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We began collaborating with Sima Wali in 1998 to strengthen the Afghan perspective in the US. We traveled back to Kabul in 2002 to film Wali's first return since her exile. As the first Afghan refugee to come to the US in 1978, Sima transformed herself from victim to advocate. As President of Refugee Women in Development she’s worked for decades to empower uprooted women around the world to assert their human rights. The Woman in Exile Returns, the film we produced about Sima's return to her homeland has been screened around the country.
Sima's most recent op-ed has been running on the Huffingtonpost.
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Extremists cross the border: A Major Concern to Rebuilding Afghanistan
I recently returned from Kabul where I went to launch a project on building democracy among women funded by the National Endowment for Democracy. While there, I visited Jalalabad, a provincial town bordering Pakistan where I experienced the frightening ordeal of nearly being taken hostage by an angry mob of fervent Islamists.
In my moment of personal terror, I vowed to tell the story of the Afghan people’s growing pleas to the West. But more desperate pleas are not enough unless a more self-effacing process emerges in the West for confronting the sources of Afghanistan’s growing danger.
Afghanistan still reels from twenty five years of Superpower victimization. Our borders, once conduits for the vast riches and high culture of the silk trade, are today abused by foreign infiltrators bent on subjugating us to their barbaric will. Without a viable international policy which guarantees the disarmament of warlords and their militias in addition to the extension of comprehensive security beyond Kabul, the new government will not succeed in building the institutions necessary for a stable Afghanistan.
We came to Jalalabad at the invitation of the Governor. Housed in a palace built by King Amanullah, we were reminded that nearly a hundred years ago his efforts to introduce female education and abolish the head to toe veil -- which has come to symbolize Afghan women’s oppression -- revolutionized Afghan life. The symbolism of conducting our classes in the former home of this champion for women’s rights, was not lost on us. Neither was the role of the present Governor, whose efforts to help restore Afghan women's basic rights to freedom follows in a long tradition of the bravest of Afghan men.
Soon after our meeting I began to hear what sounded like gunfire, protests, and explosions. The environment grew more tense as we heard protestors’ shouts and the electricity went out. Soon we realized we were alone in the dark, overhearing the demonstrators’ screams. No one outside the palace knew of our plight. Alarmed, I inquired about the disturbance, only to be escorted outside, through the garden to our hiding place. Within minutes the protestors broke through the gates, setting fire to our meeting room and the cars we had traveled in. But the danger was only beginning.
Desperate, I used my mobile phone to call as many contacts as I could reach. One call was to a tribal leader in Kabul. One of only a handful of Pashtuns still allowed to carry arms, he came to our aid, echoing the sentiment of many Afghans. "It is the duty of all Afghans to ensure your safety since you come from a long way off to help rebuild Afghanistan," he insisted. When our armed tribal protectors arrived at the compound gates, they were reluctant to approach for fear they would attract protestors. We were then forced to take refuge away from the palace by scaling down walls and across the fields to the gardener’s home. The gardener’s wife greeted us warmly with nan, water and fruit. While fanning flies away from us, she kept ensuring us of our safety. I was too shaken and sick from dysentery to partake of the fruit and politely ate the nan. I had concealed my passport in my bra and was willing to leave everything else behind. It was hot and I was sweating profusely. In addition to our traditional clothes given to me the day before, I was sporting a bed sheet worn in a desperate attempt to render myself invisible. A burqa would greatly help in such a moment, I thought.
Finally, after what seemed an eternity, the Governor, at my request, intervened with the American security firm, DynCorps, who had arrived to airlift its own people. This seemed our only salvation, since no one, including the US Embassy, had an evacuation plan. Sitting in the convoy, I was fearful all over again as we stopped in the middle of a crossroads. Fully armed men piled out of the vehicles. Luckily the road cleared and we climbed into the plane.
Back in Kabul, I learned from credible sources that the armed insurgents were Al-Qaeda, Pakistani, and Taliban protestors who had crossed the border from Pakistan. A large amount of cash had been disbursed among the insurgents the day before. Afghans widely commented that these protests were externally organized. In the days that followed there were counter-protests by Afghans decrying the vast destruction of their cities by infiltrators, such as a suicide bomber who had attacked an internet café frequented by foreign aid workers just days before. Suicide bombings are an un-Afghan trait, notwithstanding two decades of conflict in Afghanistan.
Although it was a harrowing experience, it also renewed my appreciation of the Afghan people’s continuing commitment to rebuilding despite the danger. Many Afghans came to our aid unconditionally even though it put them at great risk. But as the world has come to see in vivid terms, Afghan bravery cannot alone stop the tide of barbaric extremism. Without a meaningful and realistic policy for protecting Afghanistan and its borders, the crossroads that has enriched the world from ancient times will convey only untold sadness and pain.
