Medecins Sans Frontieres by James Maskalyk

I sat down with the mother.

"Your baby's not breathing well. See? He's only breathing small. Not good. We need to help him breathe. Put this tube down his throat to push in air. I think if we do not do it, he will die. Even if we do, he might die. I don't know. It's the only thing I can do."

The nurse translated and the mother agreed.

I put the flat blade of the laryngoscope past his tiny white teeth and pushed his tongue to the side. I lifted the blade until I could see his vocal cords. They flickered with each breath. I pushed the tube past them, into his trachea, then attached the bag to it.

His oxygen saturation improved to 100%. His chest rose and fell with each small squeeze of the bag.

Muriel arrived from compound 2. She's young, was trained in Khartoum, and worked for years with MSF in Darfur. She was interested and competant, the best we have.

"Okay. Like this. Just a gentle push. Watch his chest. In...and out...in and out. This is the suction machine. You work it with your foot, like this. You'll need to suction him every hour or so"

I adressed the other nurses. "This is a hard job. You will have to help her. You too, Mom. She can't stop. If she does, the baby won't be abe to breathe and he will die. Okay?

We left them, Muriel pushig on the bag, twelve times per minute, 720 times per hour.

I wonder in cases like this, if the battle is worth fighting. The war is a long one and the odds are stacked so heavily that perhaps energy is best conserved. Maybe it's best to use likely defeats to increase our resolve to work towards a day when it will be easier to win. But then there is the other tack. Battle every time, with everything you have. Do the best you can for the person in front of you. Persuade the family of every malnourished kid to get into the truck, to come to the hospital to be fed until they are better. Track down each TB patient who left, frustrated, halfway through his long treatment and try to get him to come back even though the countryside is littered with tuberculosis patients we will never see and one case will not tip the balance sheet noticeably towards a TB-free future. To the world it doesn't matter that much. Until you remember that it means the world to the patient. One exact world, bright and full of sounds, per person. That's what is lost...

The next morning when I got to the hospital, Muriel was still pushing the bag. She had not taken a break all night. The mother was lying down on the bed, her hand resting on her child's chest, feeling its rise and fall.

I relieve Muriel, and she stumbled towards the waiting Land Cruiser. I explained to the mother that we had needed to take the tube out, to see if the child would breathe on his own. I suctioned his small mouth, removed the tape from around it and from the tube. I stopped bagging.

He was breathing. A little. More than a flicker, more than last night. I pulled the tube.

On my way home for lunch, I got a call from the hospital. His breathing was getting worse.

"Put him on oxygen," I said. We couldn't intubate him again. We didn't have the resources or the trained staff. Fifteen munutes later they called again. He was dead.

The Martyrdom Of Cassie Bernall by Dave Cullen

Greg Scott took it hard.. He had seen horrible things in the library at Columbine High that morning, but he'd heard something wonderful. During the worst of it he'd heard a girl profess her faith. Amazing. Craig began telling his story that first afternoon. It spread like a brush fire. Among Evangelicals, e-mails, faxes and phone calls whipped across the country.

On Friday it hit the the mainstream media. Both Denver papers featured it. The Rocky's piece, "Martyr for Her Faith", opened with a play-by-play:

A Columbine killer pointed his gun at Cassie Bernall and asked her the life-or-death question: "Do you believe in God?"
She paused. The gun was still there. "Yes, I believe in God", she said.
That was the last thing this 17-year old Christian would say.
The gunman asked her "Why?" She had no time to answer before she was shot to death.
Bernall entered the Columbine High School library to study during lunch. She left a martyr.


The Post ran a similiar account. The national press quckly jumped aboard. On Saturday, an Evangelical Teen Mania rally in Michigan "turned into a Cassie Bernall festival" according to Weekly Standard writer J. Bottum. He described 73,000 teens in the Silverdome "weeping along with sermon after sermon about her death."

