White House Chronicle

News Analysis With a Sense of Humor

In Search of the Real Elizabeth Warren

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By Llewellyn King

I went to Boston this week in pursuit of the real Elizabeth Warren. You see, I don’t think the whole story of Warren comes across on television where she can seem overstated, too passionate about everyday things to be taken seriously.

Like others, I’ve wondered why the progressives are so enamored of her. Suffolk University, mostly known for its authoritative polls, gave her platform as part of an ongoing series of public events in conjunction with The Boston Globe. But whether the dearest hopes of the progressives will be fulfilled, or whether the senior senator from Massachusetts has reached her political apogee is unclear.

What I did find is that Warren has star power. She is a natural at the podium, and revels in it. At least she did at Suffolk, where the cognoscenti came out to roar their affirmation every time she threw them some red meat, which she did often.

Here’s a sampling:

On student loans: “The U.S. government is charging too much interest on student loans. It shouldn’t be making money on the backs of students.”

On the U.S. Senate: “It was rigged and is rigged [by lobbyists and money in politics]. The wind only blows in one direction in Washington … to make sure that the rich have power and remain in power.”

Warren’s questioner, Globe political reporter Joshua Miller, led her through the predictable obstacle course of whether she was angling to be the vice presidential candidate, if Joe Biden runs and becomes the Democratic nominee. She waffled on this question, as one expected, admitting to long talks about policy with Biden and declaring herself prepared to talk policy with anyone. She said the subject of the vice presidency might have come up.

Short answer, in my interpretation: She would join the ticket in a heartbeat. This isn’t only for reasons of ambition — of which she has demonstrated plenty, from her odyssey through law schools, until she found a perch at Harvard as a full professor — but also age.

Warren is 66 years old and although her demeanor and appearance are of a much younger woman, the math is awkward. There are those in the Democratic Party who say she needs a full term in the Senate to get some legislative experience and to fulfill the commitment of her first elected office. But eight years from now, she’ll probably be judged as too old to run for president.

Clearly Warren didn’t fancy the punishment, and probable futility, of a run against Hillary Clinton. But the vice presidency might suit her extraordinarily well, given Biden’s age of 72.

Warren has stage presence; she fills a room. She is funny, notwithstanding that you can be too witty in national politics, as with failed presidential aspirants Mo Udall and Bob Dole. She reminds me of those relentlessly upbeat mothers, who were always on-call to fix things in the children’s books of my youth.

Although Warren comes from a working-class background, years of success at the best schools has left her with the patina of someone from the comfortable classes; someone for whom things work out in life. She counters this by stressing the plight of the middle class, the decline in real wages and her won passion for fast food and beer — light beer, of course.

Warren’s father was janitor in Oklahoma who suffered from heart disease and her mother worked for the Sears catalog. The young Elizabeth did her bit for the family income by waitressing.

However, it’s hard to imagine her at home at a union fish fry. My feeling is  that she’d be more comfortable — the life of the party, in fact — at a yacht club.

Progressives yearn for Warren and she speaks to their issues: the lack of Wall Street regulation and federal medical research dollars, and the need for gun control, student loan reform, equal pay for equal work, and government contracting reform.

Less dour than Bernie Sanders, and less extreme, it’s no wonder they long for her to occupy high office; she’s a classic, untrammeled liberal.

All in all, I’d like to go to a party where Warren is the host: the kind where they serve more than light beer.  — For InsideSources.com.

May 12: A Disease Gets Its Day, but Who Cares?

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May 12 is not a day that is written into history. It is not a day when there will be, like clockwork, a presidential proclamation, or a moment of silence. Yet, for some, it is a day of recurring infamy.

Since 1992, it has been the day on which Myalgic Encephalomyelitis (ME) sufferers — and those who care for them– have marked the disease. It is, for these people, a day of sorrow, of remembrance and of yearning. They remember those who have died, or committed suicide.

They are angry — often too angry to be persuasive — that ME is not on the national radar. They are angry that after more than three decades, the federal government is still seeking to define the disease, which afflicts about 1 million people here and 17 million worldwide; that research funding, at $5 million, is so low that in the world of Washington expenditures, you practically need an electron microscope to find it; and that the suffering goes on unmitigated.

They are angry that the government, through the Centers for Disease Control, abandoned the old name, Myalgic Encephalomyelitis, in favor of the dismissive new name, Chronic Fatigue Syndrome. They believe this trivializes the disease, and favors those who want to define it as a psychological affliction rather than a real disease.

They are angry that distinguished researchers, like the virus hunter Dr. Ian Lipkin of the Columbia University Medical Center, has had to resort to crowdfunding to continue his work that might help ME patients.

Why does the ME community observe May 12? It is the birthday of Florence Nightingale, who may have suffered at the end of her life from a variant of ME.

