Sunday, November 30, 2008
Adhesions News
Doctor's advice - Boyfriend pressuring me to smokeJamaica Gleaner, Jamaica - Nov 28, 2008In a lot of young guys, the foreskin is still attached to the head of the organ by little bands of tissue, which are called 'adhesions'. In the teen years, ...
Six Back-Saving Tips for Holiday ShoppersPR Web (press release), WA - Nov 25, 2008The therapy has been shown in peer-reviewed medical journals to reduce adhesions, decrease pain, and restore function. It has proven effective for many ...
Treat golfer's elbow with Graston TechniquePacific Daily News, GU - Nov 24, 2008These adhesions are commonly called knots or myofascial trigger points and can be very painful. I have not examined you, but that spot you press on to ...
Omrix Biopharmaceuticals, Inc. Q3 2008 Earnings Call TranscriptSeeking Alpha, NY - Nov 24, 2008These patients were selected due to the detrimental effect ovarian adhesions can have on a woman's ability to conceive as well as the clinical revenue [ph] ...OMRI
Plant Antioxidant, Lycopene May Protect Germ Cells from Free ...MediNEWS.Direct!, India - Nov 24, 2008Adhesions, fibrous bands formed during the process of healing after surgery, is one of the common causes of tubular dysfunction, which leads to infertility. ...
Student News - Nov. 23Hudson Hub-Times, Ohio - Nov 23, 2008Her research centered on the difficulty of measuring the effectiveness of compounds used in the prevention of adhesions following surgery. ...
Range of motion exercises can prevent frozen shoulderBCLocalNews, Canada - Nov 22, 2008These adhesions cause pain and progressive loss of shoulder motion. Shoulder motion is restricted in a specific pattern, both actively (when you move your ...
Search this blogScienceBlogs - Nov 22, 2008To generate traction the actin is hooked upto these large focal adhesions that line the sides of the membrane and help the cell cling to solids from the ...
Garden Retail Research finds tomato benefitsHorticulture Week, UK - Nov 21, 2008It may also help prevent adhesions in women, where scar tissue causes internal organs to stick together after surgery, according to research at Wayne State ...
Appearance of a Gastrocolic Fistula on Sonography Including Color FlowJournal of Ultrasound in Medicine (subscription) - Nov 20, 2008During the operation, the gastrocolic fistula was not identified because of severe adhesions adjacent to the mass. Accordingly, the surgeon performed ...
Congrats to Maureen Cheung
Maureen Cheung, a senior University of Akron student who is studying chemical and biomolecular engineering, received first-place recognition for her poster presentation at the October 2008 International Society for Pharmaceutical Engineering annual meeting in Boca Raton, Fla.
A resident of Boston Heights and graduate of Hudson High School, Cheung advanced to the ISPE International Student Poster Competition with her presentation, "Development of a Swine Model for the Evaluation of Novel Compounds in the Prevention of Pelvic Adhesions," after placing first in the Great Lakes Competition in April 2008 in Chicago.
Her research centered on the difficulty of measuring the effectiveness of compounds used in the prevention of adhesions following surgery.
"Ms. Cheung's success in this rigorous international competition underlines the potential of such vertically integrated, university-industry research teams: significant findings with immediate, real-world applications," says Dr. George Haritos, dean of the UA College of Engineering.
The ISPE Great Lakes Chapter is composed of students from a six-state area. There are 18 chapters in North America and South America and 19 international affiliates.
Winning competitors at the international competition receive a plaque and a cash award as well as the opportunity to write about their research in Pharmaceutical Engineering magazine.
http://www.hudsonhubtimes.com/news/article/4471419
A resident of Boston Heights and graduate of Hudson High School, Cheung advanced to the ISPE International Student Poster Competition with her presentation, "Development of a Swine Model for the Evaluation of Novel Compounds in the Prevention of Pelvic Adhesions," after placing first in the Great Lakes Competition in April 2008 in Chicago.
Her research centered on the difficulty of measuring the effectiveness of compounds used in the prevention of adhesions following surgery.
"Ms. Cheung's success in this rigorous international competition underlines the potential of such vertically integrated, university-industry research teams: significant findings with immediate, real-world applications," says Dr. George Haritos, dean of the UA College of Engineering.
The ISPE Great Lakes Chapter is composed of students from a six-state area. There are 18 chapters in North America and South America and 19 international affiliates.
Winning competitors at the international competition receive a plaque and a cash award as well as the opportunity to write about their research in Pharmaceutical Engineering magazine.
http://www.hudsonhubtimes.com/news/article/4471419
Tuesday, November 18, 2008
The fate of Stacey Mullens
Stanford Surgeon's Procedures Raise Ethical and Legal Red Flags
Supporters say Camran Nezhat is a miracle worker -- critics call his operations bizarre and barbaric...
With a white surgical mask dangling rakishly below his chin, Dr. Camran Nezhat looks every bit the part in his promotional video: medical pioneer, gifted surgeon, millionaire inventor of operating room tools. The Stanford clinical professor, recruited from his lucrative Atlanta practice, is a rainmaker for the university's medical center and obstetrics and gynecology department. Since he arrived at Stanford in 1993, he has brought patients, prestige, and scores of surgeons to study at the Stanford Endoscopy Center, which he directs.
But along with his brother gynecologists, Drs. Farr and Ceana Nezhat, he has also brought trouble to this elite enclave of high-tech medicine.
Trailing him to Stanford are allegations of reckless and unethical medical conduct. Critics accuse the Nezhats of performing a bizarre and dangerous medical experiment on the rectums of vulnerable female patients and of falsifying data reported in medical journal articles.
