Talking Dirty to Ron Paul

Remember Dan Quayle? He was the vice-president for George Bush I who was cruelly and sometimes unfairly mocked in the press for being really dumb.

He did say things that were ignorant, and callous, too. Here is what he had to say about abortion in the case of rape…

“My position is that I understand from a medical situation, immediately after a rape is reported, that a woman normally, in fact, can go to the hospital and have a D and C. At that time… that is before the forming of a life. That is not anything to do with abortion.”

Vice President Dan Quayle explaining that Dilatation and Curettage, a form of abortion which occurs after fertilization, is not really abortion.
Reported in the Washington post, 11/03/88

Medically this is insane. A woman who has suffered a rape, possibly an exposure to a disease, will not stroll into the hospital to have her womb scraped out–(presumably to remove all the microscopic sperm that are striving to create the miracle of life.) In 1988 that woman would be lucky if she were even able to get competent and compassionate medical care at any random ER. The practice of the forensic exam for rape and medical treatment of victims is a recent development in women’s care.

You might not expect a politician whose greatest talent was looking good in a suit to be well-informed about these things, or especially concerned for victims of crime. But it really is frightening that Quayle’s statement was in the context of stating his opposition to legal abortion in all cases, and knowing that he had considerable power to influence policy that affects women’s lives. And knowing that he was so callously disinterested in those women that he never even bothered to find out what happens to a rape victim who seeks emergency help.

Legal abortion remains controversial. There are a range of opinions on when, or whether, it might be necessary for a woman to terminate a pregnancy. Surely an obstetrician, a man who puts his experience as a doctor front and forward as a reason to trust his judgement on matters related to the practice of health care in America– surely that man should speak with knowledge and compassion. Surely his experience in caring for thousands of women would put a face on the reality of sexual assault. Sadly, this crime is so common that anyone who is dedicated to women’s health has heard survivor stories.

Instead, Dr. Ron Paul shows his disinterest in the reality of women’s lives, in current practice for care of crime victims, his judgementalness and lack of curiosity or willingness to look beyond the rigid thinking he has shown on this issue.

In an interview with CNN’s Piers Morgan, Ron Paul echoes Dan Quayle.

He says that ‘if it’s honest rape’ a woman should go ‘immediately to the ER to get a shot of estrogen. An hour or a day after, you have no medical or legal problem.’ When Piers Morgan asks Ron Paul what happens if the victim is ashamed or unable to get help and shows up days or weeks later, Paul dodges the question and goes into a rant about women demanding abortions of late-term pregnancies.

I will post a transcript when one becomes available.

Just for the record, ‘a shot of estrogen’ is not the current standard of care for a rape victim. The infamous ‘morning after’ pill is what is given. The rape exam can be done up to 4 days after the assault, though the chance of getting DNA evidence decreases with time. Medical care for a woman who has been injured, fears a sexually transmitted disease, or an unwanted pregnancy can be done later.

Ron Paul seems to be saying that if you can’t prove sperm met egg, it’s okay. He also says, ‘if it’s honest rape’. Who will be the judge of that? Anyone who has worked with victims of crime– any crime, knows that the story can be confused, contradictory and sordid. Should the rape exam include an inquisition as to whether the victim has a right to treatment at all?

We’re almost thirty years on, and still a man presumes to make policy for women’s lives– displaying a mistrust of women’s honesty, and a disinterest in the dirty details of what happens in the real world.

Follow this link for the standard of care for sexual assault survivors.

Follow this link for information about Sexual Assault Nurse Examiner (SANE) , a nursing specialty instituted because doctors were unable to provide the sensitive, meticulous and time-consuming care needed by victims who come to the ER.

Any time a rapist is brought to justice by DNA evidence we should thank the SANE nurses who give respectful care to all victims. We should thank the women, physicians and nurses, who created this nursing specialty to help women to find care and healing.

