Sunday Update Week 6

This was a week of very little excitement. On Monday, we all went out for my nephew J’s birthday dinner (a little late because there had been snow delays the week before). Thursday I went out to a club with a friend – that was a bit of fun that I haven’t done for quite a while. And this weekend my nephew J has been staying with us. Friday night we discovered Galavant on Netflix. How funny! I’d never heard of it. Saturday we played a game of Fact or Crap (don’t ever play that game…boring) and then introduced J to Firefly. We unfortunately only got through the first few episodes before it was bedtime. Now he’ll have to wait a couple of weeks before he gets to see anymore.



Since I’m studying Don Quixote, I went to Half-Price Books and acquired a copy of the Cambridge Companion to Cervantes, which I’ll read once I get through that gigantic novel on which I’m making very little progress. 🙂 And because I decided that I’ll break Don Quixote up with easier reading (H. G. Wells), I got a book of essays about Wells, edited by Harold Bloom. I was then at Barnes and Noble and feeling impulsive – so I bought The Bone Witch, which I think will be quite enjoyable light reading on my upcoming road trip. I used my Audible credits on The Boy on the Bridge and Time Jumpers. The former I will listen to as my real life book club choice for April. Time Jumpers is the fifth book in a series by my favorite middle grade author Brandon Mull. Finally, my dad bought copies of the second Diary of a Wimpy Kid book for D and The Adventures of Captain Underpants for M. Both were really excited about their new books, though I think M’s book was a bit too much over his reading level. He’s only 5. But dad didn’t want to get one kid a book and not get the other kid a book.



I did almost no reading. I got about half-way through this week’s Economist, and finished the last little bit of I Stop Somewhere.

Currently Reading

Currently Reading

My hold for an H. G. Wells biography came up at the Library, so I set aside Don Quixote again and will work on H. G. Wells Desperately Mortal. Also moving back to Freeing Your Child from Anxiety. And I’m of-course listening to Brandon Mull’s new release. I really, really, really wish I could listen to audiobooks while driving on my upcoming road trip. J doesn’t mind the audiobooks, but they bore my dad silly. Maybe I’ll stick one earbud in my ear while I’m driving (which I’ll be doing ALL of). Or would that be ashamedly unsocial of me? I’m looking forward to being in Texas and maybe finding a walking path with NO SNOW ON IT. Wow. No snow. Just think. I love walking. Listening to an audiobook as I stroll along beside a lake….

On the blog

I published a few more stanzas of Facing My Demons 3, 4, 5, 6, 7, 8, & 9.

I published reviews of Island of Doctor Moreau, I Stop Somewhere, & Killers of the Flower Moon.

I published notes on the Coursera MOOC Solving the Opioid Crisis: A Physician’s Perspective, How Do Opioids Work, Analyzing Opioid Prescription Trends,

And I started participating in Top Ten Tuesday, because I liked the prompt.

Facing My Demons 9


As the cesspool rises to our chins

we panic.

Surely it will be worse further down.

We are paralyzed by indecision

all rational thought escapes.

Incongruously, I think:

Should I apply to that job tomorrow?

the one I think I won’t get?

Or do I buy a bottle of vodka

swim out into Lake Superior

as far as I can go?

To be washed out to sea

eaten by fish

escaping yet another rejection

another abandonment

another betrayal?

The final procrastination.

Solving the Opioid Crisis: Analyzing Opioid Prescription Trends


The University of Michigan is teaming up with Coursera to create Teach-Outs which are week-long MOOC lecture series which address problems currently faced in society today. Following will be notes for The Opioid Crisis.

leejay_0Jay S. Lee, MD, is a health services research fellow at the University of Michigan Center for Healthcare Outcomes & Policy, and a General Surgery resident at the University of Michigan. He received his undergraduate degree in Chemical Engineering from the University of Michigan, and his medical degree from the University of Michigan. Dr. Lee’s research focuses on characterizing variation in postoperative opioid prescribing and consumption, with a specific interest in opioid use after cancer surgery. His research is supported by a T32 training grant from the National Cancer Institute. After residency, he plans to complete a fellowship in Complex General Surgical Oncology, and pursue a career in academic surgery.

Cancer patients are generally given opioids post-surgery, and since the opioids help manage the patients’ pain, these prescriptions are a good use of opioids. However, these patients are often observed taking those medications longer than necessary. Years ago, doctors didn’t know how much opioid to prescribe, and often over-prescribed. Now that the epidemic is in the front of their minds, they are surveying patients to see how many opioids are actually being taken in order to make a guess at how much they should prescribe. They found the the actual number used is much lower than they have been prescribing. Doctors have also been spending more time talking to patients about the risks of opioid use, and patients have been responsive by taking less of the medication.

The discussion question that accompanied this lecture was: Several of our experts have mentioned the pharmaceutical industry’s aggressive promotion of opioids to doctors and patients as a significant contributing factor in the opioid crisis. Should there be some controls or limits on the pharmaceutical industry’s influence on physicians? If so, what should they be? If not, why?

Wow. Of course there should be some limits on the pharmaceutical industry’s influence on physicians! At the very least, physicians should receive no kickbacks from any pharmaceutical company, ever. I wish there could be a go-between who gathered all the information about the new meds and talked to the physicians in a disinterested way – rather than the physicians talking directly to people who are trying to market the drug.

Solving the Opioid Crisis: How do Opioids Work?


The University of Michigan is teaming up with Coursera to create Teach-Outs which are week-long MOOC lecture series which address problems currently faced in society today. The following are notes for lecture set 3 of Solving the Opioid Crisis.

clauw_190This lecture was given by Daniel Clauw, Professor of Anesthesiology, Medicine (Rheumatology) and Psychiatry at the University of Michigan. He serves as Director of the Chronic Pain and Fatigue Research Center. Until January 2009 he also served as the first Associate Dean for Clinical and Translational Research within the University of Michigan Medical School, and PI of the UM Clinical and Translational Sciences Award (CTSA).

People are mainly focused on the deaths by overdose due to opioids, but another aspect of the epidemic is that many people are on opioids long term due to chronic pain. This is not a good use of opioids, since they do not target many forms of chronic pain, so doctors are no longer prescribing them (as often) for this purpose. Chronic pain that is located in a certain body part (such as in osteoarthritis) can be helped by a small dose of opioids, but pain originates in the nervous system (like fibromyalgia) is not helped by opioids. 

Opioids bind the same receptors as endorphins, so when people are given opioids their endorphin systems are being hijacked. When someone has been on opioids for years, it is difficult to take them off because they no longer have a normally functioning endorphin system. There should be two sets of rules for prescribing opioids: those for people who have been on opioids chronically and those who are newly starting with a pain control regimen. 

Until the 1990s, people who died of opioid overdose were heroine addicts that started on heroine. They were lower socioeconomic class, inner city, and black. Therefore, it wasn’t considered a major problem by the privileged classes. However, in the 90’s, doctors started over-prescribing opioids so that now, 60 to 70 percent of people who die of opioid overdose started with a prescription. That’s something the privileged majority is willing to pay attention to.

This lecture came with the following discussion question: Dan Clauw mentions the pharmaceutical industry’s argument that access to opioids are “a human right”. Do you agree with this sentiment? If so, why? If not, why?

I believe that healthcare and access to proper medications is a human right. However, I do not believe that there is a human right to be pain-free. If the risks of giving opioids outweighs the benefits, then opioids should not be prescribed.