In the past five years, 20 doctors and surgeons across the country have signed statements of serious concern about the Nezhats' surgeries and published research and have called for an investigation.
''In my experience in the fields of law and medicine, I can't imagine a group of men who have crossed the line in more ways in the field of bioethics than the Nezhats,'' said Andrea Scott, a Los Angeles attorney and bioethicist.
And if the allegations against the Nezhats are true, soon top Stanford administrators may face troubling questions about the extent to which they heeded repeated warnings about the Nezhats and investigated the charges against them.
While the American College of Gynecology's code of ethics requires members to report questionable medical practices, a top Stanford official threatened at least one doctor with a lawsuit if he continued to criticize the Nezhats.
''There are serious, serious problems going on at Stanford,'' said Dr. Tom Margolis, a former Stanford Medical School professor who has signed a sworn affidavit charging the Nezhats with misconduct. ''Certain people are covering this up because there is a hell of a lot of money going to Stanford because of the Nezhats.''
The Nezhat brothers have declined to be interviewed. Through their Atlanta attorneys, they deny any wrongdoing and question the motives of their accusers, citing professional rivalry and economic competition. Stanford officials say they have thoroughly investigated and rejected allegations of scientific fraud.
Camran Nezhat is embraced by a large cadre of supporters, including Stanford colleagues and patients, who admire him personally and are awestruck by his abilities in the operating room.
''People like (Nezhat) are a rarity,'' said Salinas gynecologist Dr. Rene Charles. ''I'd compare him to Michelangelo, in terms of his surgical skills.''
In a letter of support sent to The Chronicle, 39 Stanford nurses and other health-care staff members describe Nezhat as a worker of ''miracles'' who takes cases ''others have given up on.''
Yet doubts about the Nezhats date back well into the 1980s, when Camran emerged in Georgia as a pioneer in the nascent art of laparoscopic surgery.
And they have been rekindled by recent developments in an astounding malpractice case that has been languishing in Atlanta courts for six years.
That case could determine once and for all whether the Nezhats are the pioneering surgeons they claim to be or whether they catapulted their careers to Stanford on the basis of a dangerous and grotesque medical fraud.
BUILDING A PRACTICE, 1988
Camran Nezhat and his brothers grew up in prerevolutionary Iran, where each attended medical school. Camran emigrated to the United States in 1974 and completed his obstetrics and gynecology residency at the State University of New York at Buffalo.
In 1978, he received a two-year reproductive endocrinology fellowship at Medical College of Georgia in Augusta. Farr and Ceana followed their older brother to Augusta and eventually joined Camran's growing practice in Atlanta.
During the 1980s, while practicing at Atlanta's Northside Hospital, the Nezhats began to develop a reputation for their skills in laparoscopy, a type of surgery in which laser scalpels, miniature cameras and long-stemmed instruments are worked inside the body through dime-sized incisions.
They published scores of articles in medical journals, claiming a remarkable series of ''surgical firsts.'' They also developed a number of ingenious instruments for the laparoscopic operating room. A company they co-founded, American Hydro-Surgical Instruments Inc., eventually sold for $40 million.
Their specialty was treating endometriosis, a painful ailment afflicting an estimated 5 million American women. It is caused when cells that make up the lining of the uterus migrate and bind to other parts of the abdominal cavity, swelling with the monthly menstrual cycle, sometimes causing debilitating pain. The condition is often linked to infertility.
Northside Hospital began promoting the Nezhats, hiring a public relations firm to spread the word about the doctors and their accomplishments. Camran was featured in Newsweek and the Chicago Tribune, and on MSNBC, CNN, ABC's ''20/20'' and elsewhere.
The brothers garnered a reputation as some of the world's foremost innovators of laparoscopic surgery, attracting cash-paying patients from around the globe.
THE MULLEN CASE, 1991
Suffering from endometriosis, 28-year-old Stacey Mullen flew from Southern California to Atlanta's Northside Hospital in 1988 to be operated on by Camran Nezhat. The surgery was quick, the pain was gone, and Mullen was elated as she walked out of the hospital the next day.
''I was ready to name my firstborn after Camran Nezhat,'' she said.
But, as often happens, the endometriosis and the pain returned. And in December 1991, Mullen flew back to Atlanta for what she thought would be another ''quick little surgery.''
The surgery, however, was neither little nor quick.
Camran and his brother Farr, with colorectal surgeon Dr. Earl Pennington assisting, spent hours using laparoscopic techniques to cut Mullen's colon and rectum free of nerves, blood vessels and connecting tissue. Her ''mobilized'' rectum was pulled inside out through her anus, and suspected endometrial tissue was removed. Her patched-up rectum was then pushed back inside.
Then the complications began.
Hours after surgery, part of her colon dropped out of her body as she sat on the toilet. For months, she suffered from extreme constipation. Sometimes she burped up her own feces.
Mullen never regained normal use of her bowel. Eventually, she received a colostomy and must insert a tube into an opening in her side to go the bathroom.
In December 1993, after nearly two years of continuing pain, she filed a malpractice suit against the Nezhats. ''Those bastards ruined my life,'' she said.
THREE ARTICLES, 1993
Shortly after taking Mullen's case, attorney James Neal discovered two medical journal articles that the Nezhats and Pennington had published after Mullen's operation.
The first appeared in Fertility & Sterility in May 1992, describing a single case using the new pull-through procedure for treating rectal endometriosis. ''As with all new procedures,'' the article said, ''there are no data to establish its safety.''
The second was published in the September 1992 issue of Surgical Laparoscopy & Endoscopy. It detailed a series of 16 rectal surgeries, similar to Mullen's, performed in late 1991 and early 1992 - the period during which her surgery took place.
Yet Mullen's case - and her complications - were not mentioned.