Doctors Who Don’t Read What They Sign are Scary

In a later post I will explain why, ‘Is Ron Paul a racist?’ is the wrong question to ask. Who knows what’s in his soul? And how much do we need to care? We’re talking about a politician here.

A more useful question is why Ron Paul’s politics attract support from activists and groups that are proudly racist, and why they think a Ron Paul presidency would advance their agenda.

Today I want to point to a statement Rep.Paul made in an interview December 21st with CNN correspondent, Gloria Borger. That interview ended when Paul walked out of the studio.

From, (appropriately enough),Crooks and Liars. Ms.Borger asks Rep.Paul about racist newsletters published under his name…

[Ron Paul:] I didn’t write them. I disavow them. That’s it.

BORGER: But you made money off of them?

PAUL: I was still practicing medicine. That was probably why I wasn’t a very good publisher, because I had to make a living.

BORGER: But there are reports that you made almost a million dollars off of them in — in 1993.

PAUL: No. Who — I’d like to share — see that money.

BORGER: So you read them, but you didn’t do anything about it at the time?

PAUL: I never read that stuff. I never — I’ve never read it. I came — I was probably aware of it 10 years after it was written. And it’s been going on 20 years, that people have pestered me about this. And CNN does it every single time.

“I was still practicing medicine.” Congressman Doctor Paul likes to refer to his MD when promising a cure for our national malaise. That’s one reason his statement raises a red flag.

As a nurse, I’ve had the misfortune to have to work with doctors who signed things they didn’t read. I’ve faxed notes asking for a simple ‘yes or no’ answer to a question about a patient– returned with signature, without answer. Makes a nurse want to get a job in a florist shop.

This is not how most doctors practice–most are concerned and mindful that their patients and other medical professionals depend on them to write clear and appropriate orders. Good doctors take responsibility for what they sign. Doctors have reams of papers coming at them, but most take the time to read and correct important things like med lists and orders.

So if Dr.Paul didn’t take time to read the newsletters he published and signed his name to, how does he prioritize? Some of what was published in ‘The Ron Paul Political Report’ was truly vile, and he disowns it today. If you believe his explanation that he signs off on views he doesn’t share, what does that say about him? If you believe that he never noticed what went out under his name for about a decade, what does that say about Doctor Paul’s attention to his political movement? What does that say about his integrity? Was he really that unaware? Or is he lying?

I once worked with a doctor who said that his lousy handwriting gave him cover. Anyone who wanted to sue him would never be able to read his notes. I hope it was a joke, but it’s not too far-fetched that sloppiness hides incompetence. It’s also possible that a very smart man might plead carelessness to dodge the big question. Not whether he is a racist, but why racists believe he is on their side.

Occupy Providence Day 2– Talking Ron Paul

A late dispatch since we’re on Day 3, but Mr.Green and I stopped by yesterday before church. It looked like almost 20 tents, good spirits and peaceful. We were standing by General Burnside reading the posters. Again, the only presidential candidate with a presence here is Ron Paul, though one of his posters had a red, drippy ‘x’ painted on it, which I think indicates non-support.

A man in a union t-shirt came up and asked John, ‘As a Black man, do you have an opinion on Ron Paul?’ This was pretty direct, but he was asking an honest question– why do Black people generally not support Ron Paul?

John said that he thought Paul’s political philosophy in practice tended to social Darwinism, and he was unhappy with Paul’s desire to undo the Voting Rights Act. John’s family originally came from Selma, Alabama, and the Civil Rights Struggle, and the role of the Federal Government in protecting demonstrator’s persons and rights are part of his family’s living history. And John reads a lot.

I said that I cannot understand how a physician can politically support letting people die for lack of insurance. Paul supports a radical deregulation and privatization of health care, I wrote about here. I also had heard Ron Paul in a radio interview say that he thinks abortion is murder, but outlawing it should be left to the states. This is doubletalk to me. ‘You can’t shoot someone in RI and have it not be a crime in MA’, I said, but our questioner disagreed, pointing out that in places like Texas you can shoot lots of people legally. Still, if Ron Paul had said he considered abortion to be murder, but that he respected the right of the woman concerned to make that moral decision since it involves her own body I would say he is consistent in his Libertarian principles.

