MD: Branded No More; Happy New Year to All!

As reported in today's New York Times,

"Starting Jan. 1, the pharmaceutical industry has agreed to a voluntary moratorium on the kind of branded goodies — Viagra pens, Zoloft soap dispensers, Lipitor mugs — that were meant to foster good will and, some would say, encourage doctors to prescribe more of the drugs."

The article is well-balanced, including commentary from those who believe such gifts are benign as well as those who believe they contribute to undue influence on doctors' prescription decisions.

Research suggests that doctors worldwide (including in the developing world) are influenced not only by the monetary value of the gifts bestowed upon them, but also subliminally by the pervasiveness of logos and branding, such that they often don't even realize that they are making prescription decisions as a result of aggressive marketing, rather than on the basis of scientific knowledge and sound reasoning.

Again, this is a worldwide problem: A 2004 study of the advertising material and marketing brochures sent out by drug companies in Germany found that "about 94% of the information in them has no basis in scientific evidence."

More on this: here and here.

The role of marketing and branding in medicine also touches on several other issues, including the role of the doctor vis-à-vis not only the drug companies, but also vis-à-vis the patient; the alleged overmedicalization of many ailments today; and the relationship between the cost of a medicine/treatment and its availability to those who might benefit from it (not always an easy, let alone consistent, relationship to tease apart).

As patients, our job is to educate ourselves about the medicines and treatments we are recommended before we agree to them, to the extent possible. Clearly however, in the case of a serious medical condition that must be treated immediately (or where our prognosis is improved the sooner we begin treatment), patients understandably shift to their physician a fair amount of the burden for determining the best course of action.

I am reminded of a conversation I had with my friend Michael Short the other day. We were talking about the banking industry and the proper role of regulation in that arena.

I may write more about the current financial crisis some other time, but what struck me most about both that crisis and the perhaps seemingly unrelated issue of regulation of pharmaceutical companies and doctors, is that both situations are compounded - indeed, it might even be argued that they are a result of - globalization and increased interdependence in today's world, as well as by the largely unfettered rise of the multi-national corporation.

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As another year draws to a close, I think of all my family and friends near and far, and about how blessed we are (if we only see it that way) to live in a world that continually gets smaller and smaller (thanks in no small part to technology). Issues of sovereignty, and the conflict between the human rights and civil rights of individuals and the legal personhood and rights of corporations show no sign of disappearing, but with that comes a tremendous opportunity for synergy, innovation, solutions to global problems like starvation and poverty (to name just two), and last but not least, personal growth and transformation.

As we say goodbye to 2008 and hello to 2009 I relish the opportunity to learn from all of our relations and every situation I am presented with in life. The world continues to get more complicated, but in that complex interplay of situations and interests lies the greatest potential for creativity and true abundance.

This year, I particularly thank Michael Short for teaching me how to focus on abundance (rather than scarcity), and Jonathan Patrizio for his guidance in learning how to live in the moment.

Love, peace, prosperity and light to all! :-)

Vote With Your Wallet at the Movies

Going to the movies is a favorite Christmas Day pastime for many.

If you haven't seen it already, I highly recommend that you see Gus Van Sant's biopic MILK, about San Francisco supervisor and gay activist, Harvey Milk, at any theater other than a Cinemark theater. (Cinemark owns the Century, CineArts, Tinseltown and Cinedome theater chains.)

Cinemark CEO Alan Stock donated $9,999 to the YES on Prop 8 campaign that stripped marriage equality from the California constitution on November 4.

Not buying from anti-equality businesses may seem drastic or inconsequential (depending on the particular business and one's perspective), but I believe that it is a worthwhile enterprise.

Boycotting a large corporation is much more challenging than boycotting a small business. We are unlikely to shut Cinemark down.

But when money is spent consciously, it is imbued with intention and that intention makes a difference, in addition to its purely monetary effect.

You can join the Facebook No-"MILK"-for-Cinemark boycott here.

Also check out the Boycott Cinemark blog.

