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March 31, 2011

Empowered by Cognition; Endangered by Emotions

Cognition, which has become the preferred term for what used to be called “thinking;” is as close to an exclusively human brain function as there is. That other complex animals have similarly organized brains with rudimentary cognitive powers is obvious; so is the fact that brains are essential to life in virtually all species possessing them because they serve as visceral and muscular control centers. For completeness, it’s also known that as far as thinking is concerned, octopuses demonstrate remarkable intelligence and capacity for learning; unfortunately their aquatic habitat and remarkably short life spans severely limit their developmental potential.

Also obvious to anyone who has studied anatomy is that the human brain is structurally far more complex than those of other mammals, amply confirming its role with respect to the capabilities that have set us apart from, and allowed us to dominate all others: language, consciousness, memory and emotions. Indeed, it is clearly our brain’s complexity- not its size- that has endowed us with our as-yet unmatched cognitive abilities. There is one important caveat however: to the extent our cognitive skills have enhanced our ability to influence our planetary environment, so has our marginal emotional control become a liability that seriously threatens our well being.

At this point, one might well wonder why a blog nominally devoted to “medical marijuana” should concern itself with such abstruse concepts. The reason is that the more my essentially private investigation of the American phenomenon of cannabis prohibition has revealed, the more it has also become clear that it’s both a national folly and an apt metaphor for our species’ most dangerous vulnerability. Ironically, our emotions, the very qualities that enhance our joy and delight at being human, and have been enriching culture for thousands of years- and literature since we first learned to write- are the same ones that lead us to lie, cheat, steal, rape and kill both ourselves and each other.

Although many would still deny it, cannabis is a complex and effective herbal remedy that moderates emotional excesses to an amazing degree (it also treats a wide range of somatic symptoms more safely and effectively than most pharmaceutical products). Sadly; it also has a disgraceful American (and global) history: one of official lies and distortions almost beyond belief; comparable only to our tragic adventure with chattel slavery. Our witless federal cannabis policy has given comfort and sustenance to a succession of fools, frauds, and mountebanks in law enforcement and the Judiciary while encouraging the destructive punishment of chronic users, most of whom were guilty of nothing more than unwitting self-medication to relieve symptoms produced by childhood emotional trauma.

That it's a story told best told by surviving victims in response to the first unbiased medical questioning of them ever permitted should not come as a surprise; but apparently that’s the case... if you have any doubt that self-appointed "experts" remain hopelessly confused, just click on some recently expressed opinions.

Doctor Tom

Posted by tjeffo at 01:43 AM | Comments (0)

March 25, 2011

Annals of Confusion

The war in Libya and the nuclear crisis in Japan remain atop the global news and even further from a satisfactory resolution. On a short trip to the supermarket I heard a snippet on CNN describing how rolling blackouts in the wake of the Japanese nuclear accident are hampering resumption of full production by Japanese industry and could thus have a prolonged ripple effect on the economies of both the United States and Japan. The reason is Japan's incompatible standards for electric power frequency: the Eastern part is on 50 Hz (220-240V) while the West is on the American standard of 60 Hz (110-120V). There are only three facilities for safely transferring power in the whole country; they are complicated and expensive to build, a situation that threatens to greatly increase the economic consequences of the March 11 tsunami at a time when the world can least afford it.

The situation in Libya is also confusing and uncertain, with mixed signals emanating from NATO. Apparently all member nations are on board with a no-fly zone, but some balk at what could be called offensive air operations. However the retired generals working for the various networks as consultants are unanimous that a single unified command will eventually be necessary, however the mission is eventually defined. Further, it will almost certainly become an American operation because we have the largest and most capable military; notwithstanding our continuing involvement in Iraq and Afghanistan.

All of which makes it clear that had President Obama not taken the time and trouble to obtain Arab League and UN support before committing American forces to Libya, the calls for his scalp would now be deafening. Yet, majority opinion also seems to be that Gadaffi's forces were poised to murder thousands, an outcome most would have found intolerable, even though his reign in Libya may still be a long way from over.

