The infamous soda battle of New York City

A recent ABC News story details the by-now-well-known proposal by New York City mayor Michael Bloomberg. From the article:

In his latest effort to fight obesity in this era of Big Gulps and triple bacon cheeseburgers, Mayor Michael Bloomberg is proposing an unprecedented ban on large servings of soda and other sugary drinks at restaurants, delis, sports arenas and movie theaters.

Drinks would be limited to 16 ounces, which is considered a small serving at many fast-food joints.

Now, let’s think about this for a minute: A 16-ounce (473 mL) limit would even ban 20-ounce (591 mL) bottles. A typical medium-size drink in most national chains is 20 ounces, sometimes up to 24 ounces (710 mL). (I say “national” because at Taco Cabana and Whataburger, 20 ounces is the small, 32 ounces (946 mL) is the medium, and 44 ounces (1.3 L) is the large. But what do you expect from Texas companies? We’d never let some Yankee tell us 16 ounces is as big as you can go.)

Once upon a time, sodas were commonly available in 16-ounce (glass) bottles. I’m not sure of the exact year of the change, but the common size for bottles now is the 20-ounce size (with some locations offering 1-liter bottles in some flavors). I know at least Coca-Cola offers aluminum bottles in 8.5 ounce (251 mL) which roughly correspond to a former glass bottle size (which I’m not sure if it’s still being made), but this is a specialty item that’s not sold very widely. The ones I bought were mainly purchased for the package design (that, and I was at a hotel and I didn’t feel like going all the way back down to the gift shop on the first floor).

Not surprisingly, it didn’t take long for a major soda company’s PR department to fire one right back:

“The people of New York City are much smarter than the New York City Health Department believes,” Coca-Cola Co. said in a statement. “New Yorkers expect and deserve better than this. They can make their own choices about the beverages they purchase.”

Kudos to Coca-Cola for striking back against this insanity. To be fair, they’ll feel anything that would kill sales in a city the size of New York, so it’s in their interest to say this is dumb. But I’m sure their customers feel the same way.

The article goes on to cite this nugget of dubious wisdom:

Bloomberg said people who want to guzzle soda would still be free to order more than one drink. But he said restricting servings to 16 ounces each could help curb consumption.

Now, I doubt this is actually true, and I’ll explain why. For one, most fast food restaurants allow free refills. Even some movie theatres allow free refills, which to be honest, at the prices charged is the least they can do. It’s not clear from everything I’ve read whether or not Bloomberg plans to ban those as well. If so, this is even worse than I could have imagined, and I would even say it could be considered restraint of trade if looked at in the right way.

Second, what I predict will happen is that people will start becoming less restrained about bringing in their own drinks. The sale on two 12-ounce cans or two 16-ounce fountain drinks will be lost to the convenience store with no limit. And the restaurant owners, rather than risk irking their customers and losing the sale entirely, will grow accustomed to seeing someone bring in a soda from the convenience store around the corner and just not say anything.

It’s obvious why Mayor Bloomberg is floating such an outrageous policy: in New York, the term limit for mayor is three terms, and this is his third term. So, not surprisingly, voters have little recourse should they feel he stepped over the line. However, it would not surprise me in the least if Bloomberg’s successor decides to repeal this law should it pass very early in the term.

So my response to this short-sighted proposal is this: If Mayor Bloomberg really cares about health, how about an aggressive tax against tobacco products (cigarettes, cigars, smokeless tobacco, etc)? Make it so expensive to smoke in New York that people will have to quit due to financial reasons. That will do far more for health than any silly “you can only have a small soda” law. And if for some reason cities can’t tax cigarettes in New York State, then the law up there is even more broken than I thought.

Revisiting the Eric Cropp story and safety in medicine

One of my more popular posts to this blog was about Eric Cropp, the pharmacist in Ohio who wound up actually facing criminal charges after the death of a pediatric cancer patient under his care. I made that post back in 2009 August, back when this was my personal blog and not yet called Rant Roulette. So it’s high time I re-visit the story and what has happened since then, and some other healthcare-related matters. This is going to be a long one, because a lot has gone on since the original post.

First, if you haven’t seen it before, is Eric Cropp being interviewed by David Mattingly of CNN. You may want to skip this if you are easily disturbed; I found it quite difficult to watch myself. Conveniently, they pair this with an interview of only Emily’s mother, Kelly Jerry, not her father, Chris Jerry. The distinction is important, as noted below.

