Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday December 15 were patient safety expert and all around wit Michael Millenson (@mlmillenson); policy expert consultant/author Rosemarie Day (@Rosemarie_Day1); writer Kim Bellard (@kimbbellard), consumer expert Lygeia Riccardi (@Lygeia) radiologist Saurabh Jha (@RogueRad), and Olympic rower for 2 countries and all around dynamo Jennifer Goldsack, (@GoldsackJen). It was a full house and lots of fun, with a lot wrapped round the theme of protecting consumers (or not) online.
BY SAURABH JHA
If forced to choose Britain’s two biggest contributions to civilizations, I’d pick the Magna Carta and the vaguely instructional “fuck off.” If permitted a third, I’d choose “managerialism.” Brits are good at telling others what to do. Managerialism is how the Brits once ruled India. Buoyed by the colonial experience, British managers felt they could rule doctors.
The new Viceroy, the manager-in-chief, is the General Medical Council (GMC). The GMC is a physician watchdog, funded by doctors, which works for the public good and is answerable to…well, I’ll get to that later. Their relevance rose exponentially when the psychopathic Dr. Harold Shipman, a charming, clinically adept, general practitioner, killed over two hundred patients. Never again, said the managers. They promised to keep the public safe from dodgy doctors with aspirations of Jack the Ripper and Sweeney Todd.Continue reading…
Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday May 19 are delivery & platform expert Vince Kuraitis (@VinceKuraitis); policy expert consultant/author Rosemarie Day (@Rosemarie_Day1); & back after a long absence dangerous radiologist Saurabh Jha (@roguerad). Some great conversation about digital health, Roe v Wade, rural care and a deep dive into Saurabh’s trip to Nepal to deliver radiology tech to Everest Base Camp!
I first clashed with authority when I was eight. Every Saturday bunch of brown kids, children of Indian immigrants to Britain with an identity crisis who longed for the culture they left behind, attended a class in the temple about “our culture” taught by a joyless scholar of Hinduism – a pundit – whose major shtick was punctuality. When I turned up late, even by a minute, he’d make me stand outside, even if freezing. Some kids called him “Hitler,” or “Hitler uncle,” the qualifier “uncle” indicated that because he was as old as our fathers, he deserved respect.
Then, I believed that Hitler meant authority. I preferred calling the pundit “wanker” or “asshole” but the foul language would have gotten me afoul with my parents, my authority figures. “Hitler” amply conveyed disdain for our pot-bellied teacher who exercised his authority whenever he could, without tarnishing our nubile vocabulary.
Eventually, I understood the significance of Hitler, and of World War 2, the Nazis, and the Holocaust. Though related neither morphologically to the perpetrators nor ethnically to the victims of this ghastly period in human history, I developed a reverence, a sensitivity if you will, to such allusions. The Lord of the Old Testament instructed Moses that his name be not used in vain, lest every blocked sink or traffic jam evoked “oh my God.” I resolved never to use Nazi as an epithet frivolously.
I was surprised how common Nazi name-calling was in American political discourse across the political spectrum, which peaked during the Trump Presidency. Some likened migrant detention facilities to “concentration camps.” Many saw in the rise of white nationalism during Trump’s reign parallels with the Third Reich. The former White House strategist, Steven Bannon, was compared to the Nazi propagandist, Goebbels. Bannon is loathsome, detestable, a wanker. Goebbels is a mass murderer – no adjectives are needed to describe him further.Continue reading…
By SAURABH JHA
Unlike medical meetings, rendering Beethoven’s Ninth Symphony isn’t easy on Zoom, so the local orchestra has been furloughed and their members work for Uber. The opera house wants to reopen, preferably before we reach the elusive herd immunity threshold. They mandate vaccinations for their artists, not least because the performers can keep their masks off. Should they extend this requirement to their patrons?
Vaccine passports, proof of immunity against SARS-CoV-2, to work, dine, fly or watch shows, are controversial. Opponents say they blithely disregard decency, are operationally onerous, and hurt liberty. Worryingly, they create a caste system, which wouldn’t be as concerning if based on just immunology. Such a two-tiered system could sadly mirror societal inequities because it’s the poor who may disproportionately be left unvaccinated. Supporters of vaccine passports further the very structural disadvantages they seek to end.
When arguments are too compelling they likely betray an obvious simplicity. Too often arguments against mandates assume they’d be a government fiat. The opponents recline on the country’s inherently liberal streak conjuring visions of rugged individuals fighting unelected bureaucrats. They say with undisguised pride “this isn’t who we are. We’re the US, not New Zealand. We can’t be controlled.”
This narrative is so tightly embedded in right-of-center discourse that it’s now folklore bordering on an Ayn Rand fairy tale. The narrative is nonsense. The state is too incompetent to either govern adeptly or tyrannize efficiently. Case-in-point: CDC’s easily forgeable paper vaccine certificate. If the state were serious about prying on people’s antibodies, it’d have made the immunosurveillance digital.
