November 13, 2022

Another weekend comes to an end with me only having accomplished about half of what I had set out to do. Some of that is due to the never ending stream of electronic health record progress notes I have to write. They take about 15-20 minutes apiece and are therefore impossible to complete during a clinic visit when my attention is supposed to be on patients and their families., leading to a backlog to be finished up over the weekend. This usually takes four to five hours leading to a major dint in my free time. Some is due to my needing to nap every time I sit down and stop moving for more than fifteen minutes. Some of that is due to various social obligations. I’m very good at saying yes to things. Trouble is that means I actually have to follow through sometime down the line.

I’m starting to prep for the show I’m directing after the first of the year, Dearly Departed. It’s another one of those southern fried comedies. It’s darker than the Hope/Jones/Wooten variety, less raunchy than those of Del Shores, and is a favorite of community theaters due to its easy technical requirements and strong characters with a preponderance of female roles. It’s been many decades since I last directed a straight play and we’ll have to see if I remember what I’m doing. I’ve got a visual concept in mind, a way in which I want to approach things thematically, some decent actors on board. I should be OK.

I’ve been watching the hubris of Elon Musk with great interest the last few days. I can’t figure out if he spent $44 billion to acquire Twitter because he wanted to shut it down, if he believes his own propaganda that as an obscenely rich person, he must be smarter than everyone else and every decision he makes must be genius by definition, or if he just stumbled clueless into a business of which he really knows nothing and is trying to figure it out under a very bright spotlight. He obviously did not study the history of the rise and fall of other tech giants such as Yahoo! to see how easy it is to completely muck things up with bone headed decisions and he seems to have the usual right wing misunderstanding of free speech. Free speech means that the government cannot punish you for expressing unpopular or political opinions. Free speech does not mean that every opinion should be given equal weight, especially when some of those opinions are based on misinformation, faulty reasoning, or are pure propaganda. The speed at which Twitter is collapsing makes me think we’re hitting Tumblr 2: Electric Twitterloo territory.

A corollary to the above is the story of Eli Lilly. Musk’s idiotic idea of handing out verified status to pretty much anyone who was willing to fork over eight bucks without actually back checking led to someone posing as the official Eli Lilly account and then tweeting out that their insulin products would be free in the future. It was retweeted and run all the way round the internet in a few hours before it was taken down but not before it tanked Eli Lilly’s stock and sparked a healthy debate as to what Big Pharma in general has been doing with drug prices in general in recent decades. When insulin was first invented and patented in 1923, the inventors refused to profit from it under the belief that the lives that would be saved were more important than their personal enrichment. So why is a drug that was gifted to the world and will be a century old in just a few months costing patients hundreds of dollars monthly? Interesting question. While insulin itself is not under patent, delivery systems, additives, ways of modifying it so as to change its absorbability or distribution in the body are.

Colchicine’s Source

Insulin isn’t the only drug where these kinds of games are played. The drug colchicine, used in the treatment of gout, and around since the time of the ancient Egyptians, used to be exceedingly cheap. The trouble was, that the drug was so old that there had never been any real scientific study of its effectiveness. The FDA was going to take it off the market as unproven until a drug company stepped in, did some studies, and showed it worked as expected. The FDA then allowed the company to exert patent rights over colchicine and it is now their exclusive and proprietary property. What was pennies is now many dollars. The common asthma drug, albuterol, had a similar fate. It was generic and cheap for quite some time. When chlorofluorocarbons were banned as aerosol propellants due to the destruction of ozone a few decades ago, that covered albuterol inhalers. The propellant in the cannister had to be changed. As the delivery system was now ‘different’, it allowed pharmaceutical companies to reclaim exclusive rights and it went from cheap generic to expensive brand only overnight.

Covid numbers, both locally and nationally, remain about the same. That’s not necessarily the same with international numbers. There’s been a significant increase in China with their autocratic government imposing more lockdowns and restrictions to bring things back under control. As several of the important industrial cities are included, this means that we will likely continue to have issues with the supply chain of manufactured goods for the foreseeable future. If you need to replace any of your consumer electronics, do it now. My next out of the country trip, coming up in about six weeks, is to the UK. They’re numbers remain relatively low so hopefully there won’t be any serious issues with that trip coming off, having already been delayed by a year.

Time for me to get up from my writings, get dressed, and head out to the next social obligation. A fundraiser for a local theater advertised as a sneaker ball. Dress formally but wear sneakers. I think I can handle that. I’m also wearing hand sanitizer and have a mask in my back pocket should I not like the ventilation available at the venue.

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