Skip to content

TODAY’S CHART: The rise of non-productive businesses and the fall of manufacturing in the US.

Pasted Graphic 2
While the timeline on this chart is too brief to demonstrate a trend, is does show something that has been occurring in the American economy for over a decade. Manufacturing continues to decline while the highly unproductive finance and insurance sector massively increase,

TODAY’S CHART: The Inappropriate Use of Antimicrobials.


This chart is very frightening. For someone like me, whose childhood saw the vanquishing of those plagues that have hounded humankind throughout history and that could kill more in a few decades than all the wars of history, finds it heartbreaking that now at the end of that life those plagues, now resistant to all our antimicrobials may soon hound the people of the earth again. Only last year, the last effective antimicrobial was proven impotent against a mutated resistant organism it was designed to kill. Somewhere in the world today there exists mutated organisms resistant to one or another antimicrobial successfully used to halt plagues of the past. They are awaiting only the appropriate conditions to spread death and anguish across the globe

There are some still fighting to protect humanity from this threat. (The US Department of Defense considers the potential spread of drug-resistant organisms to be a national security issue) They should be honored by us all. Alas, like first responders, and other selfless people like them, there are few if any parades in their honor, nor many Facebook and similar remembrances. It saddens me that we publicly honor those trained to kill to protect us from real or imagined enemies but rarely those who daily put their lives on the line or dedicate themselves to protect their fellow humans from disease, injury or death.


Estimated proportion of inappropriate antimicrobial use by type of health care service
Inappropriate use of antimicrobials
Pasted Graphic
The inappropriate use of antimicrobials is perhaps one of the most threatening forms of wasteful clinical care because it encourages the development of antimicrobial resistance. Inappropriate use represents about 50% of all antimicrobial consumption by humans, but may be as high as 90% in general practice.

More rational antimicrobial consumption can be achieved with behavioral change interventions, notably antimicrobial stewardship programs which combine multidisciplinary activities to steer both prescribers and the public towards appropriate use of antimicrobials. Mandating the use of rapid diagnostic testing can help clinicians target their antibiotic use. Economic incentives for providers and care seekers can also encourage appropriate antimicrobial consumption.

Note: Numbers in brackets indicate the number of studies used to determine the range of inappropriate use. Source: OECD analysis of available evidence published in the literature.
Source: Tackling Wasteful Spending on Health, OECD, January 2017.

A Counter-attack in the War against Women.,


For the past 100 years,  around the world women have made great strides in pushing through the economic and social barriers that have shackled them for millennia. Along the way, setbacks occurred. About 30 years ago, in the MiddleEast, the drying up of the region and the depredations of unfettered greed destroyed grasslands many families depended upon driving young men to find work in nearby communities. Finding none, unfortunately,  some flocked to an ideology that, as one of its principle tenets, required the re-subjugation of women. That particular element of ideology has since then found fertile ground among the unemployed and underemployed males around the world.

Recently, within the past three years or so, that recidivism seems to have penetrated many countries even some of the world’s most prosperous and liberal democracies. Even more disturbing, it has prompted a world wide assault on women with power.  Just take a look:

In Brazil, there a right wing coup replaced the female president and in Argentina, a liberal woman president was driven from office.

In Southeast Asia, in Thailand a military coup deposed the woman serving as prime minister and in the Philippines, the female democratic Head of Government was replaced with a decidedly autocratic male thug.

In Germany, Angela Merkel’s reign is threatened.

In America, the 2016 presidential election pitted a misogynist racist against the first woman to run for the Presidency as a candidate of a major party.  In the election, the misogynist racist, running on a platform that included a commitment to roll back many of the advances women have made over the past century, attracted enough of the nation’s predominately economically disgruntled male voters to support his candidacy with sufficient missionary zeal to eke out a victory in the election despite losing the popular vote by a substantial margin.

Crying and Tears

Speaking of tears, there have been a number of studies that indicate that women cry more readily than men.

When I was a child living on the streets, homeless or in rat-infested basements, I never recall my mother crying or for that matter any of the other women we knew in similar circumstances. The men, including my father, cried in frustration, despair and in self-hate for their failures, but never the women, even those who were beaten. Only the loss of a child could bring tears to their eyes.