Sima Wali, President and founder of Refugee Women in Development (RefWID) Inc., is an Afghan living in exile in the United States. Wali has worked for over 20 years to empower uprooted women to assert their human rights and to participate in economic and social development. She is a pioneer in providing culturally specific institutional development programs and domestic violence prevention and intervention mechanisms for women around the world.
Wali is the recipient of numerous awards for her pioneering work in developing program models aimed at the empowerment of women caught conflict, democratic civil society building of war torn societies, gender, forced migration, and human rights. She has been honored by the Women Donors Network, the Women's Commission for Refugee Women and Children, the National Conference for College Women Graduate Leaders. She was the recipient of the Gloria Steinem: Women of Vision Award for her pioneering work in addressing violence against refugee women in the United States. Wali was the recipient of Amnesty International's 1999 Ginetta Sagan human rights award for her work with Afghan women. Her website is at www.refwid.org
By Walter Pincus
Washington Post Staff Writer
September 11, 2005
The Pentagon has drafted a revised doctrine for the use of nuclear weapons that envisions commanders requesting presidential approval to use them to preempt an attack by a nation or a terrorist group using weapons of mass destruction. The draft also includes the option of using nuclear arms to destroy known enemy stockpiles of nuclear, biological or chemical weapons.
The document, written by the Pentagon's Joint Chiefs staff but not yet finally approved by Defense Secretary Donald H. Rumsfeld, would update rules and procedures governing use of nuclear weapons to reflect a preemption strategy first announced by the Bush White House in December 2002. The strategy was outlined in more detail at the time in classified national security directives.
At a White House briefing that year, a spokesman said the United States would "respond with overwhelming force" to the use of weapons of mass destruction against the United States, its forces or allies, and said "all options" would be available to the president.
The draft, dated March 15, would provide authoritative guidance for commanders to request presidential approval for using nuclear weapons, and represents the Pentagon's first attempt to revise procedures to reflect the Bush preemption doctrine. A previous version, completed in 1995 during the Clinton administration, contains no mention of using nuclear weapons preemptively or specifically against threats from weapons of mass destruction.
Titled "Doctrine for Joint Nuclear Operations" and written under the direction of Air Force Gen. Richard B. Myers, chairman of the Joint Chiefs of Staff, the draft document is unclassified and available on a Pentagon Web site. It is expected to be signed within a few weeks by Air Force Lt. Gen. Norton A. Schwartz, director of the Joint Staff, according to Navy Cmdr. Dawn Cutler, a public affairs officer in Myers's office. Meanwhile, the draft is going through final coordination with the military services, the combatant commanders, Pentagon legal authorities and Rumsfeld's office, Cutler said in a written statement.
A "summary of changes" included in the draft identifies differences from the 1995 doctrine, and says the new document "revises the discussion of nuclear weapons use across the range of military operations."
The first example for potential nuclear weapon use listed in the draft is against an enemy that is using "or intending to use WMD" against U.S. or allied, multinational military forces or civilian populations.
Another scenario for a possible nuclear preemptive strike is in case of an "imminent attack from adversary biological weapons that only effects from nuclear weapons can safely destroy."
That and other provisions in the document appear to refer to nuclear initiatives proposed by the administration that Congress has thus far declined to fully support.
Last year, for example, Congress refused to fund research toward development of nuclear weapons that could destroy biological or chemical weapons materials without dispersing them into the atmosphere.
The draft document also envisions the use of atomic weapons for "attacks on adversary installations including WMD, deep, hardened bunkers containing chemical or biological weapons."
But Congress last year halted funding of a study to determine the viability of the Robust Nuclear Earth Penetrator warhead (RNEP) -- commonly called the bunker buster -- that the Pentagon has said is needed to attack hardened, deeply buried weapons sites.
The Joint Staff draft doctrine explains that despite the end of the Cold War, proliferation of weapons of mass destruction "raises the danger of nuclear weapons use." It says that there are "about thirty nations with WMD programs" along with "nonstate actors [terrorists] either independently or as sponsored by an adversarial state."
To meet that situation, the document says that "responsible security planning requires preparation for threats that are possible, though perhaps unlikely today."
To deter the use of weapons of mass destruction against the United States, the Pentagon paper says preparations must be made to use nuclear weapons and show determination to use them "if necessary to prevent or retaliate against WMD use."
The draft says that to deter a potential adversary from using such weapons, that adversary's leadership must "believe the United States has both the ability and will to pre-empt or retaliate promptly with responses that are credible and effective." The draft also notes that U.S. policy in the past has "repeatedly rejected calls for adoption of 'no first use' policy of nuclear weapons since this policy could undermine deterrence."
Rep. Ellen Tauscher (D-Calif.), a member of the House Armed Services Committee who has been a leading opponent of the bunker-buster program, said yesterday the draft was "apparently a follow-through on their nuclear posture review and they seem to bypass the idea that Congress had doubts about the program." She added that members "certainly don't want the administration to move forward with a [nuclear] preemption policy" without hearings, closed door if necessary.