Sunday morning, April 25, the Columbine churches were packed. Afterwards, the crowds trekked down to the Bowles Crossing Shopping Center, across from Clement Park. Organizers had planned for up to thirty thousand mourners in the sprawing parking lot. Seventy Thousand showed up. Vice President Al Gore was on the platform, along with the governor, most of Colorado's congressional delegation, and a whole lot of clergy. The TV networks broadcast the ceremony live.

"Put your faith and trust in the living son of God, the Lord Jesus Christ", Reverand Billy Graham's son Franklin instructed the crowd. "We must be willing to recieve His son Jesus Christ".

Jesus, Jesus, Jesus. There was a whole lot of Him tha day. Reverand Graham dominated the ceremony with a long, impassioned plea for returning prayer to public schools. He invoked the name of his personal savior seven times in a single forty-five-second flurry. He called upon God and Jesus nearly fifty times in the course of the speech. Cassie had been ready, he said. She stood before a gunman who'd transported her immediately into the presence of Almighty god. "Are you ready?" he asked.

The country was transfixed. In the first ten days, newsmagazines on the four main broadcast networks devoted forty-three pieces to the attack. The shows dominated the ratings that week. CNN and Fox News charted the highest ratings in their history. A week afterward, USA Today was still running ten seperate Columbine stories in a single edition. It would be nearly two weeks before the New York Times would print and issue without Columbine on page 1. And Cassie Bernall's martyrdom was showing the most legs.

"She's in the martyrs hall of fame," Cassie's pastor proclaimed at her funeral. That was not hypebole. A noted religious scholar predicted Cassie would become the first officially designated Protestant martyr since the sixteenth century.


Cassie's fame grew. Her pastor embarked on a nationwide speaking tourto spread the good news. "Pack as many onto the ark as possible", he said. By summer's end, the local youth group Revival Generation had blossomed from a few local chapters to an organization in all fifty states. The organizers's put on natonal touring shows with Columbine High survivors. Cassie's name sent teenage girls storming to the stage.

In the Weekly Standard, J. Borrut compared her to the third-century martyrs Perpetua and Felicity and "tales of the thousands of early Chistians who went joyously to their deaths in the Roman coliseums." And the response felt like the Great Awakening of the eighteenth century, Bottum said. He foresaw a generation of kids rising up to recast our cultural landscape. He later described a national change of heart, "trembling on the crisp of breaking forth...It's an ever-widening faith that the whole pornographic, violent, anarchic disaster of American popular culture will soon be swept away."

Christian martyr Cassie Bernall offered hope. In September her mother went on a national book tour. She Said Yes leapt onto the New York Times best-seller list in its first week. It has since been reissued in two paperback formats, a library edition, an an audiobook. It has sold over a million copies. The Web is loaded with sites unabashedy recounting the myth. The Evangelical churches have stuck with their story.

Erasmus of Rotterdam by Roland H. Bainton

Erasmus at the end of his life felt that his lamps had been blown out by the Lutheran gust. Not that Luther was altogether to blame. The incredible ineptitude of the papacy bore a heavier responsibility. Nor was Luther to be held responsible for the excesses of his followers. On that score Erasmus was open to even greater reproach, for the Sacramentarians and iconoclasts claimed to be implementing his ideas.

But blame apart, there was no gain-saying the debacle of the Erasmian program. His followers on both sides of the confessional struggle were being sent by the Catholics to the stake and by the Protestants to the block. His spirit was extinguished and his hopes belied. The universities were being emptied and the studies by which he hoped to refashion the mind of Europe were falling into desuetude. He could do no more that hope that God in His providence would cause the wrath of men to praise Him and that Christ, as Master of the play, would give the tragedy a happy ending. His mood was that of Elijah: "It is enough. Now, O Lord, take away my life...the people of Israel have forsaken Thy covenant, thrown down Thy alters, slain Thy prophets with the sword."