Today’s medical chart:


I am not sure if this chart was intended to be posted on the examination room wall or used as a reference for some psychologist.

In reading it over I realized that I have succeeded in accomplishing everything listed on the chart often multiple times, except for Jail Term (unless nights in the drunk tank count) and Pregnancy for which I am unqualified. I wonder if one adds up the score from this chart and it totals more than 1000 will he or she win something, like two weeks in the rest home of your choice or a years supply of Valium?

A Diary Post from 2010 about Military Coups, how Women Saved the Thai Nation and Other Things:


Of those of you who spend the time reading these posts, some of you have expressed little interest in the machinations of Thai politics other than concern for my health (for which I thank you). Others have asked some searching questions about the situation.

Since things have quieted down here quite a bit on the military front, this will probably be my last post on the subject and I will happily get back to describing my ongoing struggles with short pants and Thai immigration.

As you know from my prior post, the non-combatant Red Shirts surrendered to the military sweep, its leaders jailed (perhaps to be soon disappeared) and the others sent back home to the provinces to make out best as they can. The Red Shirt fighters mostly melted into the background as the final assault was launched, inflicting what damage on the military and property that they could as they retreated. I expect, as is often the case in these situations, they will become, first guerilla groups, then terrorists and finally indistinguishable from any of the criminal bands that have always haunted Thai Society.

The hard-line military is firmly in control of the government, although from a less public position than in the past. Rolling curfew’s and roadblocks are the order of the day, while government spokespersons call for order. Calls for national reconciliation come not from the government so much as from the press, opposition parties not associated with the Red Shirts or from the Red Shirts themselves. To put this in perspective, one of the pro-government articles in the Bangkok Post, the leadingEnglishh language daily in Thailand, explained that although Thaksin, the deposed prime minister, had done much of lasting good for those who had previously had been ignored by the Thai political establishment, the gradual takeover of the all the elements of Thai society for the benefit of his own financial interests and that of his family, friends and political supporters reached an unacceptable extent when it threatened the independence of the military and the monarchy itself.

Recently several people have told me that they heard rumors that the government had retained Cambodian mercenaries to lead the assault on the Red Shirts because the Thai army troops resisted killing fellow Thais. I suspect this to be Red Shirt propaganda in an effort to appeal to the ordinary Thai solider while throwing suspicion on the government and the general staff. What I believe actually happened is that he elite troops who spearheaded the attack who are stationed in the far eastern portion of Thailand adjacent to Cambodia, contain a number of Cambodian speakers and the rumor began when some were overheard speaking in their native tongue.

Although many are calling the rout of the Red Shirts a defeat for Thaksin, he still retains influence and some control over the opposition to the military and the government. He will remain a rallying point for unhappiness with the current political ascendency in the country.

[A bit of history, the original Thaksin was a Thai general who rallied the troops after their defeat by the Burmese and the destruction of the Thai capital of Ayutthaya and the unprepared and inept monarchy. He eventually defeated the Burmese, drove them back out of Siam and established a new capital in Thonburi, a suburb of modern Bangkok. Over time, he became gradually more and more arrogant, paranoid and insane until he was usurped by one of his generals who became the first king of the current monarchial dynasty.

It should be noted that during the period of the great conflicts between the Thais and the Burmese, it was often the women and not the men whose martial exploits saved the country. There are statues honoring these women throughout Thailand. In Korat a large city in the east of Thailand by the main gate to the old walled city a statue of en elderly woman stares menacingly out from the ramparts. It honors a woman, the wife of the lord of Korat whose husband was off fighting the wrong enemy when the city was attacked. She assumed command of the defenders of the city and defeated the Burmese and their allies in several attempts to conquer the city. After the Burmese were dispatched her husband and his army returned.

In the center of the Island of Phuket stands a statue stands honoring two sisters who after the Burmese had invaded the island and driven off the male defenders, rallied the women, children and elderly and drove the Burmese back into the sea.

Even the dynasty that was destroyed by the Burmese along with its capitol city, had its warrior queen. She led the royal troops in several battles against the invading Burmese defeating them every time until at last she was overrun in the final battle. She may have even had achieved victory there had she not died in a futile attempt to singlehandedly save her monkish and definitely unwarlike husband from a Burmese assault. And just so you will not mistakenly believe that I have been in touch with my feminine side, I leave you with this little misogynist note: remember, even in the land of smiles, a Thai woman can be a real bitch if you try to mess with her property… or if you are Burmese…or….]