The article listed only a single complication: The doctors had to perform traditional open abdominal surgery in order to complete the suturing of one patient's bowel.
''This procedure has been performed safely in this initial series,'' the Nezhats wrote, and they claimed fewer problems than would be expected with regular open abdominal surgery.
The Nezhats aggressively publicized the ''success'' of the new procedure. It was touted by Ethicon Inc., the Johnson & Johnson subsidiary that made the instruments the Nezhats had used. ''For the estimated 185,000 women who suffer from endometriosis of the rectum, this new advance provides them with relief from the digestive symptoms,'' the company said.
At a 1991 American Fertility Society meeting in Orlando, and a 1992 convention of the American College of Obstetricians and Gynecologists in Las Vegas, Ethicon promoted their instruments and the Nezhats, even including a video of the surgery.
But skepticism about the Nezhats and their procedure was beginning to grow. The lack of complications did not make sense for such radical bowel surgery, doctors said. Some surgeons who viewed the promotional video were puzzled: They could not see evidence of endometriosis.
Stories began circulating in the surgical community around Atlanta's Northside Hospital. The medical journal articles said the average operating time for the surgeries was three hours, but during the time of the study, the Nezhat operating room had been burning lights deep into the Georgia night.
Then Neal discovered a third journal publication, written by one of Nezhat's Atlanta colleagues and published more than a year after Mullen's operation.
The article in Surgical Endoscopy described a ''pilot'' study testing the same procedure on pigs in order to assess its safety on humans.
''Some damage to the sphincter might occur,'' the authors wrote, but the long-term effects were unknown: The pigs were ''sacrificed'' before they awoke from anesthesia.
Neal and Mullen were stunned: Not only had the Nezhats omitted Mullen's case from their series - and in doing so did not report her complications - they apparently had tried out the new procedure on her and other women before it was tested on pigs.
Nezhat attorney David Walbert said the pig study ''had nothing whatever to do with the safety and efficacy'' of the human surgery described in the medical journals. The purpose of the pig experiment, he said, was to determine whether the procedure was suitable for treating cancer.
'BARBARIC,' 1993
When Neal began contacting medical experts about Mullen's surgery, many sent him letters and affidavits calling the operation radical and experimental; they characterized it as ''bizarre'' and ''barbaric.'' It resembled a cancer surgery that had been discredited years before, after complication rates as high as 50 percent were reported.
The surgery had not been vetted before a Northside Hospital Institutional Review Board, the usual requirement for an experimental procedure.
''Normally you go before an IRB, come up with scientific background, present a plan, torturous documentation, nine pages of informed consent, and you cannot charge for it,'' said Ohio general surgeon Dr. Francis Barnes.
Mullen and her insurance company, however, were billed $9,900 for the rectal surgery. She eventually ran up more than $1 million in additional medical expenses as a result of the operation, according to Neal.
Neal also learned that Mullen - and possibly four other women whose cases were included in the Nezhats' articles - had signed an unusual document, recently created by the Georgia legislature. It was called a ''waiver of informed consent,'' and it set aside a patient's right to detailed information about a surgery.
''This is incomprehensibly unethical,'' said Arthur Caplan, director of the University of Pennsylvania Center for Bioethics and one of the nation's foremost medical ethicists. ''You can no more sign away your right to informed consent than you can voluntarily sell yourself to slavery.''
''I never knew I was signing such a document,'' Mullen said. ''I thought it was a regular consent form.''
Yet the most disturbing discovery was made in Mullen's own medical records. In his operative notes, Camran Nezhat wrote: ''There was evidence of severe endometriosis of the rectum.''
But Mullen's pathology lab report disclosed that there had been no endometriosis on the wall of her rectum at all - just a few cells in the adjoining fat. The surgery had not been necessary in the first place.
16 MEDICAL RECORDS
Neal went to court and demanded to see the medical records of the 16 other patients the Nezhats had operated on in Georgia, convinced they would show complications, more waivers of informed consent, and surgical data different from what was reported in the Nezhat articles.
But the Nezhat legal team refused to turn them over, citing privacy concerns of other patients - at least 10 of whom signed affidavits opposing any release.
Mullen was given the waiver form by mistake, they explained, and she was told about the procedure's risks. Medical experts for the Nezhats also insist that the rectal surgery was not experimental, so no Institutional Review Board process was required.
''In my opinion, the surgery performed on Mary (Stacey) Mullen was a necessary procedure and would not require any special consent form for experimental surgery,'' said Dr. Robert R. Franklin, a clinical professor in the department of obstetrics and gynecology at Houston's Baylor College of Medicine.
The Nezhat lawyers also argue that Mullen's rectal surgery did not cause her bowel problems. ''She reported constipation before the procedure,'' said Walbert.
THE FIRST WARNING, 1993
In the early 1990s, Stanford Medical School's department of obstetrics and gynecology was in trouble. Despite the school's lofty reputation, the department was not fully accredited.
The Chicago-based Accreditation Council for Graduate Medical Education demanded more ''surgical volume'' before it would upgrade the program's ''provisional'' status.
Yet when Dr. Nick Spirtos heard that Stanford was recruiting the Nezhats, he could not believe it.
Spirtos is a Palo Alto gynecological oncologist with an august reputation of his own. Like the Nezhats, he is a clinical professor, which means he serves on the school's voluntary teaching faculty with surgical privileges at the medical center. He also holds the elected post of deputy chief of the obstetrics and gynecology department.
During the past nine years, he has become a leading critic of the Nezhats and their Stanford defenders.
''I think everything they've written is fraudulent,'' said Spirtos, whose office is just one floor below the Nezhats' in an upscale medical office building near Stanford. ''I don't think they should be allowed to practice medicine.''