A spokesman for Sen. John W. Warner (R-Va.), chairman of the Senate Armed Services Committee, said yesterday the panel has not yet received a copy of the draft.
Hans M. Kristensen, a consultant to the Natural Resources Defense Council, who discovered the document on the Pentagon Web site, said yesterday that it "emphasizes the need for a robust nuclear arsenal ready to strike on short notice including new missions."
Kristensen, who has specialized for more than a decade in nuclear weapons research, said a final version of the doctrine was due in August but has not yet appeared.
"This doctrine does not deliver on the Bush administration pledge of a reduced role for nuclear weapons," Kristensen said. "It provides justification for contentious concepts not proven and implies the need for RNEP."
One reason for the delay may be concern about raising publicly the possibility of preemptive use of nuclear weapons, or concern that it might interfere with attempts to persuade Congress to finance the bunker buster and other specialized nuclear weapons.
In April, Rumsfeld appeared before the Senate Armed Services panel and asked for the bunker buster study to be funded. He said the money was for research and not to begin production on any particular warhead. "The only thing we have is very large, very dirty, big nuclear weapons," Rumsfeld said. "It seems to me studying it [the RNEP] makes all the sense in the world."
Dear Mr. Herbert,
Re: August 18, 2005 Blood Runs Red, Not Blue New York Times op-ed.
It was when you said, " if the war in Iraq is worth fighting - if it's a noble venture, as the hawks insist it is - then it's worth fighting with the children of the privileged classes." I had to respond. It should be re-titled, Children's Blood Runs Red , Not Blue. The emphasis is on "children," whether male or female, rich or poor, it's time to question the idea that "children" should be asked to fight in wars created by adults who have failed to even provide a genuine explanation of their flawed decision making. Even more disturbing is that so few adults are held accountable in any public way for sending our children to die for their mistakes.
Increasing numbers of American parents are recognizing the inherent unfairness of using our children to fight wars at all. Even in a just war, War inherently is the failure of negotiation. There could not be a more "unjust war" than the war in Iraq. Negotiation was never viewed as an honorable option. In fact it's safe to say, the Bush administration views the use of negotiation as a failure! Let's have the Congress and Senate and anyone who thinks war is a reasonable and honorable option instead of working harder to resolve differences through negotiation sign up first instead of taking our children, male and female, rich and poor. Except for the vested interests, how fast would the war option disappear? How fast would the troops be headed home.
Let's honor the warrior who puts down his gun to end the war forever. Let's create a new role for the warrior. Turn the warrior power into negotiator power. Let's get the negotiator on the "A" list for a change!
Please Mr. Herbert, let's stop sacrificing all of Abraham's children forever.
Sincerely,
Elizabeth Gould
mother of Devon, 20 and Alissa, 23
New York Times August 18, 2005 Blood Runs Red, Not Blue By BOB HERBERT
You have to wonder whether reality ever comes knocking on George W. Bush's door. If it did, would the president with the unsettling demeanor of a boy king even bother to answer? Mr. Bush is the commander in chief who launched a savage war in Iraq and now spends his days happily riding his bicycle in Texas. This is eerie. Scary. Surreal. The war is going badly and lives have been lost by the thousands, but there is no real sense, either at the highest levels of government or in the nation at large, that anything momentous is at stake. The announcement on Sunday that five more American soldiers had been blown to eternity by roadside bombs was treated by the press as a yawner. It got very little attention. You can turn on the television any evening and tune in to the bizarre extended coverage of the search for Natalee Holloway, the Alabama teenager who disappeared in Aruba in May. But we hear very little about the men and women who have given up their lives in Iraq, or are living with horrific injuries suffered in that conflict. If only the war were more entertaining. Less of a downer. Perhaps then we could meet the people who are suffering and dying in it. For all the talk of supporting the troops, they are a low priority for most Americans. If the nation really cared, the president would not be frolicking at his ranch for the entire month of August. He'd be back in Washington burning the midnight oil, trying to figure out how to get the troops out of the terrible fix he put them in. Instead, Mr. Bush is bicycling as soldiers and marines are dying. Dozens have been killed since he went off on his vacation. As for the rest of the nation, it's not doing much for the troops, either. There was a time, long ago, when war required sacrifices that were shared by most of the population. That's over. I was in Jacksonville, Fla., a few days ago and watched in amusement as a young woman emerged from a restaurant into 95-degree heat and gleefully exclaimed, "All right, let's go shopping!" The war was the furthest thing from her mind. For the most part, the only people sacrificing for this war are the troops and their families, and very few of them are coming from the privileged economic classes. That's why it's so easy to keep the troops out of sight and out of mind. And it's why, in the third year of a war started by the richest nation on earth, we still get stories like the one in Sunday's Times that began: "For the second time since the Iraq war began, the Pentagon is struggling to replace body armor that is failing to protect American troops from the most lethal attacks by insurgents." Scandalous incompetence? Appalling indifference? Try both. Who cares? This is a war