So this May 12, Mary Dimmock, a mother of a suffering son, will endeavor to unfurl a banner made of pillowcases on the grass outside the U.S. Capitol. Her goal: Get recognition for the disease, so the long work of finding answers and a cure can be accelerated.

What is known is that ME is a disease of the immune system, and it starts with flu-like symptoms or with collapse after exercise. In extreme cases, as with Dimmock's 26-year-old son, Matt, the patient becomes almost totally incapacitated with mental fog, painful joints, terrible headaches, intestinal upset, and extreme sensitivity to sound and light. Matt Dimmock has to spend his days on a bed set up in a closet.

Patients go through periods of extreme debilitation for two or more years, sometimes recovering enough to function for several hours a day. What a healthy person would consider to be normal activity — like going to dinner or a movie with friends — can result in two days in bed for a ME patient.

Doctors, on the whole, know very little about the disease.

Mary Dimmock is an unlikely protester. She has presence: tall and distinguished. She is a scientist, who took early retirement from a large drug company to care for her son and has become an advocate for this disease, which has confiscated so many lives.

Although ME knows no age or gender, the National Institutes of Health (NIH) has lodged what little effort it makes under “women's health.” One patient said, “Maybe they think we are hysterical women, who are just making a fuss.”

Dimmock is the antithesis of an hysterical woman. She became an activist when she found, after her son fell ill four years ago, that where ME is concerned, the system is broken. She told me, “It has been profoundly disturbing to watch the world around my son, especially the medical community, ridicule and even brutalize him for believing that his disease is real and serious.”

Around the world, the ME story is the same: Doctors who do not know anything about the disease and governments that do not want to know anything about it, or want to believe, for economic reasons, that it is a psychosomatic affliction, when there is ample evidence that it is an immune system disease.

I have interviewed many patients, and some of the small coterie of doctors who are working on the disease. They all wish the Department of Health and Human Services would take a proactive role through its agencies, the NIH and the CDC. More and more dedicated researchers have been forced to turn to crowdfunding because the agencies of government, charged with the public health, have turned out to be selective in their sense of who is sick. — For the Hearst-New York Times Syndicate

The Shame of Biomedical Research in the U.S.

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When the dark shadow of incurable disease settles across a life, it is brightened only by the hope that science is on the job: The cavalry will come.
Horribly the cavalry — researchers in the big pharmaceutical companies and the government-run National Institutes of Health and the Centers for Disease Control — may not even have mounted.
 
New drug development is a murky business governed by huge risks, inertia, bureaucracy and politics.
 
I've been looking at the role of biomedical research and the development of new therapies and drugs through the lens of one disease, Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis. But it is symptomatic of the whole struggle for cures, which means funds. It is a peephole into a system in chaos; where good intentions, economic reality, public pressure, politics and bureaucratic apathy play a role in where the research dollars go.
 
I've been writing about CFS for several years now, so I understand the dilemmas those who are in charge of biomedical research in government and private industry face. It is a disease of the the immune system, like AIDS, but it is mostly a medical enigma. It is hard to diagnose because there are no normal markers in blood or urine. It prostrates its victims essentially for life. In its severest form, patients lie in bed in darkened rooms, often feeling that their bones are going to explode. It cries out for more research, as do many other little understood diseases.
 
A very small coterie of physicians — maybe not many more than 50 in the United States — specialize in CFS and have developed private clinics for research into alleviating therapies. None of them are set up to do major drug research in the way that pharmaceutical companies do.
 
Big Pharma — as the drug behemoths are known collectively — is at the heart of new drug development, aided by preceding biomedical research that takes place through government grants to researchers in universities, teaching hospitals and private clinics. It is a complex matrix.
 
A new drug can cost over $1.2 billion to develop. It is a very high-risk undertaking — maybe the riskiest investment decision made in the private sector is developing a new drug. It is also a tortuous undertaking.
 
First a target has to be selected where there is a large enough patient cohort to establish a market. Then the science begins. Diseases that are straightforward, in medical terms, edge out those where the causes may be multiple and the resolution may require a cocktail of drugs. Understandably, a rifle shot is more appealing than a shotgun blast. Eight out of 10 drugs fail and are abandoned at some point. The winners have to pay for the losers.
 
If, after years of research, a compound that may work is discovered, the laborious business of testing it on animals must precede human trials with control groups and years of analysis. Finally the drug must be approved by the Food and Drug Administration which looks for efficacy, safety, risk benefit and manufacturing stability.
 
Into this already difficult world of new drug development, enter the politicians.
 
Some believe private enterprise will shoulder all the risks and is the right place for research. Others don't understand the vital role that government research grants — administered by NIH and CDC — play in the development of biomedical knowledge: the essential precursor to new drugs and therapies. Its funding is on a see-saw; it was down under sequestration and funding is restored but not boosted under the new budget deals. It tops out at $29.9 billion, a decline of 25 percent since 2003, according to The Atlantic magazine.
 