Impact of Recession on California: Sen. Boxer Releases Report

U.S. Senator Barbara Boxer has released a report detailing the impact of the nation's recession on California's counties and cities. The report, which was based on interviews conducted with officials in 20 cities and all 58 counties, paints a stark picture of the economic strains felt across California. The analysis includes unemployment figures, home foreclosure rates, budget deficits, and first-hand accounts of the impact of the recession.

The full report is available here.

Go Pacers! :-)

My high school's football team won the state championship!

On Saturday, the Grant High School Pacers toppled the state's top team, Long Beach Poly, 25-20 in the premier matchup of the five state championships.

A frenzy of school spirit was on parade in Sacramento on Tuesday afternoon.

I don't follow the Pacers (or any team or sport, for that matter), but as my mom says, "Once a Pacer, always a Pacer!" :-)

Life Matters: "Nothing Bad Happens, Ever."

"When you gonna make up your mind?
When you gonna love you as much as I do?
When you gonna make up your mind?
'cause things are gonna change so fast."

Tori Amos, "Winter"

December 18, 1984: My parents, sisters and I were having dinner at my Tio Mario and Tia Jessie's when the phone rang. My paternal grandfather and namesake, Antonio, had suffered a heart attack and died. I was 7, and I have never been the same.

I recall parts of the car ride to my grandparents' home, but I don't recall leaving my Tio and Tia's home. Certain details, some undoubtedly important, some seemingly trivial, I cannot forget.

I remember looking at my grandmother, Esperanza, when we arrived, and not wanting to believe that my grandfather was dead but knowing instantly that it was true. I remember the funeral and feeling not only that I had lost my grandfather, but that I had also lost a part of me.

Death made its mark on my life early, and it made its mark often. My cousin Robert. My high school band teacher, Mr. Jenkins. My childhood friends, Primavera and her brother Raulie. Great-aunts and great-uncles. My Tio Lencho. My Tio Zeferino. Family friends, young and old.

When I was 16, my Grandpa Tony (my stepfather's father), had a heart attack and we arrived at my grandparents' home before the paramedics. I had recently received my CPR certification, and so choking back tears, I performed CPR. I remember thinking he would be okay - as he continued to breathe, as I continued to breathe - and then his breathing stopped, and I was heartbroken.

To this day, I have never renewed my CPR certification.

On June 21, my Tio Mario and Tia Jessie's daughter, Jessica, died at the age of 25 following a brief battle with cancer. I had hoped to bring Jessica and her partner Jo to San Francisco this year to experience Pride one last time, but it was not to be. Instead, I was in Sacramento over Pride weekend for Jessica's funeral services.

I channeled much of my grief into the campaign to defeat Proposition 8. Although we lost the election, I enjoyed being a part of something bigger than myself, and I felt more alive after the campaign, not least of all because it was a way for me to keep Jessica alive.

I used to really dread the thought of surviving, but this year I am somehow finally comfortable with it, given the alternative.

The inimitable Joan Fountain, a beautiful, life-loving woman who bought me my first computer, died of heart failure at the age of 47 in 1997. Joan wrote a book, Nothing Bad Happens, Ever. I've never read Joan's book, but today I ordered a copy on-line and I can't wait to read it.

I don't know what the future holds - I don't know how long I have to enjoy my life - but I know that I have this moment, and that life's too short to let it pass me by.

As long as I am alive (and my memory is intact :-), I will always remember 2008 as the year I decided that I really want to live. Life matters. And I love it :-)

Equality California Asking For Input

Equality California is asking for input in setting its priorities for 2009.

Please take a few minutes to share your thoughts.

Continuing the Conversation

In response to Obama's selection of Rev. Rick Warren to give the invocation at his inauguration, Courage Campaign is inviting Warren to participate in a public debate on same-sex marriage with Rev. Eric Lee, President of the Southern Christian Leadership Conference of Greater Los Angeles.

Rev. Lee is a leader on marriage equality in the faith community and in the African American community.

Courage Campaign has it right: "To repeal Prop 8, and change California forever, we need to change the conversation."

Please add your name to the invitation by December 24.

