Friday, March 30, 2012

Were Jews ever really slaves in Egypt, or is Passover a myth?

Where is the real proof - archeological evidence, state records and primary sources?

By Josh Mintz / Jewish World blogger

Here's a question for you: what do actor Charlton Heston, DreamWorks animation studios and Former Prime Minister Menachem Begin all have in common? Well, they've all, at one time or another, perpetuated the myth that the Jews built the pyramids. And it is a myth, make no mistake. Even if we take the earliest possible date for Jewish slavery that the Bible suggests, the Jews were enslaved in Egypt a good three hundred years after the 1750 B.C. completion date of the pyramids. That is, of course, if they were ever slaves in Egypt at all.

We are so quick to point out the obvious lies about Jews and Israel that come out in Egypt – the Sinai Governors claims that the Mossad released a shark into the Red Sea to kill Egyptians, or, as I once read in a newspaper whilst on holiday in Cairo, the tale of the magnetic belt buckles that Jews were selling cheap in Egypt that would sterilize men on contact – yet we so rarely examine our own misconceptions about the nature of our history with the Egyptian nation.

We tend, in the midst of our disdain for Egyptian, anti-Semitic conspiracy theories, to overlook the fact that one of the biggest events of the Jewish calendar is predicated upon reminding the next generation every year of how the Egyptians were our cruel slave-masters, in a bondage that likely never happened. Is this really so different from Jaws the Mossad agent?

The reality is that there is no evidence whatsoever that the Jews were ever enslaved in Egypt. Yes, there's the story contained within the bible itself, but that's not a remotely historically admissible source. I'm talking about real proof; archeological evidence, state records and primary sources. Of these, nothing exists.

It is hard to believe that 600,000 families (which would mean about two million people) crossed the entire Sinai without leaving one shard of pottery (the archeologist's best friend) with Hebrew writing on it. It is remarkable that Egyptian records make no mention of the sudden migration of what would have been nearly a quarter of their population, nor has any evidence been found for any of the expected effects of such an exodus; such as economic downturn or labor shortages. Furthermore, there is no evidence in Israel that shows a sudden influx of people from another culture at that time. No rapid departure from traditional pottery has been seen, no record or story of a surge in population.
In fact, there's absolutely no more evidence to suggest that the story is true than there is in support of any of the Arab world's conspiracy theories and tall tales about Jews.

So, as we come to Passover 2012 when, thanks to the “Arab Spring,” our relations with Egypt are at a nearly 40 year low, let us enjoy our Seder and read the story by all means, but also remind those at the table who may forget that it is just a metaphor, and that there is no ancient animosity between Israelites and Egyptians. Because, if we want to re-establish that elusive peace with Egypt that so many worked so hard to build, we're all going to have to let go of our prejudices.

Josh Mintz is completing his degree in International Relations and Middle Eastern studies and is the communications director at Friend a Soldier, an NGO that encourages dialogue with IDF soldiers.

Wednesday, March 21, 2012

Drug Names
by Peter M. Brigham, MD

In the research literature drugs are not referred to by brand names. In the context of rigorous attention to scientific data, as opposed to the world of sales and marketing, using trade names would suggest influence by commercial pressures, which would call into question the investigator's independence and objectivity. Shouldn't independence from commercial pressures be just as important in the clinical world? But, surprisingly, in day-to-day practice nobody seems to be at all concerned about this. Everyone — physicians, pharmacists, patients, insurance companies — seems to use brand names to refer to medications. I see this as directly related to the pervasiveness of pharmaceutical company marketing and I believe it is a serious problem. Part of the problem is that no one recognizes it as a problem.

Look at how fundamentally our thinking is affected. The alternative to using the brand name is to use the "generic" name, right? But this term in itself is misleading: what we call the "generic" name of the drug is actually the name of the drug! "Zoloft" was in fact a brand of the drug sertraline from the beginning, but everyone acts as though "sertraline" came into existence only after the patent on "Zoloft" expired. (Many people refer to sertraline as "generic Zoloft.") With older drugs our thinking is clearer — we don't think of aspirin as "generic Bayer," it's aspirin, and "Bayer" is one brand. It is remarkable that even doctors and pharmacists are often confused about this, and that it needs clarifying. Try ordering a new drug still on patent by its actual name and you're likely to get "I didn't think that had gone generic yet."

Actually, it's worse than that. I recently tried to order simvastatin from a mail order pharmacy and was told they didn't carry it — one of the dozen most prescribed drugs in the country! It took three people 10 minutes of searching around before I was told that they had "Zocor," however! A national mail-order pharmacy, and they didn't list the drug under its actual name — nor did anyone even seem to know the actual name of the drug!

"Tissues, tissues... let's see.... Hmmm, I guess we don't carry tissues.... Oh, wait — we have Kleenex, is that what you want?"