Finally; as far as the safety of nuclear energy is concerned, Fred Gardner, in his usual role of informed contrarian, reminds us that the health risks of gamma irradiation were being minimized even before our urgent development of nuclear weapons to hasten the end of World War Two, yet another reminder that humans have typically rushed to exploit the latest technology before its risks were fully understood.

Even though the major reason for our haste since 1946 has been runaway human population growth rather than global war, we remain armed to the teeth, intensely competitive, and just as oblivious to our own cognitive frailty as ever.

Doctor Tom

Posted by tjeffo at 03:39 AM | Comments (0)

March 21, 2011

Two Evolving Crises; no Solutions in Sight

Eleven days after Japan’s catastrophic tsunami, CNN was informing us that smoke is rising from two of the nuclear reactors thought to have been brought under a measure of control yesterday when electrical power became available at the site (shut-off of electricity by the earthquake itself was blamed for the nuclear crisis). Once again, soothing reassurance was followed by a new alarm; a sequence that's becoming all too familiar to an anxiously waiting world.

Meanwhile, in Libya, there is still no word on the condition of Colonel Gadaffi, that nation’s painfully bipolar autocrat whose HQ was apparently damaged yesterday by aircraft and cruise missiles launched by a hastily assembled coalition representing both the UN and the Arab League. What Libya and Japan have in common, in addition to heightened uncertainty, is their disproportionate importance to both the world’s energy supplies, and its economy, obvious facts that seem to have finally intruded on the consciousness of two wide-eyed CNN news readers who began- spontaneously and perhaps understandably- engaging in their own version of “mission creep” by discussing whether President Obama was guilty of that infraction.

Against that improbable background, we were also told that Minnesota’s governor will explore a run for the Presidency, and Wall Street, having assumed Japan will recover soon from its tsunami and start rebuilding, had just added 200 points to the Dow, a bit of news contrasting oddly with the ubiquitous ads from debt relief companies (which may be more realistic). Another straw in the wind is continued news of unrest in the Arab World, most recently from Yemen.

A quick overview of Col. Gadaffi’s history reveals that he’s been a remarkably versatile opportunist who gained control of a sparsely populated oil rich Arab state at an early age and has managed to retain it for over forty years despite (or perhaps because of) his notorious unpredictability. That he is not without his dark side is signaled by his admission of responsibility for the Lockerbie bombing and later payment of a 2.7 billion dollar indemnity.

Carping at Obama by both his liberal and conservative critics for (finally) taking action against Libya misses the point that Gadaffi is not any old despot and Libya is not Rwanda or the Ivory Coast. The US, as the unfortunate reign of George W. Bush so recently demonstrated, cannot afford to go nation building whenever GOP fat cats have a yen to steal from from the Treasury; however those complaining about its cost so soon after the Bush-Cheney debacle obviously have a very short memory indeed.

All things considered, This still shapes up as a better day for misanthropes than for the species; but I'm still looking for that silver lining...

Doctor Tom

Posted by tjeffo at 07:42 PM | Comments (0)

March 19, 2011

PTSD in Slo-Mo; the Pending Humanitarian Crisis

The tragedy now unfolding in Japan is literally without precedent; the size of the earthquake itself, together with the orientation and proximity of the culprit fault combined to produce a deadly tsunami that came ashore in less than a half hour, partially negating much of the benefit of the early warning system; but without it, the toll could have been far worse; or imagine if it had been after midnight rather than an afternoon.

Almost from the beginning attention had to be split between the search for survivors and the evolving nuclear threat; with less attention paid to the disaster’s impact on areas that weren’t affected directly. With each passing day however; the mounting disbelief occasioned by obvious denial from Japanese officials, has combined with the cautious uncertainty of overseas nuclear experts to send disturbing mixed signals. Are we not in the last days of petroleum? Were we not counting on nuclear energy to mitigate a painful transition? What about all the reactors in Japan and elsewhere built over the last 40 years? I remember that in the Sixties, so sensitive were the Japanese to nuclear energy, there were protests against the first planned visit by an American nuclear submarine. A more recent update shows how times have changed: annual sub visits, perhaps numbering in the hundreds, are probably still resented by some; but at least 1/3 of Japan's electricity was nuclear when the tsunami struck.