Stand or Die — Why it is Important to Take Seriously the Advice of Those You Choose to Advise You:

Sixth Century BC: Discussion between Demaratus and King Xerxes prior to the latter’s march upon Greece:

“Xerxes sent for Demaratus the son of Ariston, who had accompanied him in his march upon Greece, and said to him:

“‘Demaratus, I would like you to tell me something. As I hear, you are a Greek and a native of a powerful city. Tell me, will the Greeks really fight against us? I think that even if all the Greeks and all the barbarians of the West were gathered together in one place, they would not be able to stop me, since they are so disunited. But I would like to know what you think about this.’

“Demaratus replied to Xerxes’ question: ‘O king! Do you really want me to give a true answer, or would you rather that I make you feel good about all this?’
“The king commanded him to speak the plain truth, and promised that he would not on that account hold him in less favour than before.

“When he heard this promise, Demaratus spoke as follows: ‘O king! Since you command me to speak the truth, I will not say what will one day prove me a liar. Difficulties have at all times been present in our land, while Courage is an ally whom we have gained through wisdom and strict laws. Her aid enables us to solve problems and escape being conquered. All Greeks are brave, but what I am about to say does not concern all, but only the Spartans.

“‘First then, no matter what, the Spartans will never accept your terms. This would reduce Greece to slavery. They are sure to join battle with you even if all the rest of the Greeks surrendered to you. As for Spartan numbers, do not ask how many or few they are, hoping for them to surrender. For if a thousand of them should take the field, they will meet you in battle, and so will any other number, whether it is less than this, or more.’

“When Xerxes heard this answer of Demaratus, he laughed and answered: ‘What wild words, Demaratus! A thousand men join battle with such an army as mine! Come then, will you — who were once, as you say, their king — fight alone right now against ten men? I think not. And yet, if your fellow-citizens really are as you say, then according to your laws as their king, you should be twice as tough and take on twenty all by yourself!

“‘But, if you Greeks, who think so hightly of yourselves, are simply the size and kind of men as those I have seen at my court, or as yourself, Demaratus, then your bragging is weak. Use common sense: how could a thousand men, or ten thousand, or even fifty thousand — particularly if they are all free, and not under one lord — how could such a force stand against a united army like mine? Even if the Greeks have larger numbers than our highest estimate, we still would outnumber them 100 to 1.

“‘If they had a single master as our troops have, their obedience to him might make them courageous beyond their own desire, or they might be pushed onward by the whip against an enemy which far outnumbered them. But left to their own free choice, they will surely act differently. For my part, I believe that if the Greeks had to contend with the Persians only, and the numbers were equal on both sides, the Greeks would still find it hard to stand their ground. We too have men among us as tough as those you described — not many perhaps, but enough. For instance, some of my bodyguard would willing engage singly with three Greeks. But this you did not know; and so you talked foolishly.’

“Demaratus answered him- ‘I knew, O king, that if I told you the truth, I would displease you. But since you wanted the truth, I am telling you what the Spartans will do. I am not speaking out of any love that I have for Sparta — you know better than anyone how I feel about those who robbed me of my rank, of my ancestral honours, and made me a homeless exile…. Look, I am no match for ten men or even two, and given the choice, I would rather not fight at all. But if necessary, I would rather go against those who boast that they are a match for any three Greeks.

“‘The same goes for the Spartans. One-against-one, they are as good as anyone in the world. But when they fight in a body, they are the best of all. For though they are free men, they are not entirely free. They accept Law as their master. And they respect this master more than your subjects respect you. Whatever he commands, they do. And his command never changes: It forbids them to flee in battle, whatever the number of their foes. He requires them to stand firm — to conquer or die. O king, if I seem to speak foolishly, I am content from this time forward to remain silent. I only spoke now because you commanded me to. I do hope that everything turns out according to your wishes.’”

“This was the answer of Demaratus, and Xerxes was not angry with him at all, but only laughed, and sent him away with words of kindness.”

–Herodotus of Halicarnassus, Histories

Xerxes rejected Demartus’ advice, marched on Greece and was defeated primarily through the efforts of the Spartans.

%d bloggers like this: