May 29, 2020 Covid 19, Freedom Phase 1

Covid 19 continues to spread. Herd immunity may be less than previously thought. Normally 60 to 70% needed with the exception of small pox which required 90%.  Sweden already saying they may see herd immunity at a lesser percentage and may meet 50% by summer.  The westcoast of America and Canada is already at 20 to 30% contact with young people having 1/10 the risk and old people over 65 with existing medical illness still facing 10 times risk of illness. Death is rare from Covid 19 alone.
In the US because Covid 19 deaths are paid so well and do not require definitive dx, ‘natural deaths’ stopped in February  A very funny meme shows the NCIS team noting multiple gunshots and knife wounds but concluding death by Covid 19.
Belgium and the European Union centre continues to be the greatest failure bureaurcratically in the west.  Taiwan remains the best performer.
The WHO was bought by communist China and Trudeau in Canada is working for the Communist Chinese Military promoting abortion and injecting Canadians with abortus products. Really, Truth is stranger than fiction.

I’m moseying along.  I really was afraid when this began.  Now I’m no longer afraid of the disease. The doctors and nurses in BC have been incredible. UBC is an outstanding medical university.  I used to work at VGH and truly loved the hospital and staff.  Royal Columbia is a great place as well.  So if I get sick and I need to go to hospital I really believe I’ll get the care I need here to save me. Or it will be my time.
I’ve lived a long and beautiful adventurous life beyond my wildest dreams. When I was a country GP and old people came to the hospital to die, we called ‘peumonia, the old man’s friends’.  I had very peculiar flu in the spring that had me taking time off work, fever, horrible cough and the feeling I couldn’t breathe for the first time in my life. It appeared I may have had Covid then.It’s been in North American since Jan. I may have antibodies to Covid already like so many people. No need for a vaccine if you already have had the disease.  That's the science. But politics, economics and greed may change reality. When people had cowpox they didn't get small pox.  That's all in the history of immunology but today the 'winner', the 'wealthiest' writes history.  Wikipedia is so often propaganda.  

I’m looking forward to the antibody testing that’s begun in BC.

Dr. Bonnie Henry has done brilliant community medicine and public health work. I did a dual speciality in Psychiatry and Community Medicine, completing 2 years of Community Medicine and Public Health but chose not to continue and do two residency exams, opting for only Psychiatry.  I later had the honor to work with the CDC.  The CDC has a major outreach in the Northern Marianas Islands. It’s associated with the American Military there because Asian diseases first are seen in Guam and Saipan. So when I worked with the hospital the CDC had us do various emergency scenarios. First and only time I’ve worn a hazmat suit.  Not pleasant. I cringe when I see doctors geared up these days. I’ve always wanted to be a space man but I don’t like the suits. Something light and sexy please?  

I’ve had several patients become suicidal in lockdown. A couple have become psychotic.  Major panic attacks.  Lots of worsening depression.  One case of violence.  Several family break ups.  Major relapses to alcohol and drugs. Initially the drug consumption went down because the dealers couldn’t get at their prey but they rapidly adjusted.  The ones already into delivery expanded. When the churches and schools closed and liquor stores and pot stores stayed open the writing was on the wall. Government gets a cut of the booze and pot sales but not so much from God. This government has indeed been satan’s child.  Trudeau is definitely C.S. :Lewis’s Wormwood.
I believe I'd done a lot for keeping some patients out of hospital and truly believe my virtual work has been very beneficial. I've continued medications, started and stopped medications, and made medication adjustments. Because polypharmacology is merely 'thinking' it's been easy in virtual. Also assessments have been easy. The hardest has been therapy with people I've never seen.  I have however found psychotherapy with patients I've known has been just fine.  I expect I'll have a mixed practice in the future or if I do just do virtual will limit my practice to those areas which are most amenable. There's an edge in virtual and I'm not as sure of the understanding. It's even worse where the other person is culturally different or has ESL.  People don't realize that humour simply doesn't translated culturally and loving, caring emotions are subtler.  I don't feel my warmth comes through and fear I could come across cold as people do on television.  So easy to be 'flat'.  Yet psychiatry is all about dimension.

Islam is the religion of peace when all the world is Islam.  Communism succeeds when all the world is communist.  Todays’ UN promotes Sharia Communism and like the alliance between Communism and Fascism and the Japanese Emperor and National socialism (Nazi) of Germany, the same confusion goes on to day with politics making strange bedfellows.  

Just like Justin Trudeau bought the CBC News , so Xi Jinping bought the WHO.  

Freud did say ‘maybe the paranoids are right’ when the Nazi’s came for him.  The UN continues to call for the annihilation of Israel and the death of Jews. Trudeau continues to attack Christians and countless young Christian women continue to defend him because he has pretty hair.  I am reading a thriller where the new Caliphate takes over England with all the sleeper terrorists creating chaos so the British can’t respond to the invasion.  The genocide of Tibet is never discussed today.  Neither is Culloden, nor the Magna Carta. History forgetten is doomed to repeat itself. I feel like I’m living in 1939. It really is 1984.  Trudeau a 17th century fop declared it was the 20th century sometime in ancient history before he said the balance would balance itself and people realized that he’d never learned to count.  He was busy as a teacher fondling teen girls.

I like wearing skirts. It’s Scottish or gynocentric.  I may switch to shorts.  Pants constrict. Women are all transvestites.  Men still dress for war. I wandered into the sarong as a sailor and in the tropics lived in shorts or a short wrap. I should have been a pirate. Now that summer is here I’m outside waiting for Laura to come over for the weekend and rescue Gilbert and I from the boredom of being male.  I really do seriously think of having a sex change because I'm weary of male existence.  I've been cuckolded and castratred and rape and everyone has a monopoly on suffering. I loved the book, black like me and now am enjoying reading the journey's of transexuals.  I'm glad the 72 genders disappeared overnight but while I was all male into my 40's, I've slowly got tired of being pilloried for doing characteristically male things, like sailing, hunting, fishing, caring for others.

It’s hard waiting for economic collapse, more taxes, trust fund baby palace shots and rumors of war.  The Chinese Communist Party just shot down a Vietnamese fishing boat and mock attacked others in the Chinese sea.  Imperialist China.  

I was explaining Erickson’s developmental theory to a patient this week, pointing out that young adults go through a naturally occurring ‘identity’ crisis in the 20ths century and beyond. In the past there wasn’t the freedom we once had here.  Jesus was a carpenter like his father.  But at 20 I could be anything. I was straight A’s in university Arts and Science despite being expelled from high school.  I started out in theatre and dance and ended up in surgery, then medicine then psychiatry.  It’s been a weird journey.  Three totally beautiful wife all with one thing in common, insaniety, evidenced by marriage to me.  Today I have a girlfriend of 20 years despite having had male and female friends and giving up alcohol and pot 22 years ago when my wife’s cocaine addiction turned life into a nightmare. Trump reminds me of an old used car salesman of my grandfather's era and I believe today my grandfather's would be hated as much as he was. Mr. Harper reminded me of my father and he was hated too. I've actually been as flaky and ridiculous as Trudeau when I was drunk and stoned and all the girls loved me then. Today I see the hatred of Trump as principally anti male and anti american.  I'm obviously not a full fledged heterosexual but I've watched the government chastise those I've known who were the greatest doctors and family men. I've watched Christians be crucified. I'll never forget a friend saying, 'when rape is inevitable you might as well lie back an enjoy it'.  Obviously men can't fight anymore and women won't take care generally of more than themselves and their children, men historically the protector of family and community.  But that's gone. The new immigrants and other cultures do put their colour and themselves first. I've not done that with Irish and Scottish heritage folk or with 'white' people. I've helped everyone equally and seem to lack this intrinsically beneficial tribal gene. It was noted in my residency by my teachers that I treated everyone the 'same'.  I know that's really upset the rich and I've been punished by my governmnent for not preferentially treating the wealthy and powerful 'better'.  I've been told repeatedly by powerful colleagues that I'm 'wasting' my time with 'losers'. I've wasted my life by those examples but others seem to think I'm okay and I really believe in the eyes of God I'm passing. It's not even pass fail.  But I'm passing.
  

My grandfather , a rancher and a farmer, didn’t care if someone drank in the winter but he considiered everyone who drank in spring, summer and fall an alcoholic. An alcoholic (and by extension an addict) was anyone who did alcohol when there was work to be done. Like my Vietnam vets who didn’t like people using in fox holes. They were either too stoned to hear the enemy or too panicky they shot and gave away their position. It was okay to be stoned on off base R&R time.  

All the hit men and enforcers and prostitutes I treated said they had to do drugs to do their job.  I was thoroughly impressed that Mr. Harper and Mr. Turner weren’t impaired. I did a study of dope smokers and they all thought they functioned well enough but didn’t want their pilot or neurosurgeon smoking pot. It didn’t matter that pilots and neurosurgeons don’t like their hairdressers or Prime Ministers stoned. Kennedy was on pain medication with his only peculiar physician.  Hitler was on Speed and Heroin.  President Trump was on Hydroxychloroquine. Obama admitted to doing cocaine and wasn’t in office.  

When I meet St. Peter I’m going to watch a whole lot of reruns of world tv in heaven with people much smarter and in the know than me telling me who was paid by who. They’re going to have politicians and scientists colour coded with which corporation was paying them how much.  Canada’s elections were heavily influenced by foreign money.  

It was once good enough for a politician to be paid by the salary.  Obama though entered with 1 million dollars and left with 100 million dollars.  Today politicians see their salary as the wage the waitress gets. The real money is in the tips. It’s all institutionalized baksheesh.  

I’m paying the rent.  I’ve clean clothes en femme and au homme. I would live a whole lot cheaper if I was in the south where all I needed was shorts or a rwarp. I miss my sailboat and tropical winds. I’ve got all the electronics I need.  My dog has a heart condition but meds are keeping him going. My back always hurts but a whole lot worse since I stopped NSAIDS. I was so thankful for the adjustment I got last week. I think I experience tension in my back.  We have places where we somatize.  For some it’s headaches. Some it’s necks. Some it’s bellies. Mine is my back. I carried so many people and so many people’s shit when I was young and naive.  Now I don’t do any lifting. I’m trying not to crash any more vehicles which I really can’t blame on anyone else much but myself. If I’d walked and avoided the first bicycle I’d probably have no back pain.  But I love speed. Looking forward to riding the harley around on errands later today.

Life is good really.  It’s all about seeing the glass half full. I pray and meditate and try to exercise. The greater my faith the better life is. I’m also good if I live in the day. I don’t know what’s going to happen tomorrow. I don’t know what’s happening in a week or months. The weather man is no better than my own predictions.  Al Gore sure knew that the Arctic Ice Cap would be gone and he’s a multi millionarie today. Maybe I should say that the Toronto Maple Leaf’s will win the next NHL and I’ll become a millionaire. I don’t know what the formula is.  

I’m continueing to try to do what is right, help people and work with my community.  I’ve always been a good citizen even if I did party hearty when I left the front and had vacations. i wasn’t impaired at work and certainly was more present than so many in my day.  I have been shamed and humiliated. I was punished the most for doing the right things. I have been beat up falsely accused lied to and true sociopaths in the governmnent and in my leadership have literally got away with murder.  I have also seen that the most of the people I’ve known have been pretty amazing. So why do I have this kink in my neck that holds onto the resentments. I’d rather be pollyanna and have cherry glasses. I want to know joy. I want to see the past as lessons and I know that God was always there with me.  I have to trust God more  I have to love more. I have to dance more and maybe then my back would feel better.I’ve got to relax. I”m really looking forward to camping and swimming and fishing.

I love the sun today.

Thank you Jesus.  Hallelujah!

An Ethiopian Planning To Visit Canada

“Aren’t you afraid to go to Canada, “ Beca asked her friend Solomon. They were sitting in an Adis Ababa coffee shop talking.  Both were in College. Solomon had told Beca he was off to Canada to take a course at UBC

“I’m going to Vancouver in western Canada. It’s not like I’m going to Eastern Canada or the north  where there’s people freezing to death. That’s where all the crime we hear on the news is from too. Quebec is ruled by  biker gangs and mafia.  Not  Vancouver.  All they have there is money laundering in all their casinos. I’m not going to the casinos. “ 

“But they have pit bulls running in the streets of Vancouver. I read that. ” Beca said.  She really liked Solomon but thought him too sensitive and naive. Beca was a model as well as studying fashion at the college.  She didn’t think westerners had any sense of colour.   

“I heard they’ve taken care of that problem.  I’m still worried about the Beaver Fever though.” Solomon said seriously. He planned to see a travel doctor too because he’d heard they had outbreaks of measles because of all the anti vaxxers.  It really wasn’t safe for an African to travel in Canada anymore. Tuberculosis, Syphilis  HIV in the Red Cross blood supply, Hep C. All the drug addicts dying from overdoses.  Hospitals completely turned over to Heroin injections sites.  He really wished he could have gone to another university but UBC  was the one offering the course he wanted counselling gay men. 

“Are their beavers running around the streets biting people? “ Beca asked. She wasn’t sure what a beaver was but thought it sounded rude for some reason. “There’s huge black bears in Vancouver . I read that. They’re on different streets than the pit bulls and beavers probably.   There are  big cats too they call cougars killing the children and dogs.  They say the cougars chase the young men too.  ”  Beca was horrified  just thinking about Canada. She really hoped that Solomon would change his mind and go some place civilized and fashionable. 