The Lord might have answered Erasmus, as He did Elijah, that there were yet in Israel seven thousand who had not bowed the knee to Baal....the situation varied country by country and century by century. In some lands by the time of his death he was already in eclipse, in others at the very peak of his influence. In Spain by 1533 his vogue was spent. As the century advanced all traces of Catholic liberalism were extinguished. In Italy the great turning point was the year 1542 which saw the establishment of the Roman inquisition. Among the Italians the vogue of Erasmus was perpetuated only by exiles, such as the Socinians, and such champions of religious liberty as Curio, Mino Celso and Acontio. Poland, well into the sixties, was the land of refuge for those cast out by Catholics and Protestants. Hungary, too, for a time was hospitable. France was divided. The Sorbonne had long since been hostile.

In Germany Melanchthon, in accord with the spirit of Erasmus, established a pattern of humanist education which prevailed in revived universities and continued to dominate until, late in the 19th century, the natural sciences encroached upon the humanities and the vernaculars displaced Latin. In the age of Enlightenment Voltaire loved the satire of Erasmus. Herder, Goethe and Lessing found the sprit of Erasmus congenial.

England was the land where the influence of Erasmus was paramount at his death. The entire English Reformation has been characterized as Erasmian, and with justice, if it be remembered that the vogue of his ideas is not necessarily to be attributed solely to his personal impact, since other men of influence in England were of like mind. The Elizabethan settlement breathed the spirit of the Erasmian attempt to achieve comprehension through minimal doctrinal demands. During this period the devotional meditations of Erasmus were not neglected... A survey of the English translations of his works during the succeeding centuries discloses that the 17th preferred the educational works- the Colloquies were used as a school book- the 18th the satirical, notably the Praise of Folly, the 19th the pacifist treatises.

The Low Countries were presumably the area where Erasmus had the most unbroken influence. The reason may be that the temper of the land had long since been formed by that tradition in which Erasmus himself stood, the piety of the Devotio Moderna.

The twentieth century, particularly in its third decade, saw a brief resurgance of interest in Erasmus. Two causes may be assigned. The first was the ecumenical movement. After four hundred and fifty years Catholics and Protestants resumed the dialogue which was possible in the early years of Luther's revolt and which Erasmus endeavored to keep open. The second reason is that the 20th century was- like the Age of Reformation- an age of revolution. Once again the liberals, who desire to bring about social change without violence, were caught between the upper and the nether millstone, and were not ground to flour but to dust! Is drastic reform possible without violence?

Note to the Reader

This is a record of my readings, mainly but not exclusively from the New Books Shelf at the Fletcher Free Library here in Burlington ,Vermont . This record is presented primarily in direct quotations from the books themselves, abridged for highlighting and summary purposes. I apologize for errors in transcription, spelling and punctuation. When time and my inclination allow I do often go back and seek to correct these errors and, in addition, revise and extend the comments.

I recommend all the books presented in this Blog. There is alot more good stuff in these books than is feasible to present in this Blog.

Righteous Dopefiend by Philippe Bourgois

Fieldwork in the Gray Zone.


The autobiographical literature created by Holocaust survivors provides exceptional insight into how state coercion can make monsters out of the meek. Auschwitz survivor Primo Levi developed the concept of the "Gray Zone" to capture the ethical wasteland imposed by the Nazis on concentration camp inmates struggling to stay alive under genocidal conditions. In the Gray Zone, survival imperatives overcome human decency as inmates jockey desperately for a shred of advantage within camp hierarchies, striving to live just a little bit longer. The Nazis purposefully engineered the Gray Zone of the death camps to force inmates to self-administer to one another, with excruciating cruelty, the logistics of everyday life in the camps. As a contemporary ethical imperative, Levi urges readers to recognize the less extreme gray zones that operate in daily life, "even if we only want to understand what takes place in a big, industrial factory."


As with the concept of violence, we find it useful to think of gray zones in contemporary society as operating along a continuum of insupportable, structurally imposed settings. This perspective renders more visible the complex interaction between intimate behavior and larger coercive constraints. The homeless encampments along Edgewater Boulevard in San Francisco are obviously not the equivalent of Nazis death camps. The Edgewater homeless sometimes quip, "No one put a gun to my head and made me shoot heroin". Their lives also contain camaraderie, humour, and the joy of living. Never-the-less, addiction under conditions of extreme poverty and concerted police repression creates a morally ambiguous space that blurs the lines between victims and perpetrators. By extending the boundries of the Holocaust's Gray Zone to the everyday world around us, we can understand the Edgewater homeless as surviving along an especially coercive and desperate swath of the gray zone continuum.