This post on Philly.com’s Check Up blog describes some of what has gone on since then. The post dates from 2011 November, during a period I was not very active posting to this blog. Quoting the post:

As I wrote in a previous blog that touched on this case, I completely understand the angst and the call for retribution by families left behind in the wake of a fatal medical error. I also recognize they need someone to blame and to hold accountable for the pain of their horrific loss. But I truly admire one family member who took a different path, Chris Jerry, Emily’s dad. Almost from the start, he opposed Mr. Cropp’s jailing, and now he’s even forgiven him. In fact, Chris Jerry and Eric Cropp have been working together, traveling around the country to speak at pharmacy meetings to help create awareness of the vital importance of safety practices. I’ve received several emails from colleagues around the country who’ve attended these programs—enthralling is how they describe it.

(Contrast Chris’s attitude with that of Emily’s mother, Kelly Jerry, who was and is all too willing to hang Eric Cropp out to dry.)

The story goes on to mention the Emily Jerry Foundation, which is dedicated to increasing patient safety by minimizing the human error in medical treatment, started shortly after Emily’s death in 2009.

I applaud Chris Jerry for first, realizing that throwing Eric in jail really doesn’t solve anything, and second, for forgiving him for what could be said wasn’t really his fault, even if it was legally his responsibility. I say it like this because of this comment made by The Redheaded Pharmacist on a post about the Eric Cropp case by The Blonde Pharmacist:

I worry about the working conditions for pharmacists after reading these stories: long hours and no breaks have to play a role in some of the mistakes that are being made in pharmacies around the country. The problem is that if an incident does happen, it is usually the pharmacist and not the employer that takes the blame and the fall for what happens. I’m not saying pharmacists are without fault and should avoid responsibility for their mistakes while on duty, but to place the full blame with them seems to be a bit short sighted. At some point, reducing hours, [increasing] workloads, and no breaks have to play a role in the incidence of errors but the employer will simply bring in another pharmacist and move on if the one on duty is disciplined.

The ISMP’s article has the rather derisive-looking headline “Ohio government plays Whack-a-Mole with pharmacist”. Indeed, without reforming the system, and just sending the pharmacists and other healthcare professionals off to jail or just revoking their licenses, it’s just a game of Whack-A-Mole, or treating the symptoms without curing the disease. Quoting the article:

No matter how hard we try, human endeavors carry inherent risks. We can try to do everything possible to make it safe for patients, but we often fail to plan for the unexpected—a computer system that is nonfunctional when you arrive at work, causing a serious backlog of work; an inadequate level of staff on duty because of unexpected absences; a distracted technician working in a hectic high-risk IV area—just a few of the unexpected conditions in Eric’s case on the day of the event. As Marx notes in his book, civil, criminal, and regulatory systems are increasingly obscuring the differences between intentional, risky choices and inadvertent human fallibility. Thus, the net cast to catch criminals is now catching those whose only crime is that they are human. The criminal courts are playing the most extreme version of Whack-a-Mole with the lives of all healthcare professionals, for who among us cannot say, “It could have been me” when thinking about the plight of Eric Cropp and Emily Jerry?

(The article is aimed at healthcare professionals, so that’s who the “us” is referring to.)

Until it’s standard procedure for the workflow of healthcare professionals–pharmacists in particular–to allow for normal work and meal breaks, until nurses don’t do just plain stupid things like call in chemotherapy orders hours early so the pharmacists feel rushed to check the solution so it can be dispensed (like Emily’s nurse did), until pharmacy computer systems are reliable so they don’t go down for hours at a time (like they did at Eric’s pharmacy), this is still destined to happen again to someone, somewhere.

And there are other situations similar to this. This entry in HealthBlog refers to this story about mis-mixed colchicine involving Gary D. Osborne and his company, Apothécure, in Dallas, Texas. (Steve at HealthBlog does not link to this latter story, it’s possible he intended to but the link in the article goes to an unrelated story.) Gary Osborne has just as much nominal responsibility for his employees/assistants as Eric Cropp did when his assistant mis-mixed the chemotherapy for Emily Jerry. The Food and Drug Administration’s Office of Criminal Investigations (FDA-OCI) findings pursant to their investigation were that Gary and his company committed two violations of the Federal Food, Drug, and Cosmetic Act (FDCA) due to some colchicine vials containing a lethal dose.