We had a disagreement about Libertarianism– I mentioned that Ron Paul is a Republican. Our questioner said that he’s only nominally a Republican, actually he’s a Libertarian. He is, however, running for president as a Republican and participated in the Republican debates.

I like Paul’s stand against the Iraq and Afghanistan Wars, and I am happy when he takes a stand I agree with, but I don’t think he has the answers.

I don’t want to throw a discordant note into our Kumbaya. Occupy Providence is the most politically diverse group I have ever demonstrated with, and that’s saying a lot. I don’t think any politician owns this energy, though many would like to. No politician has the power to undo decades of concentrating the wealth, even those who want to.

But reform that requires the wealthy and the corporations to pay their fair share, and directing that money to a new WPA would start us on the right track. Most of the country thinks we’re on the wrong track, and some are taking it to the streets.

Ugly Questions for Ron Paul

I thought Dr.Paul might have been a little mis-understood, when some Tea drinkers at the Republican debate cheered the death of the hypothetical uninsured 30 year old man. But TPM quotes him confirming his philosophy that health care should be completely privatized, and regulations are just bad for business–herbs and charity will fill the need.

Ron Paul told TPM on Wednesday that even if there’s a “case or two” that makes Americans uncomfortable, the government should stay out of the health care business. Even if one of the cases in question is his former campaign manager, Kent Snyder, who died with $400,000 in unpaid medical bills after being unable to secure health insurance due to a pre-existing condition.

At a Christian Science Monitor breakfast, Paul took questions from reporters on Snyder, whose story surfaced in the press after Paul said in the last Republican debate that the government should not intervene even to save a comatose 30 year old who did not have insurance. As Gawker noted, Snyder died in June 2008 without health insurance, leaving behind $400,000 in bills. His friends and family set up a fund to raise money to pay off the debt. It’s not clear how much money they were able to raise: a site set up by Ron Paul aide Justine Lam to track the medical fund stopped updating in 2008 with only $34,870 in donations.

Later in the interview–

He also blamed the government for regulating medicine: “The federal government comes in and closes down shops that try to sell nutritional medicine and vitamins because the drug companies don’t want competition. That drives the prices up.”

And he’s aware that his stand can sound too cold-blooded for most Americans–

Paul added that “to twist it around and say that we have no compassion and we just throw people on the street, that to me is getting pretty ugly.”

I have some ugly questions for Dr.Paul, right here–

1. Who picked up the remaining bill for your campaign manager? Did it come anonymously from principled Libertarians, or from the government? Who do you think is already paying for uninsured people when they show up at the emergency room? How much free care could hospitals give to save lives if they didn’t get government money to provide it?

2. Did you know Kent Snyder was sick? Did you offer him any advice or help as he worked for you? Young people do die of pneumonia, but more often it’s treatable. Do you think lack of insurance might have kept him from seeing a doctor early. Do you blame him for that?

3.Do you agree that insurance companies should deny people with pre-existing conditions to maximize profits? Will that be one of your campaign platforms?

4. Can you give an example of an herb or alternative store that was closed down and why? I see them doing business all over the place. Does the government ever have the right to close down an alternative business for say, selling a cure for cancer that doesn’t work? Selling tainted or mis-labled medicine? I had a patient who was blinded by an eyedrop he got in his home country, where he had no conventional medicine to help him. Should we protect the public here from dangerous and quack remedies?

5.Does your belief that medicine should be ‘pay as you go’ extend to babies and children? If not, why not?

6. As a doctor, do you see a problem in the lack of continuity when people are forced to seek care from charity clinics and emergency rooms? Do you think we waste resources and lives by starting from scratch every time the patient seeks care, rather than having one medical home where their records are on file and they know their providers? Would you trade your own secure health care for this kind of ‘freedom’?

