 who refused to privately patent the polio vaccine because it had such great benefit to the health of the world.

Avorn notes the 1990’s drug costs in the U.S. are out of control.

Only the rich are able to pay for newer drugs that cost hundreds of thousands of dollars per year. Americans spend over $13,000 per year per person while Europe is around $5,000 and low-income countries under $500 per year. These expenditures are to extend life which one would think make Americans live longest. Interestingly, America is not even in the top 10. Hong Kong’s average life expectancy is 85.77 years, Japan 85. South Korea 84.53. The U.S. average life expectancy is 79.4. To a cynic like me, one might say what’s 5 or 6 more years of life really worth? On the other hand, billionaires and millionaires like Peter Thiel and Bryan Johnson have invested millions into anti-aging research.

Avorn reinforces the substance of Michael Pollan’s book “How to Change Your Mind” which reenvisions the value of hallucinogens in this century.

Avorn notes hallucinogens efficacy is reborn in the 21st century to a level of medical and social acceptance. Avorn is a trained physician as opposed to Pollan who is a graduate with an M.A. in English, not with degrees in science or medicine.

In reviewing Avorn’s informative history, it is apparent that patients should be asking their doctors more questions about the drugs they are taking.

Drugs have side effects that can conflict with other drugs being taken. In this age of modern medicine, there are many drugs that can be effective, but they can also be deadly. Drug manufacturers looking at drug creation as only revenue producers is a bad choice for society.

Avorn’s history of the drug industry shows failure in American medicines is more than the mistake of placing an incompetent in charge of the U.S.

Taking money away from research facilities diminishes American innovation in medicine and other important sciences. However, research is only as good as the accuracy of its proof of efficacy for the treatment of disease and the Hippocratic Oath of “First, do no harm”. A government designed to use public funds to pick winners and losers in the drug industry threatens human health. Only with the truth of science discoveries and honest reporting of drug efficacy can a physician offer hope for human recovery from curable diseases.

CHOICE

A listener/reader comes away from Pollan’s book with a feeling that there is as much at risk as reward in experimenting with hallucinogens without the aid of professionals. A bad trip can kill you.

Books of Interest
Website: chetyarbrough.blog

How to Change Your Mind (What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence)

By: Michael Pollan

Narrated By: Michael Pollan

Michael Pollan (Author, journalist, professor and lecturer at Harvard and UC Berkeley, received a B.A. in English from Bennington College and M.A. in English from Columbia University.)

“How to Change Your Mind” is a slippery slope examination of hallucinatory drugs. The slipperiness comes from a concern about drug use even though hallucinatory drugs are not addictive. Written by a liberal art’s graduate rather than a physician, psychiatrist, or scientist makes one skeptical of the author’s review and perspective on LSD and other hallucinatory drugs. However, his story is interesting and has an appeal to anyone who has experimented with hallucinogens.

RISKS AND EFFECTS OF HALLUCINOGENS

Pollan’s subject is partly about mushroom drug derivatives, like psilocybin and psilocin, that have hallucinogenic effects. But he also reviews the history of LSD which is a semi-synthetic compound accidentally discovered by a chemist named Albert Hofmann in 1938. LSD is derived from ergot, a type of fungus that grows on rye and other grains.

Albert Hofmann (1906-2008, chemist who synthesized, ingested and studied the effects of LSD.)

Pollan recalls the history of hallucinogenic drugs that evolved from ancient native rituals to public experimentation. Today, medical analysis and treatment with hallucinogenic drugs is being recommended. The revised belief of hallucinogens as a scourge of society is reborn to a level of medical and social acceptance.

One who has lived a long life in the 20th and now 21st century recalls Pollan’s rollercoaster history. Pollan falls on the side of acceptance of the hallucinogenic experience as an aid to society. His reported revisionist belief begins at the age of 60 when he tries a hallucinogenic drug and begins a study of its history. One is somewhat skeptical of Pollan’s objectivity because he is in the business of making a living from writing.

