Corruption of Doctors by Drug Companies

Several books about this have appeared recently and are reviewed by Marcia Angell here. It’s a good review, especially a good summary of the books, but I was really surprised by this:

Members of medical school faculties who conduct clinical trials should not accept any payments from drug companies except research support, and that support should have no strings attached, including control by drug companies over the design, interpretation, and publication of research results.

She expects a researcher who depends on drug companies for research support to be honest? Why? If you don’t get favorable results your grant won’t be renewed. Under this system it will be survival of the most corrupt. A reformer proposed this.

I think it’s a lot like too much humanitarian aid. Supply free milk to a needy area for too long and you wipe out the local dairy industry. Judging from this stunning proposal, the drug companies have wiped out whole medical schools. The doctors who work in them are no longer capable of doing independent research. This is worse than corruption, it’s enfeeblement.

The Four Abundances

Someday, if I am lucky, I would like to write a book called The Four Abundances. It would be about how four incredibly important things that were once impossibly scarce, became or will become, to everyone’s surprise, abundant:

  1. Water. Free and everywhere. So cheap my Berkeley landlady pays my water bill. This has been true for a long time.
  2. Knowledge. I mean general knowledge. Via the Web, reference book knowledge and news is instantly accessible for free. A recent development, although books and newspapers were a big step in this direction.
  3. Health. A future abundance. Health is far from abundant right now. On the other hand, health has improved dramatically during the last 200 years, as Robert Kugel has documented. It is clearly approaching abundance.
  4. Happiness. Another future abundance. I suppose it seems impossibly far off — but abundant water once seemed impossibly far off. Here it’s hard to find signs of improvement, much less approaching abundance. Depression has become more common, not less, during my lifetime.

My self-experimentation has convinced me that health and happiness depend on things that were common in Stone-Age life, just as there was enough water and knowledge during that time. (Now we have more than enough water and knowledge, which is fine.) We need to figure out what those elements are. Self-experimentation provides a way of doing so.

In my little corner of Beijing, transportation is becoming a fifth (or third) abundance. Mostly I ride a bike — my bike was free, costs pennies to maintain, doesn’t pollute, provides exercise, easy to park. For longer trips I take the subway (30 cents/ride) or a cab (a few dollars a ride). Many people take the bus (a few cents/ride). I might get an electric bike for a few hundred dollars. Doesn’t pollute, very cheap per mile, easy to park, little congestion.

I’ve thought about this for months; what made me finally decide to post this was noticing that two little tools I use every day — a penlight and a brush to clean my keyboard — were free, giveaways at trade shows.

My Pleasantly-Strange Trip to Beijing

I am now in Beijing. On the way (12 hours nonstop from San Francisco):

  1. Without asking, my seat was switched to one of the best seats in economy: aisle of the bulkhead row.
  2. Boarding was last rows first. So rational, so easy, no special equipment or software required. I have never before encountered this. Good work, Air China.
  3. A riveting movie, which I’d never heard of, was shown: The Children of Huang Shi, which is a Chinese Schindler’s List. In both Chinese and English, with Chinese subtitles when the characters were speaking Chinese. The best movie I’ve seen on a plane.
  4. The plane was old. Well-maintained, yes, but the film was VHS, the headphone jacks were double-pronged, and my supplied headset was broken. Maybe this is why the price was surprisingly low (about 40% less than the competition).
  5. Midflight, a fly alighted on my book (Traffic by Tom Vanderbilt).
  6. Three times I did my one-legged standing. Seeing me, two others started stretching. For the first time on one of these long flights, I had no trouble sleeping in my seat. (In the past, I’ve been able to sleep well only on the floor.)
  7. The flight was 78 minutes early. I didn’t know such a thing was possible — like the fly.
  8. The Beijing terminal (Terminal 3 at the airport), which opened six months ago, must be the biggest in the world. Nicely decorated with bamboo plants. At debarkation, a sign said we were  10 minutes from Customs. No line at Customs. After Customs, we took a shuttle train to luggage pickup. The ride — within one terminal — seemed about a mile long. I look forward to spending more time there, to study the 72 restaurants, for example.
  9. The trunk of my taxi was perfectly clean.
  10. During the taxi ride, I saw a bike rider. He was about to go from the on-ramp onto the freeway, apparently to ride on the line between lanes. It was a normal unclogged highway, with cars going 60 or 70 mph. I didn’t know such a thing was possible.