fought mostly by other people's children. The loudest of the hawks are the least likely to send their sons or daughters off to Iraq. The president has never been clear about why we're in Iraq. There's no plan, no strategy. In one of the many tragic echoes of Vietnam, U.S. troops have been fighting hellacious battles to seize areas controlled by insurgents, only to retreat and allow the insurgents to return. If Mr. Bush were willing to do something he has refused to do so far - speak plainly and honestly to the American people about this war - he might be able to explain why U.S. troops should continue with an effort that is, in large part at least, benefiting Iraqi factions that are murderous, corrupt and terminally hostile to women. If by some chance he could make that case, the next appropriate step would be to ask all Americans to do their part for the war effort. College kids in the U.S. are playing video games and looking forward to frat parties while their less fortunate peers are rattling around like moving targets in Baghdad and Mosul, trying to dodge improvised explosive devices and rocket-propelled grenades. There is something very, very wrong with this picture. If the war in Iraq is worth fighting - if it's a noble venture, as the hawks insist it is - then it's worth fighting with the children of the privileged classes. They should be added to the combat mix. If it's not worth their blood, then we should bring the other troops home. If Mr. Bush's war in Iraq is worth dying for, then the children of the privileged should be doing some of the dying.
It says a lot about the priorities in this country when the right to breastfeed needs to be supported by law. What kind of people are we in America? It's embarrassing when such an obvious and fundamental activity of life itself can be viewed as "uncomfortable" as this editorial claims Barbara Walters was made when she witnessed, horrors a baby being breast fed on an airline. Instead of getting mad at the mother why doesn't Babs try to help push for better accommodations from airlines to give breastfeeding mothers a quiet and private place on board to feed their babies instead of jamming us all in so tight we all risk our health to fly. That's a novel idea!
It's not just breastfeeding, we are all forced by the tightness of the cabins to witness all kinds of personal moments that would be better left for privacy! There is literally no room to breathe without sucking up your neightbor's air too. To get out of an inner seat to the center aisle should require a blood test in case a accidental insemination! Let's get real here folks, it is pathetic that so many serious legal issues, such as the legitimacy of many aspects of the Patriot Act, will be pushed aside to deal with something that common sense should be capable of governing.
GLOBE EDITORIAL A boost for breastfeeding August 13, 2005 INFANTS AND their mothers would be healthier if more mothers would breast-feed their babies. A Food and Drug Administration study of why women don't, or stop after a short time, found that a principal factor is their embarrassment over the reaction nursing causes when it is done in public. Changing that reaction in squeamish America will take time -- Barbara Walters riled nursing mothers recently when she said on TV that the sight of a woman breastfeeding near her in an airplane made her ''uncomfortable." A step in the direction of making nursing more routine is state legislation that would end the harassment that nursing mothers too often face. Massachusetts is one of about 12 states that lack a law spelling out that breastfeeding mothers cannot be charged with lewdness or other violations. Rarely, if ever, has a nursing woman in this state actually been arrested, but state Representative David Linsky of Natick says many women have been told to stop breastfeeding in malls, stores, or other facilities by policemen, private security officers, or store employees. Linsky has filed a bill that makes it clear that nursing violates no laws. In the Senate, Susan Fargo of Lincoln has filed a bill that both establishes a woman's right to breastfeed in any public or private location where she has a right to be and addresses the problem that mothers have of being able to express their milk at their workplace for use later. Under her bill, employers could not stop a mother from expressing her milk during any authorized meal period or other break time. Moreover, employers would have to provide ''reasonable" unpaid breaks for expressing, unless doing so ''would unduly disrupt the operations of the employer." Fargo would also have the state award companies with the designation ''mother friendly" if they go so far as to provide nursing women with accessible private locations other than a bathroom stall for nursing and make available an electric outlet, wash basin, and refrigerator space for milk storage. Children who nurse have fewer ear infections, less diabetes, lower leukemia rates, and are less likely to be obese than formula-fed children. Mothers who nurse have lower rates of premenopausal breast cancer than mothers who don't. The American Academy of Pediatrics says the United States would save $3.6 billion in annual health costs if all children were breastfed exclusively for the first six months and at least partially for the next six. Currently, almost 70 percent of mothers start breastfeeding their babies, but only 33 percent are doing so after six months. The rates for Massachusetts are slightly higher. Bills like Linsky's and Fargo's would help make nursing the right formula for children's health. © Copyright 2005 The New York Times Company
The "shoot-to-kill" police policy for an innocent man after the London bombing of 7/7/05 does raise the question, who are we at war with? In World War I the civilian casualties of war were 10%. Today we experience a rate 9 times that, yes, 90% of the casualities of war are civilian. It means that war today is mostly about killing civilians, otherwise know as collateral damage!