Pollan features several experts in the field of psychedelic research. He refers to Roland Griffiths (upper left corner) now deceased, neuroscientist at Johns Hopkins University who conducted studies on psilocybin’s effect on consciousness and mental health. He meets with Paul Stamets (lower left corner), a mycologist who is a fungi guru who explains where psilocybin mushrooms can be found, how they can be identified, while selling hallucinatory mushrooms to become a wealthy entrepreneur. He writes about James Fadiman (right), a psychologist and researcher who conducted hallucinogenic microdosing experiments on patients to show their potential benefits.

Pollan’s history persuasively argues the benefits of hallucinogenic drugs. However, a bad trip can kill you. On the other hand, Pollan notes recent research shows hallucinogenic drugs have alleviated anxiety, depression, PTSD, addiction, and the fear of dying. He notes psychedelics disrupt the brain’s default modes that negatively affect human behavior.

A listener/reader comes away from Pollan’s book with a feeling that there is as much at risk as reward in experimenting with hallucinogens without the aid of professionals.

HEALTH

“This is Your Brain on Parasites” is a bad book title but McAuliffe has written an interesting book about physical and mental health, and the treatments being researched in the 21st century.

Books of Interest
Website: chetyarbrough.blog

This is Your Brain on Parasites (How Tiny Creatures Manipulate Our Behavior) and Shape Society

By: Kathleen McAuliffe

Narrated By: Nicol Zanzarella

Kathleen McAuliffe (Author, science journalist who has published in The New York Times, The Atlantic, and Smithsonian. Received an M.A. in natural science from Trinty College Dublin.)

Kathleen McAuliffe apprises the public of the importance of personal health along with a somewhat bizarrely titled book “This is Your Brain on Parasites”. McAuliffe’s book is about the science of health and its maintenance. The idea of a parasite in one’s brain seems unworthy of a book because of the creepy implication of possession. However, McAuliffe refers to a physician and several research scientists that have found evidence of brain parasites that effect animal and human behavior.

Dr. Robert Sapolsky. (Now retired but has written several books on biology and animal behavior.)

Dr. Robert Sapolsky, a neuroscientist and professor at Stanford studied what is called a Toxoplasma gondii parasite. It forms cysts in brain tissue that are shown to affect human behavior. People who have developed the cysts have shown symptoms of risk-taking behavior, and mental dysfunction like schizophrenia.

Dr. Jaroslav Flegr is a parasitologist, evolutionary biologist and professor of biology at the Faculty of Science, and professor at Charles University in Prague.

McAuliffe meets with a Czech scientist, Dr. Jaroslav Flegr, who conducted research showing the Toxoplasma gondii parasite in cat feces can infect the brain of a human being. The author meets other American research scientists that show how parasites infect animal brains whose behavior is affected in ways that are not natural to their species. A parasite being the source of a diseased brain has implications for treating mentally dysfunctional patients that may have a parasitic infection.

What McAuliffe’s book implies is the importance of washing one’s hands when handling pets, or their fecal material.

“This is Your Brain…” reminds one of the importance of hygiene when replenishing a bird feeder or filling an animal feeding trough to avoid possible parasites.

As most know, Kennedy is not a believer in vaccination despite a growing measles epidemic and the proof that vaccination works. McAuliffe does believe there are circumstances where a child crawling across the floor of a clean house gathers some immunity naturally but that un-common pathogens require uncommon vaccination.

Two other subjects mentioned by McAuliffe is natural and science made vaccinations and the benefits they provide humanity. This is a particularly timely suggestion considering Trump’s appointment of Robert F. Kennedy Jr. (a confessed anti-vaxxer) as the Secretary of Health and Human Services.

McAuliffe notes how research is showing how certain microbes can remove calories from food and how certain drugs can reduce hunger among overweight patients. She reflects on the intersection of microbiology and human health.

Another interesting examination by McAuliffe is the science research being done on gut microbiomes, a community of microorganisms in human digestive systems.

The research on microbiomes has resulted in effective weight loss drugs that have become popular medications for people struggling with weight gain.