Many additional factors complicate the current situation. First, inclement weather: Northern Honshu and Hokkaido have a climate that’s similar to Michigan’s and those most affected by the tsunami have lost everything down to clothes, personal possessions, and even medications. Which raises another point: Japan’s rapidly changing demogaphics. As it's become more prosperous, Japan's population has aged significantly. When I was there in the Sixties, abortion was literally the cheapest form of birth control; that situation may have changed, but smaller families have clearly been the trend: Japan now has the highest percentage of elderly citizens of any nation. Nevertheless; because it was already overcrowded in the Thirties, it still has a big population, a situation made worse by its topography. As part of a volcanic chain, the Japanese islands typically have mountainous interiors surrounded by relatively narrow coastal plains upon which the population is concentrated.

In short, Japan's geography and topography, which have been affecting human culture and life style from prehistoric times, will influence the present disaster by making the delivery of relief supplies and ultimate relocation of survivors far more difficult than would be the case in Texas or Oklahoma.

Even more important may be the ultimate emotional toll that will be imposed on the psyche of a proud people being forced to simultaneously recover and bury their dead while cleaning up and rebuilding from within the wreckage of their once-proud economy.

Finally; what may well become the most crucial long-term effect of Japan's disaster will be how the rest of the world deals with the sudden impairment of its overall contribution to the densely interconnected global economy that has been evolving to serve our enormous, still-growing (but deeply divided) human population since two of its cities were obliterated in August 1945.

So far, I see no evidence that world "leadership," let alone our most vaunted institutions, have a clue as they struggle to deal with the panoply of problems that existed even before the tsunami struck.

Doctor Tom

Posted by tjeffo at 03:50 PM | Comments (0)

March 17, 2011

The US & Japan; a Uniquely Troubled Relationship

The Japanese Archipelago is the central part of a longer island chain stretching from the Kamchatka peninsula in the North to the Philippines in the South. Its four largest Islands, Hokkaido, Honshu, Shikoku and Kyushu, have a combined population of 127 million people who have continued to speak their own distinct language; one which is grammatically and structurally as different from written and spoken Chinese as one could imagine, yet its dauntingly complex written form was constructed relatively recently (in the first millennium) from a host of structural elements, all based on ideographs, either borrowed or revised from their closest Asian neighbors. Much of the complexity of modern Japanese is based on the diversity of Chinese which was carried over, apparently unwittingly, thus giving modern Japanese a plethora of ways to express the same idea.

Because of its insular geography and abundant natural resources, feudal Japan managed to remain aloof from European influences throughout much of the second millennium until being literally forced open by intimidation in the form of a small flotilla of modern American naval vessels led by Commodore Matthew C. Perry, who had been sent from America on to establish diplomatic and trade relations.

Thus did a very homogeneous ancient country with an inward-looking feudal society come under the influence by a younger, brash nation less than a century old. Their relationship would ultimately have enormous consequences for both and has continued to be troubled by their cultural and language differences (and not a little mutual suspicion).

The first consequence for Japan was its amazingly rapid modernization. Almost simultaneously, the US preserved its its own pathway to eventual global power by resisting the threat of Balkanization implicit in its Civil War.

Despite earnest attempts at understanding by individuals on both sides, the mutual suspicion between Japan and America continued; flaring most decisively in the Nineteen Forties after Japan entered an ill-advised pact with Germany and Italy which was quickly followed by World War 2, Pearl Harbor, and war with America.

Without lingering on its multiple complex causes, the “Great Pacific War,” as it's known in Japan, forced further change in Japan’s economy and relationship with the rest of the world. Following the nuclear destruction of two cities (the cost of averting an historically bloody invasion of the home islands) the Emperor was retained as a symbol, but could no longer provide cover for a cabal of military adventurers.