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Met chief warns more could be shot
Rosie Cowan, Vikram Dodd and Richard Norton-Taylor Guardian Sir Ian Blair, the Scotland Yard commissioner, apologised to the family of Jean Charles de Menezes, the 27-year-old Brazilian who died after being shot five times in the head at close range by police on board a tube train at Stockwell, south London, on Friday. But he admitted more people could die at the hands of police marksmen in the escalating battle against terrorism. Openly discussing the shift in police tactics for the first time, Sir Ian defended the policy of "shoot to kill in order to protect", saying it was necessary to shoot suspects in the head if it was feared they might trigger devices on their body. "The Metropolitan police accepts full responsibility for this," he said. "To the family I can only express my deep regrets. What we have got to recognise is that people are taking incredibly fast-moving decisions in life threatening situations. There is no point in shooting in someone's chest because that is where the bomb is likely to be. There is no point in shooting anywhere else if they fall down and detonate it. The only way to deal with this is to shoot to the head." The block of flats in Tulse Hill, south London, where Mr Mr De Menezes lived, was under surveillance following the discovery of its address in a rucksack containing one of four bombs which failed to explode in the capital last Thursday. He was followed for several miles by undercover officers. According to eyewitnesses, he bolted after being confronted by armed officers at the tube station, resulting in a chase and him being shot on the train. Mr De Menezes' family branded the police "stupid and incompetent", insisting they had no reason to suspect him. Alex Pereira, his cousin, said: "He was 100% good guy who never did anything wrong and had no reason to run. What the police have shown is that they are incapable and stupid." A criminal inquiry will be launched into the shooting today. The Independent Police Complaints Commission will bring in independent investigators to assess whether officers will face criminal or disciplinary charges. It is, however, unclear, whether the special shoot-to-kill tactics, codenamed Operation Kratos, were authorised by a senior officer. The shooting has increased the already huge strain on the Met, which Sir Ian has admitted is facing the biggest challenge in its history in hunting down the four men responsible for last week's bomb attempt, and their support network. Three men are currently under arrest but it is not known if any of them are the bombers. In Little Wormwood Scrubs, north-west London the bomb squad carried out controlled explosions on a package found hidden in bushes. They believe it may have been a fifth bomb linked to the devices which failed to go off last Thursday. Meanwhile, Charles Clarke and Jack Straw, the home and foreign secretaries, backed Sir Ian. Mr Clarke, who has postponed his holiday to attend an anti-terrorism summit chaired by the prime minister today, said: "It is an absolute tragedy for Mr De Menezes and his family and I send my deepest regrets." Mr Straw, who will face difficult questions from Celso Amorim, the Brazilian foreign minister, today, said: "We have to ensure that clear rules are operated. But we also, tragically, have to ensure that the police do have effective discretion to deal with what could be terrorist suicide outrages about to take place."
Monday July 25, 2005
Dear Mr. Sharpe,
Sad to say there is an obvious reason for the apparent anomoly that the use of a truly dangerous drug such as meth should be less focused on than the use of marajuana, a durg more akin to liquor that meth. It is very simple, so simple that the reason is usually overlooked. Anyone can grow marajuana in their own backyard. No drug company can compete with that. So the attack against legalization of marajuana is because of the inability to control the distribution. It is also obvious why many of our politians of many stripes find common ground on this issue. They are owned by the drug companies.
Plain and simple.
"The biggest drug problem is meth July 25, 2005 YOUR JULY 15 editorial, ''Meth Math," was right on target. While local governments are struggling with a methamphetamine epidemic, the Office of National Drug Control Policy is spending millions on a reefer madness revisited ad campaign. This reflects a bizarre sense of priorities. A National Association of Counties survey found that the vast majority of county officials report that methamphetamine is the biggest drug problem. These are the public safety professionals who deal with drug offenses on a daily basis. And it's not marijuana that concerns them, but rather meth. Meanwhile, an out-of-touch federal government continues to be obsessed with marijuana, even going so far as to prosecute terminally ill patients who use medical marijuana. The biggest lie to come out of the ONDCP is that new, potent strains of marijuana allegedly make pot a far more dangerous drug. This is nonsense. The only difference between weak and strong marijuana is that potent marijuana requires significantly less smoke inhalation to achieve the desired effect. It's actually less harmful. The tax dollars wasted on the ONDCP's misleading anti-marijuana campaign would be better spent on treatment for methamphetamine addicts.
ROBERT SHARPE Policy Analyst Common Sense for Drug Policy Washington, DC
Da Vinci, it turns out, got it right when he rendered man as blueprint: We are marvels of ancient engineering, a latticework of levers and pulleys and fulcrums, ligaments and muscles and bones.