“This is Your Brain on Parasites” is a bad book title but McAuliffe has written an interesting book about physical and mental health, and the treatments being researched in the 21st century.

SERVICE & PROFIT

Government is not a business for profit and should not be solely measured by its cost. America will survive the catastrophic mistakes being made by President Trump but American citizens, and the welfare of the world will suffer for years to come.

Books of Interest
Website: chetyarbrough.blog

Who is Government (The Untold Story of Public Service)

By: Michael Lewis, Casey Cep, Dave Eggers, John Lanchester, Geraldine Brooks, Sarah Vowell, and Kamau Bell

Edited By: Michael Lewis

The stories of these writers are a tribute to those who have chosen careers in American government. Having personally earned a master’s degree in public administration, worked as a local government manager, then as a manager of a private business division, and finally, as a personal business owner, I have an opinion about President Trump. My experience is based on three different types of employment. All were rewarding experiences but in fundamentally different ways.

The writers of “Who is Government” show how ignorant business creators and managers like Donald Trump and Elon Musk are in discounting the contribution of employees of government organizations. Private corporations do not survive without profit to its owners. Public organizations do not survive without service to the public.

Profit is simple to measure. Public service is measurable but more abstract and difficult to quantify.

One can choose, like Musk did with Twitter, to reduce costs by firing employees. That may improve profitability but at a cost that may hurt or destroy the future of a business. In the case of Twitter, the company lost much of their advertising revenue because an unsupervised public forum could spread false and defamatory information that embarrasses advertisers who were protected by Twitter’ employees that were fired. No analysis was done by Musk about Twitter information’ controls provided by employees. The new entity, “X”, seems to have assuaged some advertisers’ concerns because they have started to use Musk’s new company. The point is that if Musk had taken more time to evaluate what fired employees were doing, he may have retained many of the advertisers who left the forum.

Trump’s employment of Musk to decimate the government employee workforce is following the same foolish path that was taken with Twitter.

No analysis of employee contributions is made. The goal is only to reduce government’ cost regardless of employee’ contribution to public need or service. The consequences have likely reduced health and welfare of American citizens; not to mention harm done to incomes of thousands of government employees’ families.

With exceptions of George Washington, Harry Truman, Carter, and the two Bush presidents, the worst former businessman that became President was Herbert Hoover who served as President before the greatest depression in America’s history. With Trump as President, one has to wonder whether he is leading America and the world toward its second great depression.

HERBERT HOOVER (31ST PRESIDENT OF THE U.S.)

“Who is Government” illustrates how government employees have contributed to the health and welfare of America. They are unknown and viewed by people like Trump and Musk as just a cost, without benefit to the public. How many science, medical, veteran, and welfare services are being decimated by their narrow vision of government management?

LIFE’S LOTTERY

The randomness of life and what we make of it is the most important theme of Weston’s insightful memoir about being “Alive”.

Books of Interest
Website: chetyarbrough.blog

Alive (The Richness and Brevity of Existence)

By: Gabriel Weston

Narrated By: Gabriel Weston

Gabriel Weston (Author, English surgeon, television presenter.)

Gabriel Weston’s “Alive” is an intimate, blunt, and enlightening explanation of her experience as a woman, surgeon, mother, and member of the human race. For some, Weston’s story contains more information than one is prepared to take.

It begins with a self-effacing assessment of her early education in liberal arts where she achieved an MA in English. However, she decides to go to medical school in London where she qualifies as a physician in 2000. Her very personal memoir explains a great deal about being educated as a physician but more about being a woman.

Some reader/listeners will be put off by Weston’s blunt explanation of the human body. However, some will find much of what she writes as revelatory.

Weston explains what it means to be human and a woman who becomes a mother of twins at the age of forty, with two younger children.

It is hard to imagine a younger person who is uninterested in science, technology, engineering, or math, who receives an MA in English, would be interested in becoming a surgeon.