While there is some relief that at least the Justice Department and the FDA-OCI understand it’s merely human error and are only charging Gary and Apothécure with misdemeanors, it’s still troubling that a human error is being pursued under criminal law at all. It’s as if nothing was learned from the Eric Cropp case, or what was learned is being willfully ignored.

I strongly believe criminal prosecution should be reserved only for the most egregious of offenses, where there is a repeating pattern of conduct which endangers human life. Are there cases where criminal prosecution is the most fitting remedy? Yes. Does a shipment of two bad lots of colchicine qualify as such an egregious offense? Probably not. If it had been a repeat pattern over a longer period of time of substandard quality control, then criminal prosecution would make more sense to me. In this case, I don’t think Gary or Apothécure should be subject to more than a civil or administrative penalty.

Quoting Steve’s Healthblog post:

This was also dealing with a compounded drug… we all are aware of how the FDA is AGAINST Pharmacist compounding… could these criminal charges – 5 years after the fact be at the prodding by the FDA to the Justice dept?

If the FDA is pursuing this only to advance its own agenda against compounding pharmacies, it’s despicable and abhorrent. Especially when there are so many other areas of healthcare that need more aggressive and stringent regulatory oversight.

There’s another great post in HealthBlog which shows where the priorities really lay for at least one pharmacy. Hint: it’s not about patient safety, or customer service. Quoting the post:

[…] [T]he chain store where [another pharmacy blogger] works… puts anyone wanting a flu/vaccine shot AHEAD of all waiting Rxs.. […] WHY??? because … giving flu/vaccine are MORE PROFITABLE to the chain than filling the typical prescription(s).

In all honesty, this kind of thing should be illegal, and the pharmacy chains doing this should be hit with huge monetary penalties. This is the most despicable, horrendous, and egregious thing I have ever heard of in our healthcare system! It’s a shame that the blogger in question does not (and cannot, lest he risk his job) reveal which chain pharmacy this is with this insane policy.

When an otherwise good pharmacist like Eric Cropp loses his license and goes to jail after what is, in all honesty, one really bad day, and we have pharmacists willing to go along with ludicrous policies like this, it’s a wonder we don’t have more meltdowns in our healthcare system.

I fear the message we are sending to would-be pharmacists is this: Sure, become a pharmacist. Work 12 hour days with no rest breaks, let alone meal breaks, and take all the blame when one of your technicians screws up despite your best efforts to check his/her work. And if you’re really unlucky, you make a mistake (due to the work conditions setting you up for failure) and someone dies, you could actually go to prison and lose your license (like Eric Cropp did) while the technician that actually made the mistake walks free.

(There’s another way to look at this, too. How many other pharmacists around the US have made a mistake resulting in someone’s death in the past 20 years? I would be willing to bet most of them didn’t go to jail for their mistakes. So, if we assume for the moment that Eric Cropp’s imprisonment was just, that means that untold numbers of pharmacists out there got away with it.)

In light of this, who will want to become a pharmacist today? What happened to Eric Cropp is just the beginning of setting us up for a serious shortage of pharmacists within the next 10 years, if not sooner. We can’t wait 10 years to realize we have this kind of a problem. The time to start is now.

Erased from the yearbook

This is probably the most egregious case of revisionism and exclusion I’ve seen in recent memory. Not surprisingly, it’s another homosexual student at a high school in the South.

A post on The Stranger (warning: linked story contains profanity) details the story of Ceara Sturgis and her senior yearbook of Wesson Attendance Center, and links to the original story at the Jackson Free Press. What the yearbook staff and/or school officials did (it’s not clear exactly who did what) is one of the worst things that can be done to a high-school student, particularly an honor student like Ceara: all references to her were deleted from the yearbook. From the Jackson Free Press story:

“They didn’t even put her name in it,” Sturgis’ mother Veronica Rodriguez said. “I was so furious when she told me about it. Ceara started crying and I told her to suck it up. Is that not pathetic for them to do that? Yet again, they have crapped on her and made her feel alienated.”