Update on Rev. Rick Warren

Today, Obama defended his pick of evangelical pastor Rick Warren to deliver the invocation at his inauguration next month as one of "a wide range of viewpoints that are presented."

"And that's how it should be, because that's what America is about," Obama said responding to a question at a news conference about his and Warren's differences on social issues. "That's part of the magic of this country is that we are diverse and noisy and opinionated."

I agree that it's part of the magic of this country that we are "diverse and noisy and opinionated," but the magic of Obama, on the campaign trail, and as he prepares to take the office of President of the United States of America, is that he professes to be (and we believe he is) a uniter, and not a divider.

A diverse political discourse is precious and not to be taken for granted, but at a time when Obama is working double time to move us forward as a united nation, the selection of Warren absolutely sends the wrong message.

The Human Rights Campaign sent a letter to Obama yesterday, urging him to reconsider the invitation to Warren.

"By inviting Rick Warren to your inauguration, you have tarnished the view that gay, lesbian, bisexual and transgender Americans have a place at your table," says the letter by HRC President Joe Solmonese. "We feel a deep level of disrespect when one of the architects and promoters of an anti-gay agenda is given the prominence and the pulpit of your historic nomination."

The letter ties Warren to James Dobson, chairman of Focus on the Family and a vocal leader in the social conservative community. "Rev. Warren cannot name a single theological issue that he and vehemently, anti-gay theologian James Dobson disagree on," Solmonese says. (You can read the full letter here)

Petition to Obama to Rescind Invitation to Rev. Rick Warren

Last week, I wrote of my hope and belief that, as President-elect of the United States, Barack Obama is focused on our unity.

Today Obama selected ardent Prop 8 supporter Rev. Rick Warren to give the invocation at his inauguration.

It is difficult not to view Warren's selection as a slap in the face not only to the LGBT community, but to everyone who is committed to equality for all.

Linda Douglass, a spokeswoman for Obama, defended the choice of Warren, saying, "This is going to be the most inclusive, open, accessible inauguration in American history."

As reported by CNN, Douglass continued: "The president-elect certainly disagrees with him on [lesbian, gay, bisexual, transgender] issues," Douglass said. "But it has always been his goal to find common ground with people with whom you may disagree on some issues."

That is simply not good enough.

It is imperative - now more than ever - that we not disengage from the society we want to embrace us truly and fully; but rather, that we press on and continue to demand an equal voice at the table and nothing less than full equality.

Although our equality does not trump other pressing concerns like poverty, the economy, or the environment, nor do those issues trump our basic human rights.

I ask that you join me in signing Equality California's petition to President-elect Obama to immediately rescind his invitation to Warren.

Why I Am Committed to Equality For All

It's amazing that so many people have been energized by the November 4 election results. It is heartening to know that my brothers and sisters in California - and throughout the United States and the rest of the world - are coming together to create the change we want to see in the world.

People should help in the ways that they are willing and able. Those who have time to volunteer should volunteer. Those who have money to spare should use their money to produce the change they want to see in the world.

Stand OUT for Equality / The Gay & Lesbian Community Center of Southern Nevada has organized an Our Money Talks! march to be held this Saturday, December 13, and is calling for a boycott of businesses that do not support equality, including Cinemark Theaters.

I couldn't agree more: It is crucial that Californians and Nevadans and all of us support businesses who are pro-equality and LGBT friendly - not only this holiday season, but throughout the year and throughout our lives.

Not buying from anti-equality businesses is a worthwhile enterprise, particularly when it comes to businesses that earn a large percentage of their revenue from the LGBT community but do not support equality for all. Some of these business owners will choose their values over business; some will not; but in any event, I think it is a very good thing for people to make purchasing decisions that align with their values and the change they would like to see in the world.

When money is made or spent consciously it is imbued with intention, and that intention makes a difference, in addition to its purely monetary effect. But money is most effectively utilized as one strategy among many.

If we are truly committed to equality, regardless of money, or the lack thereof, we need to do more, however: We need to make the argument that although some of us have financial resources, and some of us do not, we don't deserve equality because we have those resources; we all deserve equality as our birthright - not as Americans or Californians - but as human beings.