The post war occupation was an extraordinary period of rapprochement that has endured since I945 despite several stresses. It was my privilege to live in Japan for four years as an Army surgeon at a military hospital about thirty miles from downtown Tokyo between August 1963 and August 1967. When I arrived, JFK was still alive and Tokyo was preparing feverishly to host the first Asian Olympics. My four year tour in Japan is logically divided into two phases: the first two were like a leisurely small town surgical practice, which gave me a chance to learn a good bit about Japanese culture and Asia in general. The last two were frantic, dominated by America's progressive involvement in Vietnam, during which the US Army Medical Corps played an important, but relatively unchronicled role. Fresh battle casualties were air-evacuated from Tan Son Nhut airport near Saigon to Yakota outside Tokyo as early as four days after wounding. The rapidity of the medical preparations made in the wake of the Gulf of Tonkin Resolution is indicated by the expansion from 150 functional beds at Zama Hospital where I was stationed to 750. The total in Japan eventually reached over three thousand in four separate facilities of which the last became operational just as I departed in August 1967. The project involved "renovation" of three existing structures into hospitals with little public disclosure, either in Japan or America; a remarkable bit of military history yet to be studied or described in much detail. By the time I returned to the US for further surgical training in San Francisco, both the Summer of Love and the Viet Nam war were in full swing and the game-changing Tet offensive was only five months in the future.

It now appears that the ongoing nuclear crisis in Japan will sustain enough interest to excuse a short break from drug policy issues, but I can't help observing that the crisis is as good a real-time example of denial as a characteristic human behavior.

Anxiety is also mounting: as world's economy skates on thin ice, there seems to be more interest in dismissing the importance of Japan's still-unresolved nuclear crisis than concern over the consequences of losing production from the world's third largest economy and the potential conversion of that nation into an economic cripple.

Doctor Tom

Posted by tjeffo at 06:19 PM | Comments (0)

March 12, 2011

Annals of Denial

In less than 48 hours since an 8.9 megaquake rocked Japan on Thursday evening (Friday afternoon their time), it has produced a huge tsunami that came ashore about 20 minutes later on the main Japanese Island of Honshu approximately 230 miles NE of Tokyo and nearly obliterated the city of Sendai (population 1 million).

In stark contrast the the Indian Ocean tsunami of 2004, this one affected an industrialized high-tech nation with the third largest economy and ninth largest population in the world. Japan is also the nation with the most tsunami experience (it's a unique Japanese word).Therefore it played a key role in developing the Pacific Ocean’s tsunami early warning system, (a system sadly lacking in the Indian Ocean in 2004) thus it had early notice; but, because of the strength of the earthquake and Sendai’s location on a coastal plain on the Pacific side of the Ou mountain range, there was little opportunity to mitigate the worst of the tsunami’s damage. On a more positive note, Japan's world-class earthquake preparedness, whetted by the Kobe disaster of 1995, undoubtedly reduced the mortality and morbidity that would have otherwise been produced by building collapse following such a huge quake.

Also, thanks to Japan’s saturation with video and communication technology, the tsumami was soon being shown by CNN on local Bay Area TV almost in real time. That was likely why I overreacted to the near-certainty of a series trans-Pacific waves, for which arrival times began appearing on the internet shortly after midnight, local time. As it turned out, because the major direction of the energy generated (as determined by the obliquity of the undersea fault) was more to the Southeast than due East, the continental US was spared a major hit.

It now appears that the biggest risk to both Japan and the world may be the combined disaster's as-yet unknown effects on Japan’s nuclear reactors, five of which are overheating and about which officials are being typically close-mouthed (shades of Three Mile Island and Chernobyl). Probably because no government likes admitting mistakes, either in policy or in execution, there is a collateral tendency for all to minimize death and damage reports early on. Hopefully the Japanese authorities responsible for its nuclear program can solve their core overheating problems before too long, but we can't count on it.

Because my research has convinced me that humans tend to favor denial to the extent possible and our failing drug war is a particularly florid example, I tend to be pessimistic.