Levi and other survivors assert that we do not have the right to judge the actions of inmates in the concentration camps because the Gray Zone was omnipotent. He implicitly contradicts himself, however, by devoting much of his writing to eloquently dissecting the moral dilemmas of human agency at Auschwitz through detailed descriptions of individual behaviors, decisions, and interpersonal betrayals. Following Levi, we explore the agency and moral responsibility of the homeless addicts we befriended without obscuring the structural forces that impose a gray zone. We examine in detail the micro-level mechanisms through which externally imposed forces operate on vulnerable individuals and communities; the everyday "state of emergency" ('space of death' and 'culture of terror') in which the socially vulnerable are forced to live.

Our Daily Meds by Melody Petersen

In 1980, as an incentive to get American scientists to work harder, U.S. lawmakers passed a measure that allowed researchers recieving federal grants to patent and profit from their discoveries. The law was known as the Bayh-Dole Act...it reversed decades of policy. Before this law, any discoveries made during studies paid for by the federal government had been in the public domain- that is, they had been owned and controlled by the taxpayers who paid for them.

In the same year the Supreme Court unleashed a deluge of industrial science by allowing the first patent to be placed on a living organism..reversing the ruling of the U.S. patent Office and opening the door to the patenting of genes, cell lines, tissues and organs..


These two changes put dollar signs in the eyes of college administrators and their faculties. Between 1980 and 1995 University researchers helped start 1,633 new companies. In 1997 alone researchers at Stanford Univ. filed 128 new patents, created 15 companies and earned $52 million from licenses of its products... the role of the academic as a referee to the drug companies' clinical trials became a minor one. And the moderating force that kept scientific studies honest and impartial began to disappear.

When the FDA decided in 1997 to allow prescription drug commercials on TV Omnicon and the other ad agencies grew rich from a new stream of advertising revenue, one worth millions of dollars a year, At the same time, the pharmaceutical industry had been paying ad firms to ghostwrite publications, to organize dinners and meetings for physicians, to create medical education courses, and for public relations work they called "managing the media" Now the ad firms were expanding their services to include scientific research and clinical drug trials,
with ghostwriters and pharmaceutical executives editing the papers submitted to medical journals each step of the way, picking certain words and phrases that helped boost the image of the product. Dangers of a medicine could be toned down. Benefits of a drug could be pumped up. A serious injury in a patient taking a drug in a trial might be referred to simply as "an event". The words "adverse reaction" might be changed to the more benign "side effects". A drug that worked only slightly better than a sugar pill might be described as having "proven efficacy". It was all a matter of degree. The ghostwriters were like photographers who airbrushed family portraits, softening blemishes and facial lines until their subjects looked far better on paper than in real life.

The pharmaceutical companies and their ad firms developed a publication planning strategy, flooding the world's medical journals with articles and clinical studies that, when taken together, would create an image of a product so safe that doctors would be convinced to prescribe it. As the pharmaceutical companies realized the powwer of this marketing technique, they increased spending on what they called research and development, although it would have been more accurately decribed as "selling and promotion."... at the same time they gradually took control of most of the country's medical research. In 1980 the pharmaceutical industry paid for just 32 % of the nation's medical research. By 2000 the companie's share of total research spending had grown to 62%.

By the mid-1990's, many American doctors had grown frustrated with the financial limits imposed on them by health maintenance organizations and other forms of managed care that became popular in the 1980's and 1990's as a way of restraining medical costs. Watching their salaries stall, the doctors were easily seduced by the welcoming arms of the drug industry, where the money still flowed. They found they could significantly boost their bank accounts and upgrade their lifestyles by winning favor with the pharmaceutical sales representative and joining a company's payroll as a speaker, consultant, researcher, or advisor or by serving all these functions at the same time.