Spirtos had traveled with colleagues to a gynecology convention in Florida to see the 1991 presentation by Camran and Farr Nezhat sponsored by Ethicon. The program included videos of two new Nezhat operations, one of them showing the rectal procedure that would be performed two months later on Mullen.
''We couldn't believe what we saw,'' Spirtos said, noting that there was no evidence of endometriosis. ''The surgeries didn't make any sense.''
But before they could quiz the Nezhats about their presentation, Spirtos recalled, the Nezhats left the podium, refusing to answer questions.
Two years later, after studying their journal articles, he warned university administrators not to bring them to Stanford. Spirtos argued that the Nezhats' published data were simply too good to be true.
But Spirtos said his advice was ignored.
''It was a perfect marriage,'' he said. ''The Nezhats had all the dough in the world but no title. And Stanford needed desperately to have surgical volume to legitimize their (obstetrics and gynecology) department.''
NEW TROUBLE, 1993
Within two years of the Nezhats' arrival in Palo Alto, Camran became director of the new Stanford Endoscopy Center for Training and Technology. And Ethicon, which had retained Nezhat as a surgical investigator, agreed to provide a $125,000 annual grant to the center.
Quickly, the Nezhats began pairing up with surgeons outside their immediate discipline - including specialists in cancer, heart and brain surgery - with the goal of expanding the use of minimally invasive surgical techniques.
The practice troubled Spirtos, and when he learned that Camran Nezhat intended to operate on a patient of one of Spirtos' medical partners, he wrote in protest to Dr. Mary Lake Polan, the chief of the obstetrics and gynecology department.
The patient was a 74-year-old woman who had undergone extensive surgery for the removal of pelvic cancer, and Spirtos told Polan that the patient's cancer had spread so extensively that laparoscopic surgery would be useless.
''Certainly, (Nezhat) has no experience in this area (treating cancer), and it seems to me serious patient care issues are being placed on the back burner in your headlong rush to promote the Nezhats,'' he said in a 1993 letter to Polan.
Despite Spirtos' protests, Nezhat and Stanford cancer surgeon Dr. Nelson Teng went ahead with the operation.
The patient was on the operating table for seven hours and was hospitalized for seven days afterward. Her bladder and bowel were punctured during the operation, Spirtos said, and the doctors could not remove all the cancer. In his report to the university's ''quality assurance'' review committee, Spirtos charged that Nezhat, credentialed as a gynecologist, was performing cancer surgeries, a specialty that requires years of extra formal training. He also laid out four other Nezhat cancer cases for the quality assurance review committee.
''No other hospital would allow a gynecologist to perform (cancer) surgeries,'' said Spirtos.
But his hope for a quick review of the five cases soon faded. ''Stanford sat on those cases for years,'' he said.
NEZHAT'S AFFIDAVIT, 1994
Meanwhile, Mullen and her attorney continued to press for the release of the files on the 16 other women who had undergone the rectal procedure. And the Nezhats continued to refuse.
In a sworn 1994 affidavit, Camran Nezhat declared it would disrupt his practice for months if he were ordered to produce records demanded by Mullen's legal team.
He described a filing system with 20,000 patients, each listed only alphabetically, with no index, no computer database and no cross-referencing by type of treatment, surgery performed, or journal publication.
''I would . . . have to manually review every single patient record . . . to determine whether the record referenced a patient whose procedure was the subject of a journal article,'' he testified.
The affidavit shocked Nezhat's critics, who say it has cast a pall on the validity of the Nezhats' research ever since.
''I've been doing this kind of research for 25 years. There is a substantial problem if you cannot link patient records to publications,'' said Dr. David Grimes, former chief of obstetrics and gynecology at San Francisco General Hospital, who briefly served as a paid expert to Mullen's legal team.
How, asks Grimes, can the Nezhats publish extensive studies based on old charts and old data involving hundreds of patients over many years if those patients' files are not indexed or cross-referenced?
Grimes was not the first doctor to question the Nezhats' research. Long before they publicized their controversial bowel surgery, competitors and collaborators alike were skeptical of the brothers' claims of surgical firsts and problem-free procedures. In 1987, Dr. Harry Reich, a world-renowned laparoscopic surgeon at New York's Columbia-Presbyterian Medical Center, agreed to collaborate with Camran Nezhat on a surgical study of 105 tubal pregnancies.
But Reich was bothered by Nezhat's repeated failure to share his data on 40 patients to be included in their article in the Journal of Reproductive Medicine.
''So we had to delete the data from the paper,'' Reich recalled.
The Nezhats' lawyers say Reich never requested any data that were not provided.
In 1990, a Nezhat report in the journal Obstetrics and Gynecology also raised eyebrows. The Nezhats stated they had performed 4,000 laparoscopic surgeries without injuring a ureter, the tube connecting the kidney and bladder.
Their claim drew a sarcastic response from three Yale University doctors: ''The authors are to be congratulated. . . . Either these surgeons had other complications, perhaps as serious, or they possess an unbelievably high level of skill and judgment.''
Other articles in which the Nezhats claim to have reviewed thousands of old cases include:
-- A 1995 textbook article describing 214 complications among 6,949 cases in Atlanta and Stanford from 1982 to 1993.
-- A 1996 medical journal report of severe urinary tract endometriosis in 28 women among 2,226 treated for endometriosis from 1989 to 1994.
-- A 1997 study examining 5,300 surgeries dating back to 1988, counting up 11 hernias caused by insertion of the laparoscope.
Atlanta attorney Walbert scoffs at accusations of medical fraud. ''Many, many surgeons'' have conducted research with the Nezhats, he said. ''Those who have any knowledge have never claimed there was anything 'bogus' about any of the reports.''