Doctor Tom

Posted by tjeffo at 08:07 PM | Comments (0)

March 10, 2011

Annals of Duplicity

Since 1970, a stoutly defended principle of America’s war on drugs has been that no “drug of abuse” listed on Schedule 1 of the CSA, especially marijuana or LSD (the first listed), could possibly be “medical.” In fact, the adamant refusal of the DEA to reschedule cannabis was what eventually led to a series of 15 successful “medical marijuana” initiatives or state laws now allowing a disputed modicum of medical (“medicinal”) use. This blog has been reporting informally on what thousands of Californians have been telling me since 2001 about their own use of pot. Proposition 215, the first such state initiative to pass (1996) is what allowed the necessary access, but first it had to survive determined federal opposition, before becoming operational throughout the state. There is, to be sure, still strong resistance from both local law enforcement and the federal bureaucracy.

In the past 24 hours, I've come across two unusual items relating directly to the medical marijuana controversy; both to the study just referred to and to an interesting facet of the stubborn federal opposition.

Starting with the study: an e-mail alerted me to a report from the Rand Corporation with a title that is uncannily like that of the paper we'd published in 2007, but which, on comparing the full text of the two papers, proved remarkably different.

No sooner had I obtained a pdf of the Rand paper and started comparing those differences than Google led me to a discovery that was even more surprising: The US Patent Office, also a branch of the federal government, has been issuing patents for cannabinoid agonists since at least 2001.

For those unfamiliar with agonists, they are compounds which enhance the action of a drug by acting at receptor sites. No one had the foggiest idea of either agonists or receptor sites when the Marijuana Tax Act was passed in 1937 or when it was intensified by the Controlled substances Act in 1970. In fact, the relevant concepts only became known about the time endorphins were discovered in the mid-Seventies a discovery that quickly led to the formulation of potent opioid agonists such as Fentanyl and Sufenta.

The discovery of a homologous endocannabinoid system (ECS) followed in the late Eighties and early Nineties.

What puzzles me is how different agencies of the same government can become so ensnared in cognitive dissonance that one is busy issuing patents for drugs that two others insist must always remain illegal.

Doctor Tom

Posted by tjeffo at 08:25 PM | Comments (0)

March 02, 2011

Don’t call it “Victory” yet; but it’s probably the beginning of the end.

In a seemingly abrupt change in federal policy: the DEA announced anonymously and sotto voce over the past week-end that it would allow “natural” cannabinoids to be used by designated pharmaceutical companies to manufacture oral medications. That news was greeted with deserved skepticism by “reform” publications and has yet to even be noticed by mainstream media outlets which remain focused on the spectacular dissolutions of authority now taking place around the world from Madison to Mexico and from North Africa to South Asia.

The DEA announcement was nevertheless, very significant because it represents such a radical departure from cherished drug war dogma that it’s almost certainly the beginning of the end of an enduring policy of failure that began during the Presidency of Teddy Roosevelt, was augmented under FDR, reached its legislative peak under Richard Nixon, and has since evolved into a tar baby with the potential to besmirch the memory of every subsequent White House occupant because all supported it. As confirmation that it has been an equal opportunity federal disaster, all three branches of US government have cooperated in protecting the policy from scrutiny and arguing on its behalf at various key occasions. So also, have its false precepts become so institutionalized within US Commerce and Academia that it’s almost impossible to speak out publicly against it.

We are thus at the beginning of a tedious and contentious argument; one filled with enough shame to discredit the cognitive abilities of our entire species. The good news is that it could also be filled with lessons on how to avoid similar traps in the future. As with the related issues of climate change, and population growth, humanity stands at an important crossroads; we can, as a species, follow the time-honored paths of greed, fear, and mysticism; or we can opt to study the past through the more objective lens of scientific empiricism that has, for the last five centuries, demonstrated repeatedly that relative truth, honestly arrived at, is both safer and more reliable than absolute truth by decree.

The choice is ours; but it must be made as a species if we are to significantly alter history's current trajectory. The good news is that total extinction is unlikely; even if we are slow to "get it." In fact, a series of successive disasters could reduce the number of humans required for rational choices to be made.

In future entries I hope to relate exactly why I see the DEA's concession as so significant.

Doctor Tom

Posted by tjeffo at 12:10 AM | Comments (0)