And further down in the article is perhaps the most damning evidence of all (quoting Veronica Rodriguez, Ceara’s mother, again):

“They mentioned none of her accolades, even though she’s one of the smartest students there with wonderful grades. They’ve got kids in the book that have been busted for drugs. There’s even a picture of one of the seniors who dropped out of school.

“I don’t get it. Ceara is a top student. Why would they do this to her?”

There is no mention of her academic honors. Her name isn’t in the list of graduating seniors. And of course, no picture of her wearing a tux at the prom. See, Ceara’s a lesbian, and that is apparently just too much for the folks at Wesson. This not only reeks of community exclusion, but of revisionist history as well.

I don’t know if there’s any way the school can even make things right at this point. They can’t. The yearbooks have been printed, and Ceara’s been left out. The truly insidious part of this is the damage that has yet to happen, years from now at reunion time when it is doubted that Ceara is a legitimate alumnus of the school. That’s the part that really makes my skin crawl and my stomach churn. I’d like to think most of the students will notice Ceara’s consipicuous absence from the yearbook, and note it now while it’s still fresh in their minds.

This does hit rather close to home for me, so I can’t just post this without relaying a personal experience of mine, which is intentionally going to be a little light on details. It somewhat parallels Ceara’s.

On at least one occasion, I feel I was cropped out (either in post editing, or intentionally out-of-framed at exposure time) of audience/attendee shots at a local event, which were later posted to Facebook. While arguably, what an amateur photographer does with his/her camera is his/her own decision, there is no question in my mind based on the identity of the photographer and certain people that were at this event that this was an intentional effort to leave my image out of the documentation of the event. Of course, the person in question is a tech community leader widely known as “an \*\*\*hole” and is probably less known for his photography than his attitude.

Still, for anyone to think I and others would not notice smacks of naivete. To realistically expect I’d just sit there and be happy-go-lucky about it? To quote Bob Barker in the “cheaters prosper” playing of Shell Game on The Price is Right, “that’s dumb.” (I linked the clip because it makes great comic relief if you need it right now, and I suspect many of you might.)

Now, please don’t get me wrong. I am thankful that what happened to me was relatively ephemeral, all things considered. It’s possible it’s not even going to be an issue weeks, months, even years from now, or it’s acknowledged with “yeah I remember having to zoom in to crop Shawn out of the shot” and I laugh with everyone else as we all take sips out of our drinks.

Since this is somewhat relevant, I’ll go ahead and mention this little detail about me: I had to switch schools prior to my senior year, so yes, I am missing from the senior yearbook of the school where I spent the majority of my time in high school. I’m not bitter about it, as my exclusion is legitimate, and I’m in the three yearbooks where I should be.

On community, respect, and trademarks: the story of Nexuiz

About a month ago or so, I started playing a community-maintained GPL first-person shooter (FPS) called Nexuiz. I checked it out after tiring of OpenArena; I played tons of Quake 3 Arena back during my second round of getting into proprietary PC games back in the day, so OpenArena fit me style like a glove at first. But Nexuiz had a bit more of an allure to it, and after a while I realized the more I played Nexuiz, the more I liked it.

And it took me a while to really put my finger on why. I remember a certain player saying something like “I’m surprised you haven’t given up already” during a particularly bad game. And the players came to know me as the guy that has really weird taste in maps, but I’m welcomed and appreciated. That’s what it was: the community around the game, as much as the game itself.

So it was a bit of a shocker to pop on the IRC channel and read a whole bunch of flaming and controversy about a console (PlayStation 3) version of Nexuiz being made by a company called Illfonic. What upset everyone was not the console version itself, but that the domain name nexuiz.com had been repurposed to promote almost exclusively the console version, at the expense of the community-developed GPL version for the PC. (I’m not linking to them here for reasons that should become obvious.)

Now, there’s all manner of bad blood against Lee Vermeulen, the nominal owner of the nexuiz.com domain (he did not actually transfer the domain to Illfonic) and Alientrap (Vermeulen’s company). It’s widely believed that Mr. Vermeulen just saw the dollar signs and acted on his own best interests, caring little about the community around the game. Many consider Vermeulen’s actions paramount to theft and fraud against the community that made Nexuiz what it is while Vermeulen sat mostly idle. Contributing to the ill will is that Vermeulen’s idea of who was actually in Alientrap for the purposes of splitting the income from the licensing deal leaves out several people who thought they were “in” but are being left out in the cold.