Money is only one expression of who we are as human beings. It can absolutely be used as a vehicle for our values, and many will use it to place a value on themselves and others - but it is vital to recognize and articulate that money can never adequately capture our value as human beings.

It is also crucial that we not focus our efforts, whether it be our time or our money, or even our conversations - which are absolutely the most effective way to get people to see and appreciate that we are all the same and yet different - on "preaching to the choir."

Particularly in our gay urban centers (I appreciate that the considerations in rural America may be different), it it simply not an efficient allocation of resources or even much of an effort, frankly, to spend our dollars supporting pro-equality and LGBT friendly businesses and then go home and make an online donation to a couple of gay rights organizations before having a nice dinner party with our pro-equality and LGBT friendly / LGBT friends. We should absolutely put our money where our mouth is; but our mouth is still our most effective resource (along with our writing fingers) in changing the minds of people who are not already committed to equal rights.

Today has been dubbed a "Day Without A Gay" by one of the many groups that have organized as a reaction to the anti-equality and anti-LGBT election results on November 4. I think this action has the potential to make a huge difference in parts of the country and in organizations that are truly unaware of what they would not have if there ever really was a "day without a gay."

But in our gay urban centers, and even in many of our smaller towns and communities where we have a well-established and/or close-knit LGBT community, what sort of message does it send, and what sort of difference does it make, to disengage (even for a day) from the society we want to embrace us truly and fully?

I was watching the local television coverage of "Day Without A Gay" today and the newscast noted that "even in the Castro" many people did not seem willing or able to "call in gay" for a day, and that not a single business they spoke to planned to shut down for the day.

Leaving aside the many possible reasons for this (and also, leaving aside the very real distinction between those who are not willing to "call in gay" vs. those who truly might lose their job or truly cannot afford to lose even one day's income or to use even one sick day when they are not in fact sick), it strikes me as particularly odd that anyone might think it makes sense for the Castro (or West Hollywood or Chelsea or any other "gay neighborhood") to shut down for a day, to support LGBT-equality or otherwise.

Although it might make sense for Castro residents to "call in gay" if they work for a business that 1) truly would miss them; and 2) does not already value diversity in its workforce, including LGBT employees, I fail to see how "calling in gay" might have much positive impact if these two conditions are not met.

I feel very strongly that this is not just (or even mostly) about marriage. Indeed, although I have come a long way from my radical anti-anything-that-even-remotely-smacks-of-authoritarian-or-homogenizing-institutions days (including the legal privileging of certain family arrangements over others), the reason I am so committed to repealing Prop 8 - and the reason many of my family and friends feel the same way too - is because we are committed to basic human rights. I personally don't think about it in terms of even civil rights - I think of our right to enter into the relationships and create the families we want to choose as a basic human right, to be protected and recognized by the state, but not at its core created by the state.

Some have argued that the focus on civil marriage above all else by the small group of organizations and individuals that constitute the "gay movement" elite (Human Rights Campaign and others) is too narrow a focus - and one that does not speak to the basic needs of poor, minority or otherwise "other" (gender nonconformist, intersex, to give just a couple more examples) members of the LGBT community.

I don't find it productive to argue that point. I think that each organization (and individual, for that matter) needs to focus on goals that it can effectively contribute to achieving, but that we also need to be honest with ourselves and those around us when we talk about why we are engaged in a particular social movement, and why we are engaged in the particular ways that we are with that movement.

I grew up in a family that was very much aligned and involved with the United Farm Workers movement to achieve basic human rights and dignity for farm workers.

At first I found it odd when Barack Obama used "Yes We Can" as one of his campaign slogans. And I still find it odd that many members of the LGBT community find themselves so enamored of Obama when he does not at this point in time support full equality.

But in his use of this slogan, an appropriation of the UFW's "Si se puede," I chose to see his solidarity with a still very much-maligned group - a group that is often scapegoated for taking jobs that very few are actually willing to do - and to focus on his recognition that even in our differences we are all the same, and that as President-elect of the United States he is focused on our unity.

As long as we are united, we are in conversation; and it is only when people come together that true change emerges and can be sustained.