Sometimes, the parts break down. So, during the past few decades, millions of patients have had hobbled hips and clunky knees replaced. They have had devices installed to make slow hearts beat faster, erratic ones beat steadier.
Now, even the replacement parts are wearing out. It was inevitable, really. Once, only old people got new hips and pacemakers, and most of the patients died before their new parts wore out. Not anymore. Today, orthopedic surgeons and cardiac specialists regularly operate on middle-aged patients, who have decades of wear and tear ahead.
And those younger patients demand more from their replacement joints and repaired hearts. They want to play 18 holes of golf, not watch it from the sedentary comfort of their La-Z-Boys.
''These replacements are machines, and they actually wear," said Dr. Thomas S. Thornhill, chief of orthopedics at Brigham and Women's Hospital. ''Whether it is a tire tread or brake lining or joint replacement, there is going to be some wear."
Just ask John Piotrowski. He had a defibrillator put in his chest in 1998 to stop his heart's propensity to beat wildly.
For seven years, the defibrillator did its job well enough -- in fact, the device lasted a couple of years longer than his doctors expected. But one Saturday morning a few weeks ago, as he got ready to go to his job as an express mail clerk at Logan Airport, the device delivered a jolt to his heart.
And then another.
''It feels like getting kicked in the chest with a boot," said Piotrowski, 43, who lives in Melrose.
That's bad enough when the jolt is necessary to keep his heart beating properly. But it turned out there was nothing wrong with Piotrowski's heart that Saturday morning -- it was the wire snaking from his defibrillator to his heart.
''They're sort of the weak link of the whole system," said Dr. Laurence M. Epstein, the Brigham and Women's specialist who wound up removing Piotrowski's frayed wire, and replacing it with a new one.
''Think about it," Epstein said. ''It's a man-made thing and you're putting it in the body and asking it to work for years in an environment where it's subjected to the beating heart."
The result: The wires can kink, they can disintegrate, they can simply stop working. Epstein estimated that up to 15 percent of patients with defibrillators and pacemakers experience problems with the wires. And taking them out can prove more difficult than implanting them in the first place.
That's why whether it's pacemakers or defibrillators, hips or knees, scientists are working to develop more durable replacement parts.
The need is especially great when it comes to joint replacements. Upward of 800,000 US patients each year have their hips or knees fixed with an implant.
Operations to replace or fix existing artificial joints have risen dramatically: From 1991 through 2002, the number of redos on knees doubled, and the growth was almost that fast for hips, too, according to figures from the American Academy of Orthopaedic Surgeons. In 2002, the same data shows there were 43,000 operations to replace or repair earlier hip implants, and 35,000 to replace or repair knee implants.
''Early on, this operation was reserved for elderly individuals who were looking for pain relief, and their functional level and their expectations were at a level appropriate to their age," said Dr. David C. Ayers, chairman of orthopedics at UMass Memorial Medical Center. ''Over time, the operation has been sought by younger patients who are inherently looking to be more active."
So Ayers is presiding over a medical study examining whether the use of a new metal in hip implants is superior to the current standard.
The socket that's widely used is made of the metal titanium. The 80-patient trial at UMass involves a socket made with a different metal called tantalum. (The study is underwritten by a company that makes both kinds of sockets, Zimmer Inc.; Ayers said he has no financial connection to the firm.)
Researchers want to know if the new metal will reduce chances that the implant will come loose -- one of the prime reasons hip implants have to be done over -- and if it will be less prone to shedding microscopic fragments that can deteriorate nearby bone. Using dual beams of X-rays and tiny markers on the implant, scientists will periodically examine the patients' new hips to determine if their implants have shifted.
Dalton Bickford got a new right hip May 2 and is among the first participants in the study. He'd been bedeviled by a throbbing, rickety hip for years. Why didn't he get it fixed sooner?
''I kept putting it off, putting it off until I couldn't stand it anymore," said Bickford, 62, who lives in Worcester, and has resumed climbing ladders since his surgery.
Bickford hopes his new hip will last well into retirement. He knows one buddy who's had an artificial hip more than two decades, but another who had to have his replaced after 10 years.
Those surgeries aren't cheap. Federal figures show that the average US hospital charges about $36,000 for hip surgery, though most insurers negotiate payments substantially below that. For instance, UMass officials said they're reimbursed $16,500 for hip and knee surgery by Medicare, the federal health plan for the elderly.
At some point, American society will have to decide whether to keep paying for replacement hips and joints for patients well into their 80s and 90s, said Dr. Lachlan Forrow, director of ethics programs at Beth Israel Deaconess Medical Center.
''Who's to say to this person that in the last year of their life, walking around isn't worth it to them?" Forrow said. ''That is a very clear crystallization of money issues that almost everyone in our country today is trying to run away from."