Chronic Fatigue Syndrome — which has 1 million Americans suffering hopelessly every day — gets about $6 million a year from NIH. What's wrong with that largesse? Well, remember, it costs $1.2 billion to develop a new drug once the biomedical case is made. As they say, you do the math – and don't expect the cavalry to ride to the rescue anytime soon.
 
Across the board, researchers are dependent on government funds augmented by foundations and charitable giving. Yet biomedical research pays as a national investment. American drugs are an export commodity, the cost of healthcare is contained and, yes, the suffering is reduced even as life is extended. China, by the way, has said it will surpass the United States in actual biomedical research dollars in five years. — For the Hearst-New York Times Syndicate

The Awful Disease Washington Forgot

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In the end, as with so much else, the fight against disease leads to Washington. There are big diseases with big lobbies, like AIDS, Alzheimer’s, cancer, diabetes and heart. Their millions of sufferers have associations and lobbies to push for federal research money and to shape its expenditure. Most have their celebrity backers, like Elizabeth Taylor for AIDS, Jerry Lewis for muscular dystrophy, and Mary Tyler Moore for diabetes.

Big lobbies mean big federal dollars, the attention of the National Institutes of Health in Bethesda, Md., and the Centers for Disease Control in Atlanta. If the disease is the kind for which a single or series of silver bullets can produce a cure, Big Pharma comes in with big funding, in the hope that it can develop a lucrative line of medicines, patentable for long-term profits.

Yet there is a vast archipelago of diseases as cruel in their impact, horrible to bear and crying out for research that is not sporadic, underfunded or, through ignorance, misdirected.

One such is Chronic Fatigue Syndrome (CFS), a name so gentle that it belies the ghastliness of this affliction. Sufferers accuse the U.S. government, abetted by other governments, of choosing this name over the older and more commanding name, myalgic encephalomyelitis.

CFS is not about a name game. It is about debilitation lasting decades, essentially from inception to death. It is about years of lost living, terrible joint pain and total collapse, as the immune system more or less shuts down. It is like some great constricting snake that denies its victims the final convulsion.

Enter Sen. Harry Reid (D-Nev.). While he is not generally regarded as a man on a horse these days, to CFS sufferers he is a figure of hope. He has stood up for CFS research.

This is not because the Senate majority leader sought to know a lot about a hard-to-understand and terrible affliction, but because CFS was found in two clusters in his home state. The largest outbreak was at Incline Village, Nev. In New York state, there is a cluster too.

In the 1980s government scientists looked at these clusters, but refused to accord them the respect the suffering deserves. It was then that the name was changed; “fatigue” was less politically incendiary than myalgic encephalomyelitis.

Incline Village is significant because it shows that CFS is infectious, or that it has environmental causes. The thinking is that while clearly not having a strong transmission path, it does happen.

Recently a sufferer in England wrote to The Daily Mail, saying that her husband, who had cared for her for nearly 20 years, had become infected. This is particularly serious in England, where the medical establishment has insisted on treating the disease as a psychological disorder, despite recent research suggesting strongly that it is retrovirus XMRV.

Now, at last, two world-famous pathogen hunters, Anthony Fauci of NIH, previously seen as a debunker of CFS science, and Ian Lipkin, a celebrity pathogen hunter, are heading a major safari into the dark world of retroviruses.

For the first time, the loose global network of sufferers–nobody knows how many there are in the world, but in the United States there could be as many as 800,000—are beginning to apply political pressure.

Their plight is pitiable. The full horror of the disease is described in a paper by Deborah Waroff, a gifted New York writer who was stricken in July 1989. An energetic cyclist, skier, squash and tennis player, Waroff wrote in a paper for a Washington conference:

“My sickness began with a flu-like illness. After a week, thinking I was pretty much well, I went back to my ordinary activities, like tennis and my biking. A week later, I was sick again. This repeated several times that summer until I soon got to a point where I was never well again. I had classic symptoms. After a little activity I would just collapse, totally fold up. I also had symptoms like fevers, dizziness, upset tummy, swollen lymph glands and a new type of frequent headache. I had cognitive problems embarrassingly often, including dysphasia—putting the wrong words in sentences. I was often too weak to talk on the phone, or after five minutes of talking I would fold.”

In 2003, things got worse. But two years later, Waroff regained some of her life through the controversial treatment of ozone therapy. This treatment cannot be prescribed in most states. Allowed in New York, it is hard to come by and expensive. Some other countries, particularly Canada, have been more committed to fighting CFS and the use of ozone therapy.

Harry Reid, and others, there is more work to be done.