7. Do you see prayer as a substitute for medical treatment? If parents use prayer instead of medicine for a child’s treatable illness and the child is at risk of death, does the government have a right to take custody of the child? These cases come up regularly, and even worse, children die because parents refused to take their child to a doctor. Do you think that lack of access to conventional care will drive people to faith healers and ineffective but cheap herbal remedies?

I have to hit the road now, I have clients to see for home care. I’m grateful every day for Medicare. Seven adult children are very tired these days caring for our sick father, and Hospice has given us help and support that make it possible for him to stay at home in comfort and dignity. It’s interesting seeing this situation as both a provider and recipient of help.

Ron Paul says we won’t throw people out on the street to die, and he’s right. We are not that kind of society. But people will die– killed by neglect, by too little too late, quietly and un-noticed unless it’s someone you love. Some will kill you with a fountain pen, as Woody said.

So, how do you think Dr.Paul would answer these questions?

AND ANOTHER THING: There’s something funny about the way Rep.Dr.Paul keeps talking as if herbs and alternative medicine were in a fugitive underground somewhere. You can buy herbs and alternative medicines at the supermarket– though I’d put a word in for Providence local business Farmacy Herbs. When you go to Whole Foods or GNC, you are protected by laws that say the ingredients have to be listed on the label, so you know what you’re getting. And unlike the good old days, you can’t spike some herb tea with opium and sell it as a cure-all. We’ve been there, done that, don’t want a re-run.

REMEMBER STEVE MC QUEEN: Brilliant and handsome actor, died tragically of cancer. He tried an alternative medicine called Laetrile. Remember that? Naturally derived from apricot pits, miracle cure for cancer. The only problem was that every reputable drug trial showed it to be ineffective and poisonous in large doses. Laetrile never passed the first step for any new drug in development– a Phase 1 clinical trial that tests for safety, never mind the Phase 2 for effectiveness…

As Laetrile became newsworthy, several cancer victims treated with it drew widespread media scrutiny. One was Chad Green, who developed acute lymphocytic leukemia at age 2. Although he was rapidly brought into remission with chemotherapy, his parents started him on “metabolic therapy” administered by a Manner Metabolic Physician. When Chad developed signs of cyanide toxicity, Massachusetts authorities had him declared a ward of the court for treatment purposes only. His parents then brought suit to reinstitute “metabolic therapy.” When the court ruled against them, they fled with Chad to Mexico, where he was treated by Dr. Contreras. Several months later Chad died in a manner suggestive of cyanide poisoning. Dr. Contreras stated that the boy had died of leukemia, but was a good example of the effectiveness of Laetrile because he had died a pleasant death! Chad’s parents stated that he had become very depressed because he missed his grandparents, his friends and his dog.

Follow this link for an epic story of unfounded claims, conspiracy theories and shady practices around Laetrile.

I have the greatest sympathy for parents of a sick child, and for people facing a serious illness. They are in desperate circumstances and should be protected, not thrown into the mix of legit medicine and quacks with no advocate or defender. Medicine fails, people die, humans are not gods. All we can do is make the best choices we can with the knowledge we have. When people seek alternative remedies they deserve transparency and accountability from the providers, and protection from false claims and tainted ingredients, protection from exploitation and the consequences of delaying conventional treatments that offer a known chance of cure.  It’s possible to be pro- alternative medicine and anti-quack. I am.

I actually think some of Rep.Paul’s critiques of our over-technical, expensive, pill-pushing medical system are valid and deserve discussion. But using the flaws of the present system to justify triaging the poor and working class out of care so that the rich can enjoy top-shelf services is truly ugly, and there’s nothing Rep.Paul is saying that offers a real answer to the millions of Americans who do not have secure access to care.

MORE: Susan at Daily Kos cites examples of adults and children who died for lack of timely care, including her own brother. This is not the America we want to be.

Free to Die

Economist Paul Krugman in today’s New York Times takes a closer look at Libertarian views about ‘freedom’. Millions of American children, for instance, make the ‘bad choice’ of being born to to poor parents– should taxpayers bail them out?