Brand name drug marketing is by far the biggest product promotion success in the whole world of commercial enterprise, because the primary brand names have not just become synonymous with the actual names of the drugs, they have replaced the actual names of the drugs. Adofen, Affectine, Alzac, Ansilan, Deproxin, Erocap, Fluctin, Fluctine, Fludac, Flufran, Flunil, and 27 other trade names besides the one everybody knows — all are brands of fluoxetine, but even pharmacists still call the stuff "Prozac." Imagine how the marketing folks at GM would be rubbing their hands with glee if everyone referred to their Toyotas and Hondas and Fords and Subarus as "Chevys!"

These habits are very deeply ingrained. For instance, remember that each nation handles its own trademarks and patents, so brand names are local to a specific country. On the psychopharmacology mailing list — a listserv that has over 1000 subscribers from all over the world — American psychopharmacologists routinely refer to "Celexa" and "Trileptal" and "Remeron" despite constant reminders that these names are unknown to prescribers in England, Indonesia, Turkey, Australia, Brazil, South Africa, etc. I have seen the periodic notice about not using brand names go out from the list moderator (as it has regularly for years) and the very next day someone from the US posts a comment mentioning "Luvox," prompting a follow-up question from a member in Japan politely asking what Luvox is. It is remarkable that even in a group of medical professionals, in a context in which it has a direct and personal impact on successful communication, and in the face of constant reminders, people still can't wake up to what they are doing. Judging by the psychopharm mailing list, this seems to be especially problematic in the US.

Note that Luvox is a particularly illuminating example, since the original manufacturer of fluvoxamine no longer makes this drug. Thus, there is actually no "Luvox" on the market any more. But try referring to it as fluvoxamine and see how many blank stares you get until you say, "You know... Luvox."

What is so insidious is that everyone seems completely unaware that there is a problem here. The health care system and the public have been hypnotized by the drug companies. I use the word deliberately: the methods used are classic hypnotic techniques. With doctors, the drug reps first establish a context of support and nurturance — gifts of "Cymbalta" pens and notepads, sandwiches — and then they set up a discussion that embodies a further distraction: they show us data on Cymbalta. We say, but what's the difference between Cymbalta and Effexor, they respond with more data about noradrenergic effects at low doses, we're partially convinced but a bit skeptical, etc. We think that we are being objective, that we're sophisticated enough to critically evaluate the data on Cymbalta and thus are immune to bias — and all the while the real marketing agenda succeeds brilliantly: we're talking about "Cymbalta," not about duloxetine. Cymbalta, Cymbalta, Cymbalta, Cymbalta. A lot of us end up a little fuzzy about what duloxetine is. ("Oh, you mean Cymbalta!")

I am convinced that this is one of the big reasons the drug companies find it worth their while to spend collectively over $11,000 per doctor per year on detailing: in between bites of "complimentary" chicken pesto panini they train us in a language and a habit of thinking. And we doctors remain completely unaware of what we have bought into and then talk to our patients and each other using exclusively brand names — the language that we learn from the drug reps — thereby teaching our patients how to think and talk about meds. All this is now reinforced by direct consumer marketing: "Ask your doctor if Paxil is right for you!" Patients begin requesting "Paxil," and after the original patent expires some will say, "I don't want that generic stuff, I want Paxil." And we write prescriptions for "Paxil." And the shareholders are happy.

I think that a doctor should be somewhat embarrassed to use brand names in talking about medications. It suggests that her/his primary source of information about meds is the drug rep rather than the medical literature. It shows that s/he is not involved first and foremost in assessing the research data. When I use the actual names of the drugs instead of brand names, my viewpoint changes — the language reminds me that my position is that of an applied scientist, that my job is to weigh all the information available and make judgments about what is best for my patient based exclusively on the evidence, not on the pitch of a salesperson.

It has occurred to me more than once when talking with a drug company representative that I could say, "OK, I'll refer to olanzapine as 'Zyprexa' if you pay me for advertising your product each time I do it." But that would be grossly unethical, wouldn't it? Well, is it less unethical for me to do it for free? (Or for "free" lunches and pens and notepads and clocks and letter-openers and mugs?)

So I'm stubborn in fighting this. I'll endure the puzzled pause of a pharmacist when I phone in a refill for escitalopram — though, sadly, to be certain that they get the prescription right I usually have to add, "You know... Lexapro." I try to teach my patients the names, not just the brands, of the meds I prescribe them. I refuse to be a marketing tool. The drug companies may be taking over the world, but they're not going to take over my mind.



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COMMENT: OBEY - like a good little doggy - and be rewarded for your obedience.


Fail to obey, and you are shut out. That is an Evil country. What are you going to do about it, my fellow Americans?
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