In the coming days it would become more obvious that the name and goodwill behind it meant as much to the community as the game itself. I never really saw this happen with any other FPS game, whether it be any version of Doom, Heretic, Quake, Half-Life, etc. As it stands now, the next move is a fork of the Nexuiz codebase and probably a name change. I view this as very sad, very unfortunate, and something that should have been unnecessary, but it highlights the advantage of free software: if one doesn’t like the direction a project is taking, one can always take the source code, fork and begin one’s own.

I learned a lot about public relations, trademarks, goodwill, and community from this incident. I’ll summarize a few of the key points:

  • Communication is key when it comes to communities and community projects. If you’re part of a community project and the registration for the domain name or the Web hosting account is in your name, that does not make it yours outright. If there is any doubt at all in your mind as to whether others might object, consult with them before making any moves. This is especially true in the case of games being adapted to proprietary game consoles, something many who respect their freedoms will object to on philosphical grounds.
  • Goodwill and trust take a long time to build and can be lost very quickly. Few people in the community now trust Mr. Vermeulen. I sure don’t. I don’t really trust or like Illfonic a lot either. I cannot honestly say I wish the console port of Nexuiz much success. Now to be fair, it’s not really Illfonic’s fault that they are less liked than they otherwise might have been had Vermeulen been more transparent with the community in his dealings. But that’s the way things are. There are still people who will call it “FeeNex” or “Noxuiz” (the latter being pronounced a lot like “noxious”) thanks to the dubious circumstances under which the console port came to be.
  • Trademark law as it stands appears not to adequately recognizes a community-based or community-held trademark for a non-profit project such as Nexuiz. In general, copyright, patent, and trademark law needs to be brought up to current times now that free software and community-based projects are often the rule rather than the exception. This goes beyond software, it also extends to things like BarCamp and other community-based events.
  • The community is often just as important as the thing that brings that community together. I still talk to someone from the Dance Dance Revolution/Bemani games scene of the mid 2000’s even though that scene has mostly died off and I probably could not play DDR worth a damn today were I to try again.

As further developments arise, I may follow up on this post. This is still ongoing as I write this.

Rotten Apple dealings, part number gee-I-lost-count

I’m combining my commentary from these three recent stoies into one post, because they are all about Apple’s latest shenanigans and I don’t want to post three in a row.

The first two are about yet more arbitrary iPhone app rejections. ZDNet’s The Apple Core blog reports on Apple taking out certain wi-fi discovery applications, on the grounds they use an undocumented interface (i.e. something Apple decided was too good to let just any old programmer use). Another one is more troubling; TechCrunch reports on the phone radiation monitoring application Tawkon and its denial.

Both of these examples have something in common: they highlight the arbitrary nature by which iPhone applcation developers can be put out of business. As it stands now, the iPhone developers are at the mercy of Apple.

With regard to wi-fi discovery, the responsible thing to do would be to open up the API (interface), properly document it, and ensure that every programmer who wishes to use it may. I’m not sure of the gory details, but this certainly smacks of something Apple would just do on a whim. At least one of the applications in question is releasing a version for jailbroken iPhones, though again I will note that jailbreaking shouldn’t even be necessary to begin with.

Tawkon actually performs a very useful function, something that really should be built into most mobile phone handsets. It’s sad, but unfortunately no big surprise, that Apple’s own interest (covering up exactly how much radio frequency emissions come from its product) trumps those of the people who wish to make money by selling such an application. Does Apple really have something to hide here? I would not be surprised if the final, Apple-approved version of Tawkon is crippled beyond usefulness.

The last article is about the iPad and Associated Press, courtesy of TechJackal. Apparently the good old AP is planning to offer a paid service to read its news articles on the iPad. Yes, the same ones available for free via the web.

The closed model of the iPad breeds greedy schemes like this of dubious merit. It’s a great deal for the AP and Apple, and a lousy deal for the people out there who have placed their trust in Apple by buying their wares. I know, it’s nothing really new. It’s sad that we have so many Apple lemmings out there willing to jump on the company’s latest offering, none of whom even care about the implications behind Apple’s unfortunate use of Digital Restrictions Management (DRM) where it is clearly not needed and works to the detriment of its customers.

Shame on you, Apple. Your customers and developers deserve better than this.