‘I think it’s okay if you only go out during the day.” Solomon said,  “ It’s just like here in the rural towns. . You only have to worry about the animals mostly at night.” 

“ I read the bears and pit bulls are out in broad daylight. Outside of the city they  have polar bears so the people living in the igloos can’t even go outside at night.” 

 “ I’m not going outside of the city, Beca.  It’s winter there now.   I don’t want to have to get the boards everyone wears on their feet there. I saw them on pictures in Whistler. It looks very awkward. I know it’s  a really backward uncivilized place  but I’m not going to take any risks.   It does look so pretty on the television. I just don’t know why all the  white women wear yoga pants, running shoes and  back packs. It’s like  they’re always ready for some emergency.   I think it must be the earthquakes or maybe a tsunami they’re afraid of. “ said Solomon thoughtfully. He was sipping his Ethiopian coffee and realizing how much he was going to miss real coffee. He couldn’t imagine what swill they served in such a place.  He’d heard they had an Ethiopian restaurant called Axum so he hoped he’d be able to get some decent food and maybe they’ve have real coffee.  He worried he was going to have to eat bannock and moose the whole time he was there, whatever bannock and moose was. . 

“I think it must be the poverty, why the women all have back packs.” Beca said. “  We have poverty in Africa but there’s way more poverty in Canada in the CBC news.” Since Solomon said he was going to Canada she’d downloaded some CBC news podcasts and thought the poverty must be awful especially since everyone was so old and no one took care of the old people but just euthanized them. “ I think the women are carrying food in their back packs.” She told Solomon.  ‘So many of them are obese. I don’t think they share their food with the children like we do.” She continued. .

“I don’t like the men, Solomon. You have to be careful.  On the feminist Utube channels all the men in Canada are violent rapists. Every woman in Canada is a rape survivor.    I’d never go there as a woman.  I’d rather go to Saudi Arabia.  Saudi Arabia was elected head of the Women’s Rights Committee for the UN. .   Canadian men are rapists and bullies.  It’s  no wonder all the Canadian women abort their babies. They’re trying to get civilized families now from Africa who like children to move there. I’d never move there. How can people hate children so much.? “ said Beca. 

“You know me Beca, I’d like to go anywhere else but that’s where the course on counselling   gay men is being held.   Gay men are in the government and heads of churches there. That’s better than here or anywhere else in Africa. When I graduate I want to help the gay men here. The Muslims are killing them but the Christians still lock them up.  I want to help them Beca.  At UBC the course I’m taking is about helping gay men. If I’m going to be a counselor I want to be able to help them. We have no courses at the university here about counselling gay men. We have gay men, even in government, but no one admits it.” 

“I know Solomon, you’re such a big heart.   But we don’t have as many gay men as Canada.  Look at their Prime Minister in the gay parade with his tongue out.  Ethiopian men are virile..   Ethiopian men love their children.  Canadians are gay.  They don’t have any testosterone in the west.  I think it’s their food.  Ethiopians who have eaten Canadian say the food is awful.  No spices.  And everyone eats with forks and knives like they don’t want to touch their food.    Ethiopian men,  since we got rid of the DERG Red Terror communists killers and pigs,   have all been really intelligent,  Ethiopian men are gentlemen. They love their families. I loved when we had  Emperor Haile Selassie.  Canada’s never even had an emperor. They haven’t even  had a king or queen. They’re as immature as the communists.  Everyone is a worker with only the elite having all the wealth like the DERG..Canada’s a backward country.   I don’t think you can learn anything about culture from them. They don’t even eat with their hands, that’s how backwards they are.  And don’t even think of going swimming in the bay there. I saw on the news they’ve got  sharks and killer whales right in their bay.  I worry about you, Solomon. This is a really bad idea to go to Canada. You should go someplace safe like South Africa. They’re only killing white farmers there and the universities are better than what Canada has, even this UBC you think is so good because of it’s medial school and counselling.”

“I’m going to be okay, Beca. . I’m just going for a few weeks. I’m going to do this one course for counselling gay people.  I’ll be right  back where it’s safe and people love each other, before you know it.” Solomon said , trying to reassure her all the while wondering what was he thinking when he thought he’d go to Canada. There were no courses at the University of Addis Ababa on counselling gay men, that’s for sure. But Beca was right he could have gone to South Africa. The universities were the best and it was a lot safer and more civilized than Canada.

‘I hope so, Solomon. I hate to think of you being bit by a beaver, gored by a pit bull,  attacked by one of their  bears or cougars or have those gangs of violent Surrey men  shoot you.  I hope you’re not travelling on a bus either.  I read a man was just sitting on a  bus when another Canadian passenger  chopped off his head with a machete.  They put him in hospital then let him out..  I don’t know what they did with the guy whose head went rolling down the aisle of the bus.  . Then I heard another story  a  terrorist who killed the American medic and  the gay clown Prime Minister paid him $10 million dollars. Our government leaders in Ethiopia wouldn’t  payAl Shabaab terrorists if they killed Americans.  Canada is  a terrible dangerous  place, Solomon.  .  I don’t care if they don’t care who you have sex with it’s not safe.  There’s too many Canadians there. I’d rather you come with me to Saudi Arabia or South Africa where it’s safe.  “ Beca was close to tears pleading with him then.

“I know all the whites in Canada  are racist and the men are all rapists and bullies but the UBC professor whose putting on the course is from India. He assured me  its safe for a black man in UBC. He told me that Vancouver isn’t like Toronto. Black Lives Matter was in Toronto demonstrating against the police which are the most racist police in the world apparently. The Toronto police and the RCMP who ride horses are worse than the Africaner apartheid police used to be.  But they’re all in the Eastern Canada.  The police in Vancouver don’t even have cars. They ride bicycles.   It’s not safe for a black man  in Eastern Canada  but Vancouver is mostly Chinese.  I’ll be okay Beca.” Solomon said.  “I ‘ll call you on my cell phone and send you pictures”

“Are you sure they have cell phones?” Beca said gathering up her lap top and finishing the last of her fine Ethiopian coffee.

“Yes, Beca, they have  cell phones.” Solomon wasnot completely certain but was hoping they did. .  