For example, Dr. Martin Keller, the chief of the psychiatric department at Brown University, earned more than $500,000 in consulting fees in 1998, mostly from companies whose drugs he touted at medical conferences and in published reports. In 2004 the written contract between Dr. Arnold Klein, a Bevery Hills dermatologist, and Allergan, the company that makes Botox, became public when he was sued by a patient. The contract paid him $25 thousand every three months for consulting and as much as $10 thousand a day for meetings, plus expeses for airfare, hotel and meals.

By 2003 the drug companies had even recruited and hired many of the physicians and scientists at the federal government's esteemed National Institutes of Health. For instance, Pfizer paid Dr. P.Trey Sunderland, an expert on Alzheimer's disease, more than $500,000 between 1998 and 2004 for dozens of speaking appearances all over the world.


Only about 10% of the price of most brand name pills goes to cover the cost of the raw chemicals and manufacturing, the pharmaceutical industry has plenty left even after paying for advertisements, research and the high salaries and expensive perks of its executives. From 1995 to 2002 they were the nation's most profitable industry. In 2004 the pharmaceutical companies tirned nearly sixteen cents of each dollar of revenue into profit, according to Fortune magazine. That compares with the median profit earned by America's five hundred largest public companies that year of a little more than five cents.


Pharmaceutical executives talk about their company's medicines as if they were Hollywood producers about to release a new film. They speak of "launching their next blockbuster", which they define as a medicine that could bring in sales of one billion dollars. Sellinmg medicines is an odd business. Disease meant money. Suffering brought profit. When I visited the phramaceutical executives I often heard something like this;" Our respiratory business is doing extremely well, as is our cholesterol business. The depression business has performed better than expected. Parts of that business are really growing strongly. It is the migraine market that is the problem."


By the year 2005 Americans were spending $250 billion on prescription drugs, more in 2004 than they did on gasoline and fast food, twice as much in that year as they spent on either higher education or automobiles. They spend more on medicines than do all the people of Japan, Germany, France, Spain, the U.K., Australia, New Zealand, Canada, Mexico, Brazil and Argentina combined.

The vast majority of drugs-more than 90% only work in 30 to 50 percent of the people....across all drug categories today an average of 50 percent of the people treated with individual drugs are recieving treatments that are not efficacious for them.

The Historical Background of Shakespeare's Tragic Equation by Ted Hughes

In the turmoil of sixteenth and seventeenth century England one broad pattern emerges which will help lift into relief Shakespeare's tragic myth and which may, to a degree, validate it.


Such a vast complication as the crisis of religious belief at this time, which was also a crisis of political, intellectual, economic and social life, can be spoken of only in the largest kind of generalization. But it can perhaps be said that between the Catholic regime (repressive terror, executions, martyrs) of Queen Mary, who died six years before Shakespeare was born, and the Puritan regime that executed Charles I thirty-three years after Shakespeare died, England went through the final phase of its Reformation and was transformed.


These two historical points were extreme opposites in that events immediately preceeding Mary's reign pushed her Catholic fanaticism to a ferocity beyond anything that England had ever suffered before, while the momentum of the passions of the Civil war carried Cromwell's victorious Puritans to a severity beyond what the country would ever tolerate again. The conditions that prevailed, between these two episodes, were also, at every point, one way or the other, extreme. And peculiar- in being so uniquely productive.


It is not really possible to seperate, except artificially, this energy wave from the convergence on England of various other tidal global movements, from Europe and America, over and above the tectonic shifts of the Reformation, that lifted everything from its old foundations and simultaneously opened all horizons, physical and mental. But the decisive factor in England- the factor which perhaps more than any other determines the nature and evolution of Shakespeare's Tragic Equation- was that the process of religious change was arrested, or rather held in suspense, by the historical accident of Elizabeth I. Those two savage competitors for the English soul, which were the new Puritan spirit and the old Catholic spirit, each intending to exterminate the other, both uncertain of the outcome, were deadlocked, and in a sense spellbound, by her deliberate policy throughout her very long reign. They were not openly deadlocked, as on the Continent, with the embattled cities and occasional massacre of populations. They were deadlocked out of sight, forcibly disarmed, and forbidden any physical, direct expression whatsoever, inside Elizabeth's crucible.