However, Weston chooses to become a doctor and graduates from a London medical school in 2000. She briefly explains her journey in “Alive” by reflecting on her classes in body dissection to explain the details of the human body and differences in sexual anatomy. Some will choose to leave her story, but others (if they stick with it) will be enlightened and surprised by her observations and opinions.

Weston notes the equivalent of the male penis is a woman’s clitoris. This is an interesting observation that most would be unlikely to publicly discuss or write about.

Presumably, Weston is making this point to show there is a great deal of similarity between men and women. However, she notes a significant difference. Menstruation is a sluffing process where the uterus sheds a layer of bedding material that exits the body through the vagina, i.e., something unique to women. The purpose of menstruation is to prepare the body for possible pregnancy by providing a thickening to the uterus that supports fertilization. That thickening is removed (sluffed off) approximately once per month. As is often noted, only women give birth, a singular difference between the sexes.

**Weston goes on to explain her experience of birthing twins.**

The two girls come late in her adult life. They are delivered in a caesarian operation. Children are born in amniotic sacs. This is likely a surprise to most men because birth of a baby is thought of as a delivery with a squirming body through the birth canal rather than a body within an amniotic sac. However, Weston notes the second twin is delivered within its amniotic sac which suggests she is a fraternal, rather than identical twin.

Syria’s use of nerve gas to murder their own citizens.

Weston’s story moderates in future chapters with notes about nerve gases used by governments to suffocate their own people as well as perceived foreign enemies. The point she makes is that oxygen deprivation in the 21st century and beyond is increasing with rising pollution on earth. She notes oxygen deprivation is the same suffocation caused when governments used lethal gases to kill their own citizens as perceived enemies. The obvious inference is today’s denial of earth’s environmental degradation risks the lives of all oxygen dependent lives.

Weston is an example of a working mother who succeeds in England despite the world’s history of misogyny.

Some women become a success despite the many obstacles they face. Weston symbolizes human grit and determination in the face of sexual inequality of opportunity but, as a human being, she is subject to the physical limitations of every life. She mentions during the course of her story a heart murmur that is caused by a defective heart valve. The last chapters of her book explain Weston is on a transplant list.

The randomness of life and what we make of it is the most important theme of Weston’s insightful memoir about being “Alive”.

TIPPING POINT

Today, some look at the American government with concern. Are we at a tipping point in America?

Books of Interest
Website: chetyarbrough.

Revenge of the Tipping Point (Overstories, Superspreaders, and the Rise of Social Engineering)

By: Malcolm Gladwell

Narrated By: Malcolm Gladwell

Malcolm Gladwell (Canadian Author, journalist, public speaker, staff writer for The New Yorker.)

Malcolm Gladwell returns to the subject of “…Tipping Point” that originally explored how small actions or events can trigger significant changes in society. “Revenge of the Tipping Point” provides several stories of tipping points that have had vengeful consequences for society.

One of the most consequential tipping point stories is about America’s attempt to engineer social equality.

America is struggling with social diversity. Gladwell infers social diversity is a great strength in American society. However, our government and domestic leaders have legislated discrimination, fought wars, murdered innocents, and promoted ethnic separation throughout its history as a nation. Despite our most famous statement of American value, i.e. “E pluribus unum” (Out of many, one), America has failed.

The value of social diversity is it allows Americans to achieve great things despite inequality that exists in America.

Gladwell tells the story of a community in Florida that prides itself on being an exemplar of American society because of its strong educational values, cultural pride, community support, and economic mobility. The people who live in this community focus on preserving and celebrating their ethnic heritage, traditions, and identity. They assemble an island of cultural sameness that overtly and covertly resists change. Those who are not of the right ethnic heritage or race who may have the same drive for high educational achievement, community participation, and relative wealth are not welcome. The tipping point revenge Gladwell notes is in the stress this community places on its children to excel academically and conform to expectation. Gladwell notes student suicides are disproportionately high because of the social pressure children feel to conform. The social pressure for conformity and educational expectation overwhelms some who live in the community. Some parents choose to send their children outside the community school system to allay the social pressure they feel.