Dr. Harold L. Lazar, a cardiothoracic surgeon at Boston University, said if patients are otherwise healthy and expected to resume a quality lifestyle after surgery, he is willing to put replacement heart valves in patients even in their 80s.
He remembers one woman who was 88 or 89. She had a reason other than just her health for wanting to get a replacement valve made from animal tissue: It turned out she had a cache of so-called Wampum points, credits Foxwoods Resort Casino gives loyal gamblers that are redeemable for hotel stays and free meals.
The woman told Lazar she wanted to make sure she lived long enough to cash in all those Wampum points. She got the surgery.
Stephen Smith can be reached at stsmith@globe.com.
Dr Breggin's assessment that "Modern biological psychiatry is a materialistic religion masquerading as a science" is quite a revelation for many people. A question many would ask is how could science in any form be religious in nature. A good source for that question is a book called "A World Without Women" It chronicles the history of the religious/misogynistic aspects of science going back to the roots of Christianity. Even more interesting is Dr Breggin's applause of Tom Cruise for publicly lambasting biological psychiatry as a total hoax on the public. I applaud Tom Cruise for taking on the drug issue but Scientology itself also needs to be further exposed. Cruise is for no drugs at all calling it all a fraud, effectively a form of biological mind control. But what does Scientology promote as a replacement for drugs, a non-biological form of Mind Control. It's as additive as any drug can be but does not leave any trace at all. Dr Breggan's analysis of the abusive use of drugs in psychiatry is laudable but let's not give the impression that Tom Cruise has the answer in Scientology without comment.
In the early 1970's I had one Scientology moment and I didn't need another. It was my first job after college and a new friend at work invited me to visit her church one evening. It turns out to be the Church of Scientology. It was located right outside Kenmore Square in Boston. I happen to live right down the street from the Church so when my friend invited me (recruited) I didn't hesitate. I didn't know anything about Scientology at that time. I think it had just opened inBoston recently. I was open to new ideas even though I not particularly intersted in joining any religious groups.
We arrived in the early summer evening as the sun was setting. We walked into the entryway which opened up into a large receiving area filled with small groups of people chatting and milling around.We were greeted by a well scrubbed young man wearing a very clean cut outfit, white shirt and tie, whom my friend was delighted to see. As the three of us began to talk, the young man looked deeply into my eyes and suddenly I had strange feeling come over me. My mind felt in a way it had never before. It felt invaded, literally invaded and I knew it was the young man with the piercing eyes taking liberties with me. Fortunately I realized he didn't know that I was aware he had entered by sanctuary, my mind! I also sensed if he knew I was aware of his presence he'd might try to hide inside my brain or become more controlling. I just stayed as cool as I could. I kept smiling sweetly and nodding in agreement to every thing he suggested. When our time was up I even bought one of Ron Hubbard's books just to keep him from suspecting that I was about to escape!!!
Tom Cruise I feel sorry for you. Yea no drugs Dr Breggin but pure mind control none the less.
07.17.2005 Dr. Peter Breggin Thanks Tom Cruise
On June 25, 2005 Tom Cruise did the unthinkable on TV. Actually, he did several “unthinkables” in a filmed interview with NBC’s Matt Lauer for the Today Show. First, Tom stopped smiling. He deprived us of that multi-million dollar grin and got serious. For a star to do this to the American public was unthinkable. Second, Tom pointed out that Matt Lauer actually was very “glib” (shallow) and didn’t know what he was talking about. He also urged Matt to be “more responsible” and to learn something about psychiatry before touting it. For a star to do this to a media personality was unthinkable. Since nearly all of them are shallow, this was a threat of potentially epidemic proportions. Suppose other guests began pointing out that media hosts don’t know what they are talking about and are shallow? Third, he got serious about one of the most important issues in our personal lives, in this case our widespread use of psychiatric drugs to solve our personal distress and anguish. Tom concluded, “I’m passionate about life.” For anyone to speak this way on television, except perhaps on the Catholic channel, is truly beyond the TV pale; and even the Catholic channel doesn’t criticize psychiatry. Fourth, he criticized psychiatry and drew attention to its genuine flaws and failings. I suspect he’s actually read my book, Toxic Psychiatry. Tom said that psychiatry had a long history of abusing people, including electroshock. He said, “There is no such thing as a chemical imbalance.” He said that antidepressants can only “mask the problem” and that “these drugs are very dangerous.” He called psychiatry a “pseudoscience” and suggested that there are better approaches. He was right about all of this. A few days later NBC invited me to New York City as a psychiatric expert to discuss the Tom Cruise affair on the Today Show, and when I began by saying it sounded like Tom had been doing some serious reading about psychiatry, I got cut off, again and again, throughout the show. Why was the media both drawn into the story and shocked by it? It was too good a story to simply ignore: “Tom Cruise Gone Wild” was the theme. It should