Dr. Sally Tazuke, a Stanford reproductive endocrinologist who has worked with Camran Nezhat frequently, said his reported complications are low because he is exceptionally good at what he does - even while taking on the riskiest cases. ''If I were a patient, I would sign up with him. I'd send any family member,'' she said.
Skeptics say the stakes are high. Dr. Thomas Lyons, an Atlanta gynecological surgeon who believes the Nezhats have published journal articles with phony data, said medical fraud can lead unsuspecting doctors to hurt their patients.
''This is as dangerous a situation as you can run into in medicine, because people may be making medical decisions based on something that doesn't exist,'' he said.
If someone ever questioned the veracity of his own data, Lyons said, ''The first thing I would do is throw that data right in their face. . . . The best defense in the world is the truth.''
NEAL'S LETTER, 1995
In January 1995, Mullen's attorney, James Neal, wrote to Stanford, alerting the university to the allegations his legal team was making against the Nezhats. As a former hospital counsel himself, he said he thought they would appreciate a copy of the Mullen lawsuit.
''I feel that your institution should have the opportunity to evaluate these matters . . . given your understandable and overriding concern for the patients within your institution,'' Neal wrote.
But Stanford took no action.
Instead, Margaret Eaton, a university lawyer, forwarded the letter to Nezhat's attorney in Atlanta, with a note saying that ''we do not intend to respond to this letter, nor are further communications from Mr. Neal welcome.''
In June 1995 the Accreditation Council for Graduate Medical Education approved full accreditation to Stanford.
ALLEGATIONS, 1996
A year later, Neal sent Stanford a thick package of documents, laying out in more detail the charges against the Nezhats and asking Stanford to investigate.
Dr. Richard Popp, Stanford's senior associate dean for academic affairs, said Neal provided a ''massive amount'' of what he called ''disorganized'' information.
Popp finally opened an inquiry into the charge of scientific misconduct. But university officials contend that by that time, some of the allegations, including Neal's claim of medical journal fraud, had been thrown out by the Georgia courts.
Neal, who freely admits that he has become obsessed with exposing the Nezhats, was running up a list of legal setbacks. In his dogged pursuit of the Nezhats, he was building a reputation as a crank.
He was disqualified from the malpractice case by a Georgia judge in 1995 for ''unethical behavior'' and could no longer represent Mullen. After a federal judge last year tossed out his attempt, on behalf of another client charging malpractice, to use racketeering charges against the Nezhats, Neal was charged with contempt of court. The judge also assessed $384,000 in ''sanctions'' against the plaintiff and her remaining attorneys. The sanctions are on appeal.
Neal denies the unethical conduct allegation, and the contempt of court charge was recently dropped. The only thing he is guilty of, he says, is aggressively representing his clients against institutions willing to look the other way.
''These guys are bad doctors, some have even said evil, and they have to be stopped,'' he said.
WITNESS, 1996
Shortly after Dr. Tom Margolis joined Stanford as an assistant professor and chief of pelvic surgery, Farr Nezhat invited the newcomer to watch him perform a complex laparoscopic procedure.
During the operation, Nezhat cut the patient's ureter. Margolis, who had also served as director of urogynecologic/pelvic surgery at Northwestern University Medical School, assumed it was an accident, a known but unwelcome complication of the difficult surgical technique. He stepped in to assist Nezhat in repairing it.
But a short time later Margolis learned that, in a post-operative review session and the operative report, Nezhat described the cut as deliberate. He said he sliced the ureter to remove endometriosis that could have blocked urine flow.
Margolis was outraged. He said that he saw no endometriosis on the ureter and that the pathology report proved it.
''It was clear that Dr. Nezhat was performing an unnecessary procedure,'' he said in a sworn affidavit.
THE POLAN MEETING, 1996
More than two years passed before Stanford's quality assurance committee took up the review of the five cancer cases in which Spirtos had alleged improper surgeries by Camran Nezhat.
Just before the review committee was finally set to meet, Dr. Mary Lake Polan, chairman of obstetrics and gynecology, dropped by Margolis' office. He was one of the physicians reviewing the cases.
''We need to make sure that Nezhat is cleared on all these (cancer) cases,'' she told him, according to his affidavit.
Ultimately Margolis - and the other members of the quality assurance committee - voted in favor of Nezhat on all charges.
Polan said Margolis' allegations are false.
''I adamantly deny the statements attributed to me and deny there has been any pressure to exonerate any physician during the quality of care committee process," she declared in a written response to The Chronicle.
Margolis' decision to vote to exonerate Nezhat would haunt him for more than a year, until finally he had to act.
THE SHUER LETTER, 1998
In April 1998, Margolis met with Dr. Lawrence Shuer, chief of staff of the medical center. He told Shuer about the cut ureter incident and the pressure Polan had allegedly exerted on him.
''He (Shuer) acutely and abruptly ended our conversation, and I was excused from his office,'' Margolis said.
More than a year later, when Shuer learned Margolis was still criticizing the Nezhats and Stanford, he sent a written warning:
''Rest assured that Stanford Hospital and Clinics intends to pursue its full legal remedies if these defamatory and libelous statement do not cease,'' Shuer wrote.
Furious, Margolis, who had left Stanford to practice with Spirtos at the Women's Cancer Center in Palo Alto and Los Gatos, wrote back, saying that Shuer's job as chief of staff was ''patient protection not doctor protection.''
''The data which (the Nezhats) have published, including the rectal eversion procedure, is fraudulent, yet their publications are being accepted as standards in the surgical community. Stanford, by not auditing this clinical data, has ignored the concerns of scores of surgeons,'' Margolis wrote.
