Monday, December 31, 2007
Saturday, December 29, 2007
Friday, December 28, 2007
Christmas tussles
An observation on Christ and the Church: The Christmas Mass has a nice reading from Isaiah on the arrival of Emmanuel, born of a virgin. Rabbi Zimmerman remarked with a 'don't let this get out' kind of expression once that the Catholics had mistranslated the word they were taking for 'virgin.' In Hebrew it may mean just 'young woman.'
Catholicism has high standards for marriage and sexual relations. In 1st Corinthians, Paul answering the question what it takes to be Christian starts out with a 'proper marriage.' If your spouse leaves, you're stuck with having to get an annulment. I wonder if the severity doesn't really start with Mary (or center on her).
An, in a sense, competing line of justification for the Kingship of Jesus falls on his being a descendant of David. This is competing in my view because, if the Holy Spirt was the father and not Joseph, then where's the line of descent?
Catholicism has high standards for marriage and sexual relations. In 1st Corinthians, Paul answering the question what it takes to be Christian starts out with a 'proper marriage.' If your spouse leaves, you're stuck with having to get an annulment. I wonder if the severity doesn't really start with Mary (or center on her).
An, in a sense, competing line of justification for the Kingship of Jesus falls on his being a descendant of David. This is competing in my view because, if the Holy Spirt was the father and not Joseph, then where's the line of descent?
Sunday, December 16, 2007
Tuesday, December 11, 2007
Saturday, December 08, 2007
Candide and health care
Candide was famous for saying 'all is for the best in this best of all possible worlds.' Megan McArdle has a blogpost which has devolved into 'efficiencies' and 'minimum standards.' This puts me in mind of a patient who was happy with what we did. It developed that he 'had an income of $24,000' a year. Though he said 'he needed to get cheaper medicines, his previous psychiatrist had continued to prescribe him Risperdal.. which had cost him $700 a month.' I was prescribing him perphenazine and lithium and 'he was now able to afford a car.' He also appreciated that I charged him $60 a visit; most doctors would have charged him more (though insurances wouldn't pay more). I added cyproheptadine which because of its serotonin 2 receptor blocking action will, in combination with the perphenazine, make this Rx set like Risperdal. The same day I wrote a prescription for Abilify, the most expensive antipsychotic, for a Medicaid patient. I had sent this prescription in electronically with a refill some 3 months ago but the state makes you write it out. He has a developmental propfschizophrenia and his mood and interest are better on this than cheaper antipsychotics. The state tries to discourage me from writing it by insisting that I literally write it each time rather than provide it any other way. I was thinking today, well was this unfair that the man with the limited income had less expensive medicine than the person totally dependent on the state. Overall I don't think so because both are getting a very satisfactory treatment. If the state were paying for both though, I think some further way would be found, as hinted at in my second patient, to degrade the potential treatment of them and others.
Tuesday, December 04, 2007
A New York visit
Really enjoyed New York a few weekends ago. The New York Public Library was surprisingly fun. They had a Kerouac exhibit which included one of his letters or essays, Who is a Reactionary?, written in the 40's. Among the criticisms in it were of Stalin or Russia which banned the works of Dostoevsky because he believed in God. There is a room of oil portrait paintings, many Astors, apparently the library was initially an Astor philanthropy, including an Astor (as modern aristocracy) in a Navy uniform. There is only one bust and that of Raoul Wallenberg, the man who as a diplomat provided many hundreds of Jews with made up parers to escape the Nazis and who himself disappeared at the end of the war into a Soviet concentration camp apparently dying in one in 1953. There is a portrait of the son of Alexander Hamilton. In one of the nearby reference rooms I ran into a book reviewing Southern novels which talked of several from the twenties and thirties which expressed the pain of small town life in its religious intolerance and materialism; thus the authors difficulties in finding empathy.
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