have been, “Tom Cruise gets serious.” The media would have liked to attack Tom on the grounds that he’s a Scientologist. Scientologists seem to share a number of views about psychiatry with me, including everything Tom said. In fact, I’d go further. Modern biological psychiatry is a materialistic religion masquerading as a science. How can I say that my profession of psychiatry is a materialistic religion? Because modern psychiatry makes believe that psychological and spiritual problems, such as anxiety and depression, are caused by mechanical failures in the physical brain, and because psychiatry then attempts to correct these psychological and spiritual problems with physical interventions such as drugs and electroshock. Modern biological psychiatry takes these views and implements these interventions on faith and it has won a lot of converts with the help of billion-dollar marketing campaigns. If you want more detailed analyses of the faith and fake science behind the claims of modern psychiatry, you’ll find them in my books such as Toxic Psychiatry (1991), Brain-Disabling Treatments in Psychiatry (1997), Talking Back to Ritalin (Revised, 2001), the Antidepressant Fact Book (2001) and the Ritalin Fact Book (2002). You can find my scientific papers on my website. In my books and on the website you’ll also find discussions of the many drug-free alternatives that are available for helping people with problems such as anxiety and depression. The media kept hinting that the problem was Tom’s Scientology beliefs but they didn’t want to say it. To some extent it’s not politically correct to criticize someone’s religion, especially when people like Tom and John Travolta are members. But that was really not the issue. The media is afraid of Scientology because the religion has been extremely aggressive toward media critics, often charging them or threatening to charge them with libel and slander. I was also invited on to CNBC’s the Donny Deutche talk show. This time I remained in Ithaca, New York, only a few blocks from my office in a high tech TV studio. I was kept waiting in front of the live camera for almost an hour and a half to get a word in as I watched Tom get excoriated. Although I could see the show on the uplink for this entire time as I sat waiting at any moment to be called upon, they decided not to link me into the show at all and I never got to say a thing in Tom’s defense or in criticism of biological psychiatry, drugs and electroshock. Sitting upright that long without twitching in anticipation of momentarily appearing on millions of televisions was hard enough, but listening to Donny was worse. While I sat listening to the CNBC show that I was never brought onto, I felt a mixture of outrage and sadness. Outrage that the show host Donny Deutche bragged up his work in advertising where he helped to produce the Zoloft TV ads with their clever little bouncing faces that made the antidepressant so much more “accessible,” in his words, to millions of Americans. Donny was bragging about an actual fraud—ads that falsely suggest that Zoloft corrects biochemical imbalances and that leave out the warning that the drug causes mania, not to mention psychosis, violence and suicide. What was tragic? Donny’s guest was Jane Pauley who was flogging her new book, Out of the Blue. Jane is the epitome of a media personality, having anchored the Today Show with Tom Brokaw and Bryant Gumbel, and having earned many broadcast awards. Jane is also a promoter of psychiatry. She admitted to having developed “hypomanic” (milder than full-blown mania) symptoms on an antidepressant. At the time, she explained, her mind and thoughts were racing and she couldn’t control them. But then she added that of course the drug didn’t make her become manic; the drug just “brought out” her underlying or pre-existing bipolar disorder. Of course, I don’t know anything about Jane Pauley except what she’s told us and she’s not really the issue. Celebrities are actively recruited by marketing departments to promote medical and psychiatric treatments. I do know that psychiatrists often lie to patients to protect themselves and their drugs. My colleagues lie by saying the antidepressant merely “brought out” their mania, psychosis, violence or depression, rather than the drug caused it in the otherwise innocent victim. Jane Pauley thinks she is a victim of bipolar disorder when she sounds to me like a victim of psychiatry. It’s no small matter to falsely inform a person that their drug-induced mania shows they have bipolar disorder. It results in a false diagnosis and a stigmatizing label (bipolar or manic-depressive disorder) that follows people for the rest of their lives. It leads to additional medications, often including antipsychotic drugs like Zyprexa and Risperdal that can cause lethal diabetes and pancreatitis, and tardive dyskinesia, a potentially disfiguring and disabling neurological disorder characterized by bizarre-looking abnormal movements. So the media personalities had a feast promoting their religion, psychiatry, while Tom Cruise got hammered for criticizing psychiatry, and indirectly promoting his religion, Scientology. No, I’m not a Scientologist. Except when they occasionally say hello to me at conferences, I have hardly spoken to a Scientologist in more than thirty years. But when I saw Tom’s bravery come out from behind his marvelous smile, I wanted to help, and I made clear I wanted to defend him. Well, Tom, you said on TV things I’ve been saying in the media and in my books and scientific articles for three decades—but boy did you generate a lot more attention to the issues. Thanks! http://www.huffingtonpost.com/theblog/featuredposts.html#a004284
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