The obsession with big government should be antiquated. By censoring content, Facebook and Twitter showed that freedom can more efficiently be curtailed by the private sector. Bottom-up censorship is arguably more powerful than top-down censorship because it has buy-in from a segment of the market. It may very well be the private sector which demands vaccine passports, which begs two questions – why and why not?Continue reading…
Joining me , Matthew Holt (@boltyboy), on THCB Gang this week were fierce patient activist Casey Quinlan (@MightyCasey), consumer advocate & CTO of Carium, Lygeia Ricciardi (@Lygeia), THCB regular authors radiologist Saurabh Jha (@roguerad) & cardiologist Anish Koka (@anish_koka), with futurist Jeff Goldsmith on hand to keep us all honest. We started with Casey’s current health journey and Anish’s inability to get vaccines for his clinic — and this moved to a really fun and raucous discussion about whether the public sector can work in health care, whether we need to mandate the vaccine and if America is becoming a failed state! Great stuff!
By SAURABH JHA and JEANNE ELKIN
Mr. Smith’s pneumonia was clinically shy. He didn’t have a fever. His white blood cells hadn’t increased. The only sign of an infection, other than his cough, was that his lung wasn’t as dark as it should be on the radiograph. The radiologist, taught to see, noticed that the normally crisp border between the heart and the lung was blurred like ink smudged on blotting paper. Something that had colonized the lungs was stopping the x-rays.
Hundred and twenty-five years ago, Wilhelm Conrad Roentgen, a German physicist and the Rector at the University of Wurzburg, made an accidental discovery by seeing something he wasn’t watching. Roentgen was studying cathode rays – invisible forces created by electricity. Using a Crookes tube, a pear-shaped vacuum glass tube with a pair of electrodes, Roentgen would fire the cathode rays from one end by an electric jolt. At the other end, the rays would leave the tube through a small hole, and generate colorful light on striking fluorescent material placed near the tube.
By then photography and fluorescence had captured literary and scientific imagination. In Arthur Conan Doyle’s Hound of the Baskervilles, the fire-breathing dog’s jaw had been drenched in phosphorus by its owner. Electricity and magnetism were the new forces. Physicists were experimenting in the backwaters of the electromagnetic spectrum without knowing where they were.
On November 8th, 1895, when after supper Roentgen went to his laboratory for routine experiments, something else caught Roentgen’s eyes. Roentgen closed the curtains. He wanted his pupils maximally dilated to spot tiny flickers of light. When he turned the voltage on the Crookes tube, he noticed that a paper soaked in barium platinocyanide on a bench nine feet away flickered. Cathode rays traveled only a few centimeters. Also, he had covered the tube with heavy cardboard to stop light. Why then did the paper glow?Continue reading…
Episode 39 of “The THCB Gang” will live-streamed on Thursday, Jan 21. You can see it below!
Matthew Holt (@boltyboy) was joined by regulars: futurists Ian Morrison (@seccurve) & Jeff Goldsmith, surgeon and now digital health entrepreneur Raj Aggarwal (@docaggarwal), radiologist Saurabh Jha (@roguerad), and patient advocate Robin Farmanfarmaian (@Robinff3).
Like the nation we took a big collective sigh of relief. We then talked a lot about COVID vaccinations, what the newly (sort of) Dem-led Senate is going to do on stimulus and health care , and we fnished on all that money pouring into digital health, while the stock market goes crazy. It was all good grist for the #THCBGang’s mill.
Episode 32 of “The THCB Gang” was live-streamed on Thursday, November 12th. The video is below.
Matthew Holt (@boltyboy) will be joined by some of our regulars: WTF Health Host Jessica DaMassa (@jessdamassa), radiologist Saurabh Jha (@RougeRad), MD-turned entrepreneur Jean-Luc Neptune (@jeanlucneptune), benefits communications leader Jennifer Benz (@jenbenz), THCB’s Editor-in-Chief me (zoykskhan) and guest Jeff Goldsmith, President of Health Futures, Inc. The conversation followed the post-election frenzy around COVID-19 response, the vaccines, the ACA, and what a Dem. president means for the United States in terms of health care.
Joining Zoya Khan (@zoyak1594) on Episode 25 of “The THCB Gang” were regulars patient advocate Grace Cordovano (@GraceCordovano), writer Kim Bellard (@kimbbellard), policy & tech expert Vince Kuraitis (@VinceKuraitis), data privacy expert Deven McGraw (@healthprivacy), and guest Rosemarie Day, Founder & CEO of Day Health Strategies (@Rosemarie_Day1). Rosemary’s book “Marching Towards Coverage” is out now. The conversation revolved around new health technology policies, Medicaid Expansion programs, the 2020 election, and the steps to get to universal health coverage. Oh, and you can take Rosemary’s quiz about what type of a health activist you are!