Sunday, September 13, 2020

Five Rules for Conservative Culture Warriors

1. Reinforce victory (on, say, abortion, where the culture shifted a long way from Fast Times at Ridgemont High to Juno)

2. Know the other side's arguments better than they do.

3. Always challenge -- never back down -- except in the face of superior reason (my conduct in the academy since I entered college at 15).

4. When accused of something, your first impulse should be to admit it.

5. Study the abuse of power not just to protest abuse but to learn how to gain and keep power.

Friday, July 31, 2020

Israel N. Kochin, MD on HCQ+Zinc prophylaxis

I showed my brother, New York City physician Israel N. Kochin, Scott Adams's account of HCQ+Zinc prophylaxis as a risk management strategy for COVID-19.

I asked Dr. Kochin if he would prescribe HCQ+Zinc prophylaxis for a patient with no specific contraindications. Dr. Kochin said he would not, and explained why thus:

I remain concerned with physicians who advocate this treatment for COVID19- the limited published data still shows harm outweighing benefit (see my earlier post on the subject) in most studies. I hope I am wrong in my concern.
"WHO is actively following the ongoing clinical trials that are being conducted in response to COVID-19, including studies looking at the use of chloroquine and its derivative, hydroxychloroquine, for treatment and/or prevention. Currently, there is insufficient data to assess the efficacy of either of these medicines in treating patients with COVID-19, or in preventing them from contracting the coronavirus. In the context of the COVID-19 response, the dosage and treatment schedules for chloroquine and hydroxychloroquine that are currently under consideration do not reflect those used for treating patients with malaria. The ingestion of high doses of these medicines may be associated with adverse or seriously adverse health outcomes."
https://www.who.int/news-room/q-a-detail/malaria-and-the-covid-19-pandemic
COVID-19: "hydroxychloroquine (200 mg three times per day for 10 days)"
malaria prophylaxis: "400 mg once weekly"
Malaria Rx: "800 mg once, followed by 400 mg at 6, 24, and 48 hours after initial dose (total dose: 2 g)"
RA: "200 to 400 mg daily as a single daily dose or in 2 divided doses (Kumar 2013). Note: Due to the risk of retinal toxicity, most patients should not receive a daily dose >5 mg/kg/day using actual body weight or 400 mg, whichever is lower.."
https://www.uptodate.com/contents/hydroxychloroquine-drug-information

In my opinion, people who are considering they may take this medication if they develop COVID19 symptoms should be evaluated by their physician in advance for G6PD deficiency, which is the most common enzymatic deficiency in humans. This deficiency is particularly higher in those of African and Mediterranean (e.g. Sephardic) decent.

There are those advocating a lower dose, "The total 5 day dose (400 bid x 1 day then 200 bid for 5 days)." [source: Dr Jacob Teitelbaum], but I don't know where that dose originates from, but lower is certainly safer.

Some HCQ proponents are quite fanatical, it's not like they are going to let a little thing like reality dissuade them... some of them were posting in July new results about a study that was aborted in June. (Are they lying or simply willfuly ignorant?)
https://www.facebook.com/photo.php?fbid=10164060891315473&set=a.69381620472&type=3&eid=ARD6fygFusWLdYASNk2W1Qw_p9vgYWCcSrrJtTgD-_X7rCPA3kMDIA8CS-E0eajEbGQ7d4a7tXQwuCwu
Reality: This trial ended at the beginning of June due to a similar study showing "no efficacy in preventing COVID-19 for people exposed to the virus."
https://www.mitchellrepublic.com/newsmd/coronavirus/6523704-South-Dakotas-trial-of-a-controversial-COVID-19-drug-has-been-discontinued
https://www.keloland.com/top-stories/s-d-still-seeks-guidance-on-hydroxychloroquine/ also see https://www.goodrx.com/blog/coronavirus-medicine-chloroquine-hydroxychloroquine-as-covid19-treatment

Also American College of Cardiology remains concerned about fatalities from Arrhythmia https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19 and they provide additional guidance here: https://mayoclinicproceedings.org/pb/assets/raw/Health%20Advance/journals/jmcp/jmcp_covid19.pdf

Furthermore, given the strong evidence for limited efficacy, research resources should probably focus on drugs with better preliminary results and/or novel pathways.