STANFORD'S DUTY, 2000
Defenders of the Nezhats at Stanford dismiss both Spirtos and Margolis as jealous competitors. But other medical experts say Stanford should have demanded a review of the 16 cases and has shirked its responsibility to verify the Nezhats' research claims.
''Stanford has a duty to review this,'' said Dr. Warren Grundfest, chairman of Biomedical Engineering at UCLA and an expert in new medical technologies. ''Serious allegations have been made by credible people, but Stanford has played like an ostrich with its head in the sand.''
But Stanford officials contend they are not obligated to review the 16 patient records because the rectal surgeries were performed in Georgia before the Nezhats came to the West Coast. Shuer said the procedure in question has never been performed at Stanford.
It was appropriate for the Nezhats to leave Mullen's case out of the medical journal, according to Stanford, because she was ultimately found not to have rectal endometriosis like the other patients.
Stanford reviewers have never asked the Nezhats or Northside Hospital for the records to verify the accuracy of the other 16 cases. ''We have no right to the records and do not want to violate patient privacy,'' said Stanford's lawyer Debra Zumwalt.
The university also never interviewed Mullen or the 20 doctors who have expressed concern over the Nezhats' research.
According to Stanford, the appropriate institutions to investigate the Nezhats are Northside Hospital, the Georgia Medical Board and Mercer University, where the Nezhats were clinical professors at the time of the surgeries. ''Stanford will carefully review the conclusions of those investigations,'' said Popp.
But a spokesman for Mercer, a Macon, Ga., medical school founded in 1986, said the school has no investigation pending.
The Georgia Medical Board's investigation of the Nezhats is continuing. The board will not comment on its status.
Stanford attorney Zumwalt said Margolis' complaint to Shuer regarding the cut ureter incident was never put in writing. Shuer said he asked Margolis for more information, and none was provided, but the case has now been identified and is being investigated by the quality assurance committee.
The university said the Nezhats have been cleared of allegations that they operated outside their specialty. Officials would not comment, however, on any details of the five quality assurance cases because they are confidential.
''One thing I can point out,'' said Zumwalt, ''is that doctors and patients and their families can reasonably disagree as to how aggressive to be in treating terminal diseases.''
GEORGIA COURTROOM, 2000
Mullen has refused to engage in monetary settlement talks with the Nezhats and promises to continue her suit until the records of the 16 other women are made public.
''My life has been changed in a very horrible and profound way by the experiment (that) Camran Nezhat has conducted upon me without my knowledge,'' Mullen said in an affidavit. ''I despair that other women will be injured by well-meaning surgeons who believe Camran Nezhat's article that there were no complications from this new surgery.''
In November, after a battle spanning six years - and six judges - Superior Court Judge Melvin Westmoreland in Atlanta ordered a confidential release of the records to Mullen's lawyers, and in January, the Nezhats and Northside Hospital turned them over.
While the records remain sealed, medical experts hired by Mullen's legal team to review the documents have written Judge Westmoreland expressing their concern about what the records contain, and urging that they be unsealed, in the public interest. ..
William Carlsen can be reached at wcarlsen@sfgate.com. Sabin Russell can be reached at sabin@sfgate.com.
Supporters say Camran Nezhat is a miracle worker -- critics call his operations bizarre and barbaric...
With a white surgical mask dangling rakishly below his chin, Dr. Camran Nezhat looks every bit the part in his promotional video: medical pioneer, gifted surgeon, millionaire inventor of operating room tools. The Stanford clinical professor, recruited from his lucrative Atlanta practice, is a rainmaker for the university's medical center and obstetrics and gynecology department. Since he arrived at Stanford in 1993, he has brought patients, prestige, and scores of surgeons to study at the Stanford Endoscopy Center, which he directs.
But along with his brother gynecologists, Drs. Farr and Ceana Nezhat, he has also brought trouble to this elite enclave of high-tech medicine.
Trailing him to Stanford are allegations of reckless and unethical medical conduct. Critics accuse the Nezhats of performing a bizarre and dangerous medical experiment on the rectums of vulnerable female patients and of falsifying data reported in medical journal articles.
In the past five years, 20 doctors and surgeons across the country have signed statements of serious concern about the Nezhats' surgeries and published research and have called for an investigation.
''In my experience in the fields of law and medicine, I can't imagine a group of men who have crossed the line in more ways in the field of bioethics than the Nezhats,'' said Andrea Scott, a Los Angeles attorney and bioethicist.
And if the allegations against the Nezhats are true, soon top Stanford administrators may face troubling questions about the extent to which they heeded repeated warnings about the Nezhats and investigated the charges against them.
While the American College of Gynecology's code of ethics requires members to report questionable medical practices, a top Stanford official threatened at least one doctor with a lawsuit if he continued to criticize the Nezhats.
''There are serious, serious problems going on at Stanford,'' said Dr. Tom Margolis, a former Stanford Medical School professor who has signed a sworn affidavit charging the Nezhats with misconduct. ''Certain people are covering this up because there is a hell of a lot of money going to Stanford because of the Nezhats.''
The Nezhat brothers have declined to be interviewed. Through their Atlanta attorneys, they deny any wrongdoing and question the motives of their accusers, citing professional rivalry and economic competition. Stanford officials say they have thoroughly investigated and rejected allegations of scientific fraud.
Camran Nezhat is embraced by a large cadre of supporters, including Stanford colleagues and patients, who admire him personally and are awestruck by his abilities in the operating room.
''People like (Nezhat) are a rarity,'' said Salinas gynecologist Dr. Rene Charles. ''I'd compare him to Michelangelo, in terms of his surgical skills.''