As the daughter of Henry VIII she had no alternative but to keep them there. The Papacy had already condemned her as 'the bastard of a heretic", and denounced her claim to the throne as illegitimate. The revolutionary Puritan doctrine, that had so frightened Queen Mary, ultimately opposed monarchy and pressed towards what could only be civil war. Elizabeth's solution, reaffirming her father's ideal of a middle way between two extremes, was to outlaw and suppress both.

She needed a police state to do it. Even so, though she could anchor her ship of state she could not anchor the tides beneath it. Behind the new Puritan, the tsunami of the Continental Reformation piled like a tidal bore into the narrow haven of England. And it carried with it the frenzies of a jihad. And behind the old Catholic, in an intermittent campaign of war that lasted through Elizabeth's life, the international might of the Catholic Empire went on gathering itself to bring England back into the fold by any means. The ghostly front line of the deadlocked spirit armies of these two giant historical forces was drawn through the solar plexis of Elizabeth's subjects.


What she suppressed, then, when she suppressed those furies in England, was virtually an internationalized civil war. She pushed it down into that subterranean region as a controled explosion, and sealed it there, in the black hole of the Englishman's nervous system, for the forty-five years of her reign. And after her death in 1603 King James contrived, by one accident or another, to raise the pressures and temperatures inside it even further.

Down there it became the inner life of that epoch. It created the psychodrama, the international proscenium of a struggle- civil war conducted by other means- that forced England through what has since turned out to be her decisive mutation, towards the day, twenty-six years after Shakespeare's death (during the lifetime of his daughter), when it would erupt into the apocalypse of the actual war....


One can imagine the nightmares of these ( the Shakespeare's ) Catholic sons. One hardly needs to imagine them: they parade the Elizabethan stage in a dense gas of suspicion and guilt. During that reign every man knew himself to be, or could suspect his neighbor of being, at heart, officially a traitor. Elizabeth could reasonably persuade herself than any of her subjects- even her nearest and dearest such as Essex- was her potential assassin. The theatre itself had materialized ( only fifteen years or so before Shakespeare had found it) from the sheer uncontainabble excess of this national struggle of conscience, this internal Inquisition in perpetual session. Even Ralegh, at his trial, was accused of having 'the soul of a Spaniard'. And though he was reprieved for a few years, he was sentanced to the death of a Catholic activist and traitor, to be half-hanged, castrated, disembowelled and the rest, his only consolation being that his rank would limit the even to simple beheading.


Flashes of this sort give a taste of the paranoia that served for air in the crucible. But Shakespeare's phantasmagoria is the thing itself. His suspectibility to large, cataclysmic visions, and the fact that his plays emerged as poetry, inspirationally, suggests how much of his life, too, was underground, and concealed, perhaps even from himself, as with the poet who planned a work on a life like Timon's:

the fire i' the flint
Shows not till it be struck.


And that is what I would like to bring into alignment: The Elizabethan/Jacobean dream not as it appears in the historian's archive, but as it appeared- the 'form and pressure' of the 'very age and body of the time'- in the tragedies. Not the mirrored image of the civic procedures, but the processes of the inner explosion, behind the faces of both judges and accused- the controlled slowness of that explosion. First, the religious substance of it, the mass, depth and pressure. Then the retardation, the deferred release, as everything inched towards a conclusion that could only be frightful.


Since Shakespeare was born, lived and died within the crucible, his art evolved as a kind of salamander. It had time to develop the means to so thrive on and to deal with the conditions and forces that had brought it into being. The elements of the creative chemistry did not blow off in a single blissful dawn, as with most revolutions, leaving him and a few other lyrical prophets to make what they could of the ringing in their ears. Within that crucible, the conditions and forces that shaped him were also, inevitably, the very substance of his vision. What I want to suggest is that the equation of his tragic myth was, in a real sense, the equation of the chemical process within that 'controlled explosion'.