So would people on the right be willing to let those who are uninsured through no fault of their own die from lack of care? The answer, based on recent history, is a resounding “Yeah!”

Think, in particular, of the children.

The day after the debate, the Census Bureau released its latest estimates on income, poverty and health insurance. The overall picture was terrible: the weak economy continues to wreak havoc on American lives. One relatively bright spot, however, was health care for children: the percentage of children without health coverage was lower in 2010 than before the recession, largely thanks to the 2009 expansion of the State Children’s Health Insurance Program, or S-chip.

And the reason S-chip was expanded in 2009 but not earlier was, of course, that former President George W. Bush blocked earlier attempts to cover more children — to the cheers of many on the right. Did I mention that one in six children in Texas lacks health insurance, the second-highest rate in the nation?

This sounds like flaming partisanship but it is sober fact– such a shocking truth that we don’t want to face it. We have a highly developed system for dealing with acute health emergencies, but we are failing in preventive care. It makes no sense in terms of basic self-interest, never mind morality.

The unspoken assumption in the concept of ‘choice’ is that we are all born with a menu of choices before us, and some foolishly choose to be sick, or poor, or victims of discrimination. In real life, most of us choose as best we can from what seems possible. If health care is available and affordable to most, but out of reach for some, then individual choice is not the problem. The problem is justice and wise leadership.

It is the role of government to promote the public good, and especially the good of the next generation. We will all be older, most of us won’t be richer. What kind of nation do we want to be?

MORE: Echidne of the Snakes has a good explanation of why the current mess, which has disincentives for young people to buy health insurance or use preventive care, is economically dumb.

Get Ron Paul off Rt. 195

Really. I was driving over the I-way and there on the India Point Park pedestrian bridge was a banner–‘Ron Paul for President’.

Paul zealots are far from the only ones to use the interstate as free advertising, putting their stamp on public property, and I’ve seen this stunt many times, for many causes.

But if you must put a distracting nuisance in the way of drivers who should be concentrating on the traffic–


I know I must die sometime, but I don’t want to leave this world with a flying Ron Paul sheet covering my windshield.

Ron Paul says he is the candidate of personal responsibility. So who’s responsible for taking that sheet down when the elements reduce it to a frayed Sword of Damocles dangling over rush hour. Huh?

Ron Paul’s Answer–Unlicensed Doctors for Uninsured Patients


Neuroscience the Old Fashioned Way

AmericaBlog has video and a transcript of Rep. Ron Paul during the Republican presidential debates, as he answers Wolf Blitzer’s hypothetical question about a 30 year old man who opted out of health insurance and now lies in a coma with a dire but treatable disease. Should we save him?

Paul >> That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody —

Audience >> [applause]

Blitzer >> but congressman, are you saying that society should just let him die?

Audience >> [shouts of “yeah!”]

Even Paul’s rival, Gov.Rick Perry, was ‘taken aback’ by the ugly mood of the crowd.

This may sound like ‘nut picking’– taking the most extreme statements out of context, but I will swear on a stack of collected Ralph Waldo Emerson that I heard the same kind of things said, shouted, and offered to me as argument at the health reform Town Halls here in Rhode Island.

[Here was a snarky example of a group of firefighters who let a house burn for lack of fees. Xavier Onassis, EMT-P, took issue with the story as reported by USA Today. He says the story was mis-represented in the press, and that dedicated volunteer firefighters had been working unfunded and without adequate support. He has an informed comment here with a link to a more complete story. I apologize here for giving legs to a story that reflected badly on people whose mission is to save lives.]

Rep. Paul did go on to say that no one would be left to die in his hospital, and he invoked the old-fashioned neighborly spirit where churches and benevolent groups would come together to save the guy in the coma (more on that following). Then he said something that the blogosphere has not picked up, though it’s one of Paul’s most radical statements yet…

We have lack of competition. There’s no competition in medicine. Everybody is protected by licensing. We should legalize alternative health care. Allow people to practice what they want.