In a letter of support sent to The Chronicle, 39 Stanford nurses and other health-care staff members describe Nezhat as a worker of ''miracles'' who takes cases ''others have given up on.''
Yet doubts about the Nezhats date back well into the 1980s, when Camran emerged in Georgia as a pioneer in the nascent art of laparoscopic surgery.
And they have been rekindled by recent developments in an astounding malpractice case that has been languishing in Atlanta courts for six years.
That case could determine once and for all whether the Nezhats are the pioneering surgeons they claim to be or whether they catapulted their careers to Stanford on the basis of a dangerous and grotesque medical fraud.
BUILDING A PRACTICE, 1988
Camran Nezhat and his brothers grew up in prerevolutionary Iran, where each attended medical school. Camran emigrated to the United States in 1974 and completed his obstetrics and gynecology residency at the State University of New York at Buffalo.
In 1978, he received a two-year reproductive endocrinology fellowship at Medical College of Georgia in Augusta. Farr and Ceana followed their older brother to Augusta and eventually joined Camran's growing practice in Atlanta.
During the 1980s, while practicing at Atlanta's Northside Hospital, the Nezhats began to develop a reputation for their skills in laparoscopy, a type of surgery in which laser scalpels, miniature cameras and long-stemmed instruments are worked inside the body through dime-sized incisions.
They published scores of articles in medical journals, claiming a remarkable series of ''surgical firsts.'' They also developed a number of ingenious instruments for the laparoscopic operating room. A company they co-founded, American Hydro-Surgical Instruments Inc., eventually sold for $40 million.
Their specialty was treating endometriosis, a painful ailment afflicting an estimated 5 million American women. It is caused when cells that make up the lining of the uterus migrate and bind to other parts of the abdominal cavity, swelling with the monthly menstrual cycle, sometimes causing debilitating pain. The condition is often linked to infertility.
Northside Hospital began promoting the Nezhats, hiring a public relations firm to spread the word about the doctors and their accomplishments. Camran was featured in Newsweek and the Chicago Tribune, and on MSNBC, CNN, ABC's ''20/20'' and elsewhere.
The brothers garnered a reputation as some of the world's foremost innovators of laparoscopic surgery, attracting cash-paying patients from around the globe.
THE MULLEN CASE, 1991
Suffering from endometriosis, 28-year-old Stacey Mullen flew from Southern California to Atlanta's Northside Hospital in 1988 to be operated on by Camran Nezhat. The surgery was quick, the pain was gone, and Mullen was elated as she walked out of the hospital the next day.
''I was ready to name my firstborn after Camran Nezhat,'' she said.
But, as often happens, the endometriosis and the pain returned. And in December 1991, Mullen flew back to Atlanta for what she thought would be another ''quick little surgery.''
The surgery, however, was neither little nor quick.
Camran and his brother Farr, with colorectal surgeon Dr. Earl Pennington assisting, spent hours using laparoscopic techniques to cut Mullen's colon and rectum free of nerves, blood vessels and connecting tissue. Her ''mobilized'' rectum was pulled inside out through her anus, and suspected endometrial tissue was removed. Her patched-up rectum was then pushed back inside.
Then the complications began.
Hours after surgery, part of her colon dropped out of her body as she sat on the toilet. For months, she suffered from extreme constipation. Sometimes she burped up her own feces.
Mullen never regained normal use of her bowel. Eventually, she received a colostomy and must insert a tube into an opening in her side to go the bathroom.
In December 1993, after nearly two years of continuing pain, she filed a malpractice suit against the Nezhats. ''Those bastards ruined my life,'' she said.
THREE ARTICLES, 1993
Shortly after taking Mullen's case, attorney James Neal discovered two medical journal articles that the Nezhats and Pennington had published after Mullen's operation.
The first appeared in Fertility & Sterility in May 1992, describing a single case using the new pull-through procedure for treating rectal endometriosis. ''As with all new procedures,'' the article said, ''there are no data to establish its safety.''
The second was published in the September 1992 issue of Surgical Laparoscopy & Endoscopy. It detailed a series of 16 rectal surgeries, similar to Mullen's, performed in late 1991 and early 1992 - the period during which her surgery took place.
Yet Mullen's case - and her complications - were not mentioned.
The article listed only a single complication: The doctors had to perform traditional open abdominal surgery in order to complete the suturing of one patient's bowel.
''This procedure has been performed safely in this initial series,'' the Nezhats wrote, and they claimed fewer problems than would be expected with regular open abdominal surgery.
The Nezhats aggressively publicized the ''success'' of the new procedure. It was touted by Ethicon Inc., the Johnson & Johnson subsidiary that made the instruments the Nezhats had used. ''For the estimated 185,000 women who suffer from endometriosis of the rectum, this new advance provides them with relief from the digestive symptoms,'' the company said.
At a 1991 American Fertility Society meeting in Orlando, and a 1992 convention of the American College of Obstetricians and Gynecologists in Las Vegas, Ethicon promoted their instruments and the Nezhats, even including a video of the surgery.
But skepticism about the Nezhats and their procedure was beginning to grow. The lack of complications did not make sense for such radical bowel surgery, doctors said. Some surgeons who viewed the promotional video were puzzled: They could not see evidence of endometriosis.
Stories began circulating in the surgical community around Atlanta's Northside Hospital. The medical journal articles said the average operating time for the surgeries was three hours, but during the time of the study, the Nezhat operating room had been burning lights deep into the Georgia night.
Then Neal discovered a third journal publication, written by one of Nezhat's Atlanta colleagues and published more than a year after Mullen's operation.
The article in Surgical Endoscopy described a ''pilot'' study testing the same procedure on pigs in order to assess its safety on humans.