Bioethics and Psychiatry, British Columbia

A young physician joined a research facility.  A number of physicians worked there. The head physician had been 'star' in his day. His research was mostly on new medications. He was well financed by  one drug company in particular.  The trouble was getting patients enough for his drug studies.
He and some of his colleagues addressed this problem by 'broadening  the "diagnosis".  Though the disease category wasn't 'cancer' it could well have been. To recruit more people for his research he included people who would not traditionally have been said to have 'cancer'  These "healthy' recruits would further 'dilute' the side effects of the medication and allow for better outcomes.  It did subject a whole lot of people to unnecessary toxicity though and in addition could cause some people without other disorders to be given simply the wrong treatment thereby missing the right treatment for their 'correct' diagnosis.
The young researcher was suspicious of this and raised his concerns early. The head researcher explained this away and used a lot of 'attitude' and 'dominance' behaviour to make his point. This of course concerned the young physician even more because people who depend on the gun don't usually have any better argument.
Using the 'local' research criteria the young researcher diagnosed a man with the condition.  The man was indeed sick with this particular condition that could affect his judgement. He was offered a position in the research trial.  When he balked the head physician came and essentially sold the man on the research.
In selection for research people can be recruited for pay, or be offered a position, or have the pros and cons explained and an advocate or family member included to help in the decision. The young physician having had some research experience before joining this community had been exposed to a much different and  more 'patient centered' approach to selection.
In this community however  there seemed to be a real 'drive' to get patients enrolled in programs.  At the time the young physician never thought that there might be incentives associated with this. He'd worked in sales to pay his way through undergraduate studies and he actually saw patients being 'sold' on being part of research that really wasn't likely to benefit them and might well not provide any benefit for the world as a whole. The interactions were distinctive to those trained in process.
Of course this is also all hypothetical and fictitious. In medicine it's said that hindsight is a proctoscope that's 100% perfect only because it's in the hands of assholes.
That the man would be treated with the research drug and die as a result of the wrong diagnosis and wrong treatment could well have happened to anyone. Medicine isn't an exact science.  Mistakes occur and only after death does one recognise the errors.
Usually after death, though,  especially suspicious deaths, there isr a post mortem. This can be a physicai post mortem done by a pathologist and it can also be a psychological post mortem done by the staff. The head physician ensured that neither was done confirming the young man's concerns.
The young man followed the old man's directions because he was  senior and more experienced. The young man  never even speculated that there was conflict of interest.
The experimental drug didn't work.  The research failed.  The man died.  Usually, having an experimental drug is sufficient cause for more intensive investigation of the factors leading up to death.
The young physician had  pleaded with the older more experienced physician but had been  silenced repeatedly. The young physician questioned the diagnosis and questioned keeping the man in the double blind research trial because he was clearly deteriorating and death was imminent.  In those days the young physician was known for being very diplomatic and respectful of authority as the young and highest trained from the finest institutes are.
He'd never encountered such a problem before and didn't know what further he could do.  There was no one, he believed, more senior he could take his concerns to. Further the young man had already been told that that he wasn't considered a good  '  team player".  Being a 'team player' was indeed the highest praise one received in this hospital research institute and perhaps this community at large. .
He sadly learned later from other researchers  that there were many discrepancies and other deaths had occurred . No one spoke up because that was considered unprofessional. The doctors in this community appeared to put the greatest emphasis on professionalism and a lesser emphasis on such matters as patient life and death, , truthfulness, transparency, patient advocacy, patient's rights or any number of considerations that might well have contributed to saving  the man's life.
Further, there was no place in the university for anyone who bucked the system. The hierarchy in research was sacrosanct and the grand man was politically well connected. This hierarchal problem is central to 'systems research' and the study of why corruption is so wide spread in some communities.  For example, the success of the Japanese car industry at one point was the result of a letter box which was solely read by the CEO of the company and open to be used by all employees. Prior to that innovation in the 'system' was blocked by middle management and yukuza who simply removed any one who suggested change in the existing system.
The reformer is the enemy of anyone who benefits from the status quo.  Only the CEO and Board were specifically interested in the quality of Japanese cars because of world wide competitiveness whereas the lower level managers were only interested in their jobs remaining unchanged with all the privileges and perks in tact.
The young man wanted to do something but exhausted all avenues except whistleblowing. Whistleblowing is not taken lightly by professionals.  It's essentially committing suicide to bring attention to someone being murdered.  It's like Tibetan monks who pour gasoline on themselves and ignite it.  Whistleblowying in Canada is routeinely punished.  In British Columbia whistleblowing is crucified. So it was not something to be done lightly.
The young man in the end had  refused to  make the unsavoury decisions alone and insisted that the old man attend the patient and give the orders publicly rather than the young man doing what he no longer believed in alone and in silence.  The old man was furious with the young man for this refusal to cooperate but saw the patient and publicly gave the order which caused the patients death.
The patient died.
The young man not trusting the older , came into the hospital and copied  the file.  The next day he learned that the old man was saying that the patient had died through an error of the young man's.  Further, the chart was suddenly missing and the orders of the old man were expunged from existence. The research assistant later said that the research data was all re written too.  It had been done before when people had died she told him.  Crying she said I can't say anything because he'd ruin my career if I objected.  He learned that several of his colleagues had been directly involved in this sort of thing unbeknowst to him.