Tuesday, June 9, 2020

An Independent Empire book talk with Kochin & Taylor


Book talk with An Independent Empire authors Michael Kochin and Michael Taylor
"We are now Friends with England: Kochin and Taylor on forming An Independent Empire"
on Youtube here.

An Independent Empire podcast with Titus Techera

Titus & I discuss An Independent Empire--empire means domination of land and people and American politicians from the beginning were decided on dominating the vast continent, in face of hostile Indian tribes and European powers.
Available on Soundcloud here.

Archived here.

Monday, May 18, 2020

Jane

Jane

Copyright © 2020 Michael S. Kochin
All Rights Reserved

Jane and I sat down at a window table in the doctors' cafeteria.  We had been up all night, gotten through rounds, but neither of us could sleep, so we went down for an 11:00 brunch.  The food, as usual, was unspeakable, but the winter sunlight was a welcome change from the fluorescents in the halls or at the nurses’ station. 

Jane and I had been friends since our first year of college.  Two young women first-years, both pre-med, though I majored in biochemistry and Jane majored in Russian Literature.  We both won early admission to the University of Chicago medical school, and both of us had chosen to stay for our residencies.  Jane had stayed because of her boyfriend, now her husband, a fifteenth-year graduate student in the Committee on Social Thought.  I, because..., well, when you are a fourth generation Hyde Parker, it just never occurs to you to leave.

We talked about various things, rounds, the attending physicians, most of whom had propositioned me, many more than once.  We also talked about Mr. Robardsun, an old philosopher retired from the University, who was dying of cancer, or so his doctors said.  The trouble is, at ninety-two everything takes a long time, including dying of cancer.  Robardsun, who had nobody to take care of him, had been admitted from the nursing home nine months ago.  Every week or so he'd have a crisis, which would keep him from being discharged, but was never quite enough to push him over the top.  What was most amazing was that he was still working, even while groaning in mortal pain.  Or at least, he would work when he wasn't entubated.  His magnum opus, demonstrating finally that only mind was real, and that body and pain where only illusions.  He had been working on the page proofs since 1947, since shortly after he'd received tenure.  And he was still at it.  As his pain had gotten worse he had taken to adding new footnotes, trying to prove to himself ever more desperately that his sufferings were only illusory.  The struggle was no doubt what was keeping him alive.

Then Jane said, "Ellen, I have the best thing to tell you."

"What?"

"I haven't had severe menstrual pains in four months."

Now you have got to realize that Jane always had the worst periods. Heavy flow, terrible cramps before and during.  She had started taking birth control pills in College, even when she wasn't in a relationship.  The pills had kept her from turning green and fainting during her periods, but had done nothing for the pain.  And she was off the pill, because she and Rick were trying to conceive.

Jane's pains were bad, well beyond the reach of Motrin or Tylenol.  "That's great, Jane," I said, "what the trick?  Chinese herbs?  Or are you trying to tell that you are four months pregnant?" I asked, straining to see her belly from across the table.

"No," Jane said, "I'm not pregnant, unfortunately.  But I have finally found a drug that works for the pain.  And would you believe it, I heard about it from an ER patient, an uneducated crack whore on welfare with three kids paid for by the state."

"You ain't smokin' crack, is you, girlfriend?" I asked.

"No, I haven't tried that," Jane said.  "But you see, this patient, a thirty-two-year-old Black female with a history of drug abuse, as we say, gets sent to me when I was covering the ER."

"'What's wrong?’ I asked her.

"'Doctor,' she said, 'I have got the worst pains in my belly'.

"So I go through the diagnostic, and get her to describe the pain.  Then I ask her, 'have you ever felt pains like this before?'

"'Yes Doctor, every time I get the monthlies.'

"'Every time,' I said.

"'Every time,' she said, 'since my last little girl was born.'

"'Do you take anything for them?’, I asked.'