“Everybody is protected by licensing.” This is a problem? Not de-regulated enough? “Legalize alternative health care.” What is he talking about? Alternative health care is thriving, and often reimbursable by medical insurance. But do we really want to just guess, when picking a doctor, whether they passed their boards, and whether their medical school was accredited? Ron Paul’s son, Rand Paul, is not board-certified by the American Board of Ophthalmology, but rather by an association that he founded and directs. That’s one way to do it. Do we crave the freedom to take our own risks with loosely-regulated doctors who can create their own credentials? Do we want an old-time doctor like R.V.Pierce?

R.V.Pierce,MD, was a good businessman. His hospital covered an entire city block in Buffalo, New York at the turn of the last century. He peddled a pre-FDA concoction called the ‘Golden Medical Discovery’. It made people feel better, allegedly because it was fortified with alcohol and opium. Dr.Pierce’s book, ‘The People’s CommonSense Medical Advisor’ contains scores of testimonials to miracle cures effected by just a few bottles. To the skeptical nurse, these stories are a window into the suffering endured by our great-grandparents, whose lives might be ruined by accidents or conditions now easily treated. Interestingly, R.V.Pierce served in Congress on the Republican ticket.

Back to Rep. Paul’s recommendation that we look to churches and neighborhood yard sales to care for our neighbors in need– check out Providence Journal reporter, Felice Freyer’s article ‘The Price of Miracles’. Neighbors do help, but the care of a baby in intensive care costs thousands of dollars a day, and then thousands of dollars a month after they go home. This is where collective responsibility comes in, and where we uphold our values as a great nation.

Back to Wolf Blitzer’s hypothetical. The life of a 30-year-old man has value. More than $800,000 according to one calculation. And the community that decided a cloud of air pollution and a smoking ruin was better than an intact house– well, just a little shortsighted. At least the firefighters woke up when they saw the neighboring roofs catching sparks.

And if you’re old enough to shudder at the mention of the drug, Thalidomide, then thank Frances Kelsey. As a pharmacologist at the FDA she kept that drug from being widely prescribed in the US. Regulation is good in its place, and what you don’t know can hurt you. Ron Paul’s nostalgia for unlicensed doctors for uninsured patients is not shared by most Americans. Most Americans want some assurance that there are standards, and recourse if they are not treated right.

The suggestion that we would all be better off if it were not for those tiresome standards and licensing requirements is easily refuted if we look back a few generations– and see why these standards were put in place.

The statement that we should just let uninsured people die if charity doesn’t intervene won’t seem so smart when it’s someone you know or care about whose life is in danger. And that would happen sooner rather than later if we lived in Ron Paul’s America.

We are not yet a nation that demands a credit card number before responding to 911, but yes, people are dying for lack of affordable care. It’s years of health and life lost to preventable disease and is a national heartbreak and disgrace.

I actually share Rep.Paul’s frustration with the current system– overtreating here, undertreating there, pill-pushing and flawed. But I wouldn’t throw it away in favor of a Wild West where sick people have no protection from quacks, where we pride ourselves on being strong enough to deny care to people who made ‘bad choices’ not to buy insurance. Especially as uninsured people are often young adults, and often can’t afford insurance.

Like many middle-class parents of young adults, I am benefiting from the health care reform that allows family insurance up to age 26. I want to see this as a beginning of more comprehensive reform that covers everyone. You may say I’m idealistic, but universal health care is more reality-based than a nostalgic vision of an America that never was.

MORE: Mark Karlin on Buzzflash says that a campaign manager for Ron Paul died young, uninsured and in debt. Would it be in accordance with Libertarian principles to provide health insurance for employees? The Huffington Post also has a comment on this sad story. Pneumonia can be fatal, but it is a disease that has a high rate of recovery if treated early. When people hesitate to go to the doctor for lack of insurance there are some whose luck runs out– this especially applies to the young and healthy.