Everyone has heard the adage, you can't make an omelette without breaking a few eggs.  No one higher in the food chain was ever concerned about such matters because they had their own skeletons in their closets to worry about.
The young man simply left the hospital. He didn't want to have anything more to do with the old man or with the colleagues whose behaviour, specifically sins of omission, contributed to the deaths of patients. As he put it, "I just wanted to play hockey. I didn't know that I'd joined a bush league run by the mafia. " He never lost his love of hockey though.
He later learned that the research funding had further caused the senior man to have a conflict of interest because there was serious support for a particular outcome measure in the research.  Alot of money apparently was involved not in finding  if the drug was good or not but solely in proving this drug was good and extending it's distribution potential.  The particular drug company involved did not itself have a good reputation.
The young man did not know any of the history of the trend of the very government  appointed beaurocrats to choosing sketchy low cost  suppliers rather than reputable institutions.  Deaths of patients could therefore be likened to the crashes of airplanes that occured increasingly because maintenance was being done by low cost knock offs rather than the specified parts the manufacturer required for wings and engines.  A patient's death could always go by quietly but airplane crashes attracted attention.
The difficulty for young doctors  in primitive barbaric systems is that they are so dependent on the context of their situation and lizards have long been known to eat their young whereas mammalian species usually care for theirs.
The young researcher left the hospital  and returned to general practice.
He was subsequently approached by a  former senior colleague to come forward and speak out against the head and tell the truth about the death of the patient,he was was less than keen.  He felt he was out of that system and had nothing further to contribute.  .  The colleagues who approached him and begged him for his assistance  said that they could not do it as their careers and positions with the university would be jeopardized if they did.  They said that the old man was crazy and killing people and it was his duty to stop the carnage because he had the evidence and could make the complaint.
He discussed this request with a colleague.  The colleague said simply, "I've known that man who wants you to do this  for many years. He's a psychopath.  He is playing on your goodness and doesn't care for anyone but himself. He lacks empathy. He hasn't the capacity for love. He's a chameleon but he's still a lizard. "
Women doctors who he'd formerly worked with also approached him and begged him to help them, his female colleagues.
So he wrote the letter.
The letter caused the head doctor to lose his position. He was deposed by a jury of his peers who felt his behaviour was wholly 'unprofessional'. .
The young physician was never forgiven.  The other senior colleagues who'd 'used' him went on to high position. The woman colleagues never looked him in the eye again. ..
At the time the young physician thought there was still nobility in his colleagues  and that he was duty bound to stop the unnecessary death which was continuing. At the time he never suspected that the persons who were asking him to make the supreme sacrifice  were indeed only hoping to get the old man's position.  He personally knew of no conflict of interest that he had.  Thanks to his teachers and his family and their values he was quite simply most interested in doing what he thought was right, helping out and helping ensure better health care for patients specifically and in general.   Otherwise  he happy to be hunting and fishing and working in his private practice. He figured he'd do research elsewhere if the opportunity arose but he wasn't going to do research locally given the lack of regulation and the tendency of governing bodies to either be themsevles corrupted or simply wholly negligent.
The longer he was in the community the more of a political Sodom and Gomorrah it appeared.
It was at this time that national and international regulatory bodies were refusing to certify the provincial institutions in general. The greatest calamity of the decade was that the Vancouver Stock Exchange lost it's license to practice due to gross corruption. The business community en mass was considered so criminal it lost the right to self government. For years thereafter it only ran with supervision of the Toronto Stock Exchange.  The government in general was notorious for questionable practices which explained why everyone called this the 'wild west'.  A day didn't go by in his office where some patient wasn't being harmed by some group of shysters and their government affliliates like those in the infamous 'leaky condo fiasco'.
Even when MLA  Moe Sihota caught the Attorney General and Premier doing dirty deals over their cell phones, the Premier and Attorney General tried to have Moe Sihota arrested for 'eavesdropping'.  They subsequently brought in a law that would severely punish anyone who exposed graft in government. I was shocked that those caught red handed seemed quite content to accuse the accuser. It was with great admiration I watched Moe Sihota avoid imprisonment.  What seemed significant was that no particular 'party' was alone in dirty tricks.
Everyone was complicit at the time in no end of lawlessness that was occuring partly because of the great growth in the city and province and because of the wealth that was flowing through the great port. The principal agricultarl trade of the community was marijuana and all manner of individuals in all levels of government were somehow involved in the multi billion dollar industry.  The city was further one of the principal avenues of heroin into the US with millions of dollars of profits dispersed through the community.
The logging companies were clear cutting and lying about replanting but at least paying taxes whereas non tax paying  fat cat marijuana criminals were planting acre large plantation in the clear cuts left by the logging companies .
The business of the administration and promotions were made for those who would 'turn a blind eye'.
Conflict of interest was the norm. Further, greed was the community pathos.  With rising costs of living and declining pension potential everyone seemed to be scrambling and no one was interfering in how their neighbour went about survival. Mad men and mad women dominated the landscape.
What was interesting was that they didn't tend to go to church as much after their deeds of dubious treachery and barbarianism, they as often as not showed their hypocricy by seeking social support for their age old villainy in psychological and philosophical theories that would justify their venomous behaviour.  Social darwinism was all the rage along with pursuit of happiness at all costs.  In this age of narcissism there were all manner of drugs illicit and medicinal which could be guaranteed to remove any insomnia or depression that might have once made guilt and shame more unbearable. Sympton management was all the rage.