"'Well, Doctor, I used to take smack, but the Judge said, last time I was in Court, that if I tested positive for smack again when I was picked up, she would revoke my probation.  And then who would take care of my babies?   So I came in to see if you could give me something.'

"I gave her some aspirin and got her out of there.  But it set me to thinking.  Heroin was out of the question, but maybe some other opiate?  So I tried codeine, but that only helped a little.  Then a while later I was walking by Mr. Robardsun's room, when I heard him shout, "Damn fucking pills, damned if I ever take any of them!"  I went in.  'Is something wrong, Mr. Robardsun?' I asked."

"Robardsun's whole being was shriveled with pain.  He did his best to collect himself, then he said, 'I dropped some pills on the floor.  Could you pick them up?'  Sure enough his morphine dose was on the floor.  I assumed that he had knocked them off his tray, somehow, since the cup of water the nurse had given him had spilled too.  When I bent down to pick up the pills, though, I noticed that his bureau drawer had a hundred of them."

"He noticed my surprise, and understood what I had discovered.  I said, 'Mr. Robardsun, are you taking your morphine?'"

"'No,' he said.  'Mind your own business.  But since you figured things out, you just take them all out of the drawer and throw them away.'"

"'Mr. Robardsun,' I said, 'the pills will relieve your pain.'

"'Pain is an illusion,' he snapped.

"'Mr. Robardsun,' I said, 'does your doctor know that you aren't taking your pills?'

"'Hell no!' He shouted.  When I told him I didn't want any of his quack "Pain"-killers he kept sending those goddamned psychiatrists to me.  They kept asking me whether I wasn't taking the pills because I was depressed.  And when I told them that I wasn't depressed, they told me I should be depressed, since I was a ninety-two-year-old man without any family who was dying of cancer.  So I decided that I would tell my doctor that I was willing to get the pills.  But instead of taking them, I just throw them in drawer.  I just happened to drop right before you came in.  But why don't you take them.  Flush them down the toilet, give them to the kids with hangnails, just get them out of here!

"So I did.  And when I next got my period, I took one, as needed.  The pains went away immediately.  And the stress too.  You know, in the last year, every time I get my period I get upset.  Another chance of getting pregnant blown.  But the morphine takes the blues and sends them on an all-expenses paid weekend in Maui."

"But Jane, you are going to get caught, and lose your license."

"Nah, nobody knows how I get them.  Robardsun doesn't know my name.  And everybody thinks he's taking his pills.  There is one thing that worries me, though."

"What's that?"

"If I get pregnant, I won't get my period.  And then I won't have any excuse for taking morphine."

"You are completely insane," I said, but I could hardly conceal the admiration in my voice.  So U. of C., and so Jane.

Wednesday, March 4, 2020

We don't need a "War on Coronavirus"

If you look back at the War on Cancer or the AIDS research boom of the 80's, you can predict with certainty that increased public or nonprofit funding of "Coronavirus research" would all be thrown away on proposals that tweaked professors' current research with the word "Coronavirus."
The best hope for a working Coronavirus vaccine or for effective treatments is from the profit motive of Big Pharma.
But don't worry, a single payer public option will ensure that the profit motive is eradicated, so that no evil drug companies get rich off of future epidemics

Tuesday, January 21, 2020

Election Prediction: Trump 349-Buttigieg 186

Iowa caucus:

1. Buttigieg
2. Sanders
3. Warren
4. Biden

New Hampshire:

1. Sanders
2. Buttigieg
3. Warren
4. Biden
After a long a bitter nomination fight, Buttigieg triumphs as corporate Democrats consolidate around him.

In the general election, Trump beats Buttigieg 349-186 in the electoral college (holding all his 2016 states + VA-ME-MN-NV-NH)
51-49 for Trump in the two-party popular vote.

Method: 1. Give CA to the Dems with 2016 vote totals
2. Apply Fair model % to rest of country
3. Move every state except CA 2% over to Trump

And if you think prediction markets offer more reliable forecasts, recall that prediction markets offer the best information you can get for free.