Gladwell notes the 2023 Supreme Court rejection of college acceptance based on diversity. The Court denies the right of colleges to recruit students based on ethnicity or race.

On the face of it, that seems an unfair decision but Gladwell notes that the schools being challenged on their diversity policies refuse to explain how they determine who should be admitted based on a percentage figure of fair representation. Gladwell notes the primary criteria for college selection has little to do with a drive for diversity but are based on revenue producing university sports programs and donor money. Minority preference admissions are based on income potential for the university, not social diversity.

The Supreme Court ruling does not preclude consideration of an applicant’s personal life experience, but Gladwell notes it nevertheless has nothing to do with a drive for equality or diversity.

Unfortunately, the Supreme Court decision may cause a reevaluation of outreach to minorities who have been denied equal opportunity for personal success. Gladwell’s ironic point is that American diversity in the pre-Supreme Court decision was never based on creating diversity but on raising money for university foundations.

Gladwell explains the drug crises is more of an American problem than for most other nations of the world.

One asks oneself, what makes America the center of opioid addiction and death.

From the greed of drug dealers, medicine manufacturers and doctors who prescribe opioids, America has the highest opioid deaths in the world. Though Estonia has the highest opioid death’s per capita because of its smaller population, the manufacturers and doctor-prescribed synthetic opioids have greatly increased American’s deaths. Purdue Pharma aggressively marketed OxyContin with the owners, the Sackler family, reaching a multibillion-dollar settlement. Many doctors like Dr. Hsiu-Ying Tseng and Dr. Nelson Onaro have been prosecuted for overprescribing opioids or running “pill mills” that provided opioids to the public.

Gladwell suggests it is the superspreaders, worldwide legal and illegal manufacturers and sellers of opioids, and incompetent/greedy medical prescribers as tipping point causes of America’s addiction crises. However, he argues there are environmental and systemic societal factors that create a receptive user base in America. Economic stability is unattainable for many Americans because of economic, racial, and ethnic differences. He argues small actions and decisions lead to widespread consequences. Every human being has a tipping point based on their experience in the world. The ideals of America conflict with its reality. The pain of that realization leads some to relief through drugs, a step-by-step addiction that can lead to death.

Berlin Memorial to the Holocaust.

There are other tipping points Gladwell explains. One that resonates with my life experience is the ignorance many have of the history of the world. Some would argue, Americans became aware of the Holocaust after the end of the war in 1945. However, Gladwell argues most Americans remained ignorant of its reality until 1978 following the release of the NBC miniseries “Holocaust”. Until then, Gladwell argues there was little broad cultural understanding of its atrocity. Having graduated from high school in 1965, much of what Gladwell notes about ignorance of the Holocaust rings loudly and clearly.

I doubt that many were completely ignorant of the Holocaust, but its brutal reality was not taught in the high school I attended in the 60s. Having visited Auschwitz and viewed its gas chamber, piles of discarded shoes and clothes, and pictures of murdered human beings, the truth and guilt that one feels for being a part of humanity is overwhelming.

We have an FBI director that wants to have men and women of the agency coordinate training with the UFC (Ultimate Fighting Championship), headquartered in Las Vegas. We have a President who publicly chastises Ukraine’s President and suggests they caused Russia’s invasion of their country. We have a President that insists America is being taken advantage of by lower cost production of product of other countries and that tariffs are a way to balance the American budget. We have a Palestinian protester at Columbia University who is arrested for social disruption. The head of the Department of Health Services orders lie detector tests for employees to find any leaks about the current Administration’s actions.

Tariffs have historically been found to damage America’s economy. Is the FBI a military force that needs to be schooled in hand-to-hand combat? One need only read Adam Smith about free trade to understand the fallacy of Tariffs. Have we forgotten the invasions of Austria and Poland by Germany at the beginnings of WWII? Is free speech a crime because of tents that disrupt college life? Should we use lie detector tests to determine the loyalty of employees?

Are these incidents a tipping point for American Democracy to turn into something different and demonstrably less than the founding principles of American government?

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