The young man thought that his colleagues  decisions  to remain mum, and protect their careers, appeared to him to suggest they were like  thieves in a den, not willing to question a thief among them, All manner of shady things had been going on at the time which he'd found offensive but none had caused the unnecessary death of a patient.  So he wrote the  letter which was used by the hospital and university authorities to depose of the  great man.
What the young man didn't know about office politics was that he was just a tool in a greater conflictt, carelessly and stupidly used to remove an opponent.  The puppet master, another drunk and thug, didn't win the gambit but someone else became head.  That person was not necessarily any better or any more caring of patients.
The old man was in retrospect just declining and scared, anxious about money and aging, clinically out dated and irresponsible. In the grand scheme of things using the retrospectoscope of highsight, he was really the best of a very bad lot.  The young man regretted seeing him brought down even if it was the right thing because this old stag was really just surrounded by wolves.  The wolves took over then and things went even worse. It wasn't for another several years before a head was chosen who actually took their Hippocratic Oath seriously and research and the hospital began to function once again somewhat as a 'patient centred' facility.
In a way the old man was like  a King Lear. In other ways he was a MacBeth. Seeing him go was like watching a Zorba the Greek episode with all the clawing old ladies and lesser rat like people grabbing the remains of what he had left. Years later the young man was sorry he'd hurt the older man simply  because he was so much better than what immediately had followed.  Further as he grew to know those who'd pressured him to come forward he realized he had indeed fallen in with worse than theives.
He' d learned however that he could depose a metaphorical Hitler.  He was like David in the Bible who could relatively easily depose a Goliath but it was much more complicated when he had to deal with Saul.   The problem wasn't just single men in his mind but rather all the alliances.  He described his predicament  as not being able to deal with the   NEST.  To explain this he'd say,  if the allies or even the Germans themselves had assassinated Hitler, it was just possible that Goebbells or Eichman would have taken  his place.  Quite possibly they'd have been worse.
The idea that removal of a leader meant better things was only a communist idea from the failed machinations of Marxism.  Revolution didn't improve things but rather as likely made things worse. Like the Beatles he'd all along sung, "We don't want a revolution" but somehow through his inability to see the Saul in a person he'd thought a friend he'd betrayed his own personal principles alligning with a project which was intrinsically ungodly from the start.
Years later one of the gang would suggest he needed to study ethics and professionalism.  By then he knew that God had a great sense of irony.
Professionalism was loyality to the group and the group's good cause. The difficulty with professionalism was specifically that it was so similiar to  tribalism. The German Army was the most professional soldiers of history yet the cause they served changed from what was called higher " kultura" or culture to low culture.  The lower unit of any society after family is  tribe.  It's a gang.  It's a self serving entity that defines all outsiders as the enemy.  Historically a profession was a subsection of society that served its membership and the greater needes of the society as a whole.  Tribes care not for society as a whole and like gangs serve only themselves.
The young man only stayed with the team because he thought it better than the alternative gang.  Professional soldiers were said to be superior to the mob because of the discipline and allegiance. But it was a Prime Minister of England who said " I don't need you to agree with me when I'm right, I need you to agree with me when I 'm wrong." That's the nature of the party system of the government.  It's especially dangerous when it devolves from professionalism into tribalism.
A National Post editorial put forward the question "What is the difference today between a Canadian Political Party and the Hell's Angels?"  This was a question that didn't need to be asked 20 years ago but was clearly one being asked today.
In medicine the doctor owed allegiance first to his Oath and his profession.  His oath was first 'Do no harm' and that the "patient should come FIRST:'.  The Beurocrats were very good at platitudes and 'saying the right thing'.  Georgia Strait newspaper  annually made a joke of banning the words over used by beaurocracy as 'buzz words' and 'politically correct' hypocrisy. There was a serious disconnect between the words and behaviours of some individuals and especially the institutions which promoted them.
By use of the corporate and beurocratic term,  'terms of reference' all investigation into any malfeance limited  their 'apparent' culpability, accountability and responsibility. Hence even  a massacre commission might insist that it was only called to judge the death of one person in a massacre when that sole person alone  had in fact, as the subsequent report showed, died of natural causes.  By limitting 'terms of reference' the commission didn't have to account for the countless machine gunned bodies.
The young physician had seen too much unnecessary death and in the end was labelled a whistle blower. He'd stopped many individual deaths. by speaking up.  His 'sacrifice' individually had been in countless lost nights of sleep, personal threats to himself,  endless hours of research and consultation with others, and immense loss of income all to conclude that the 'NEST' seemed the same as when Kafka described it as the "Castle". He had played the Glass Bead Game and become Magister Ludi but to no avail.  The best he could do was indeed simply the 'next right thing'.
Talking with the deacon of the Queen's church in Buckingham he was told by this old white haired poet, "I finally learned that there's all the money in the world to help the sheep that survive the fall from the top of the cliff as long as you don't do anything about the hole in the fence up there.  And God forbid you don't say anything about the people pushing the sheep off the cliff."
Today he was looking for a bioethicist who had sacrificed his career to save the life of one man.  From what he'd read so far philosophers learned far more from the death of Socrates than Christians learned from the death of Jesus.  He wasn't sure though they had anything to offer in tying action to word because everyone was so very good at paying lip service and no one seemed willing to pay the blood price.