''Some damage to the sphincter might occur,'' the authors wrote, but the long-term effects were unknown: The pigs were ''sacrificed'' before they awoke from anesthesia.
Neal and Mullen were stunned: Not only had the Nezhats omitted Mullen's case from their series - and in doing so did not report her complications - they apparently had tried out the new procedure on her and other women before it was tested on pigs.
Nezhat attorney David Walbert said the pig study ''had nothing whatever to do with the safety and efficacy'' of the human surgery described in the medical journals. The purpose of the pig experiment, he said, was to determine whether the procedure was suitable for treating cancer.
'BARBARIC,' 1993
When Neal began contacting medical experts about Mullen's surgery, many sent him letters and affidavits calling the operation radical and experimental; they characterized it as ''bizarre'' and ''barbaric.'' It resembled a cancer surgery that had been discredited years before, after complication rates as high as 50 percent were reported.
The surgery had not been vetted before a Northside Hospital Institutional Review Board, the usual requirement for an experimental procedure.
''Normally you go before an IRB, come up with scientific background, present a plan, torturous documentation, nine pages of informed consent, and you cannot charge for it,'' said Ohio general surgeon Dr. Francis Barnes.
Mullen and her insurance company, however, were billed $9,900 for the rectal surgery. She eventually ran up more than $1 million in additional medical expenses as a result of the operation, according to Neal.
Neal also learned that Mullen - and possibly four other women whose cases were included in the Nezhats' articles - had signed an unusual document, recently created by the Georgia legislature. It was called a ''waiver of informed consent,'' and it set aside a patient's right to detailed information about a surgery.
''This is incomprehensibly unethical,'' said Arthur Caplan, director of the University of Pennsylvania Center for Bioethics and one of the nation's foremost medical ethicists. ''You can no more sign away your right to informed consent than you can voluntarily sell yourself to slavery.''
''I never knew I was signing such a document,'' Mullen said. ''I thought it was a regular consent form.''
Yet the most disturbing discovery was made in Mullen's own medical records. In his operative notes, Camran Nezhat wrote: ''There was evidence of severe endometriosis of the rectum.''
But Mullen's pathology lab report disclosed that there had been no endometriosis on the wall of her rectum at all - just a few cells in the adjoining fat. The surgery had not been necessary in the first place.
16 MEDICAL RECORDS
Neal went to court and demanded to see the medical records of the 16 other patients the Nezhats had operated on in Georgia, convinced they would show complications, more waivers of informed consent, and surgical data different from what was reported in the Nezhat articles.
But the Nezhat legal team refused to turn them over, citing privacy concerns of other patients - at least 10 of whom signed affidavits opposing any release.
Mullen was given the waiver form by mistake, they explained, and she was told about the procedure's risks. Medical experts for the Nezhats also insist that the rectal surgery was not experimental, so no Institutional Review Board process was required.
''In my opinion, the surgery performed on Mary (Stacey) Mullen was a necessary procedure and would not require any special consent form for experimental surgery,'' said Dr. Robert R. Franklin, a clinical professor in the department of obstetrics and gynecology at Houston's Baylor College of Medicine.
The Nezhat lawyers also argue that Mullen's rectal surgery did not cause her bowel problems. ''She reported constipation before the procedure,'' said Walbert.
THE FIRST WARNING, 1993
In the early 1990s, Stanford Medical School's department of obstetrics and gynecology was in trouble. Despite the school's lofty reputation, the department was not fully accredited.
The Chicago-based Accreditation Council for Graduate Medical Education demanded more ''surgical volume'' before it would upgrade the program's ''provisional'' status.
Yet when Dr. Nick Spirtos heard that Stanford was recruiting the Nezhats, he could not believe it.
Spirtos is a Palo Alto gynecological oncologist with an august reputation of his own. Like the Nezhats, he is a clinical professor, which means he serves on the school's voluntary teaching faculty with surgical privileges at the medical center. He also holds the elected post of deputy chief of the obstetrics and gynecology department.
During the past nine years, he has become a leading critic of the Nezhats and their Stanford defenders.
''I think everything they've written is fraudulent,'' said Spirtos, whose office is just one floor below the Nezhats' in an upscale medical office building near Stanford. ''I don't think they should be allowed to practice medicine.''
Spirtos had traveled with colleagues to a gynecology convention in Florida to see the 1991 presentation by Camran and Farr Nezhat sponsored by Ethicon. The program included videos of two new Nezhat operations, one of them showing the rectal procedure that would be performed two months later on Mullen.
''We couldn't believe what we saw,'' Spirtos said, noting that there was no evidence of endometriosis. ''The surgeries didn't make any sense.''
But before they could quiz the Nezhats about their presentation, Spirtos recalled, the Nezhats left the podium, refusing to answer questions.
Two years later, after studying their journal articles, he warned university administrators not to bring them to Stanford. Spirtos argued that the Nezhats' published data were simply too good to be true.
But Spirtos said his advice was ignored.
''It was a perfect marriage,'' he said. ''The Nezhats had all the dough in the world but no title. And Stanford needed desperately to have surgical volume to legitimize their (obstetrics and gynecology) department.''
NEW TROUBLE, 1993
Within two years of the Nezhats' arrival in Palo Alto, Camran became director of the new Stanford Endoscopy Center for Training and Technology. And Ethicon, which had retained Nezhat as a surgical investigator, agreed to provide a $125,000 annual grant to the center.
Quickly, the Nezhats began pairing up with surgeons outside their immediate discipline - including specialists in cancer, heart and brain surgery - with the goal of expanding the use of minimally invasive surgical techniques.
The practice troubled Spirtos, and when he learned that Camran Nezhat intended to operate on a patient of one of Spirtos' medical partners, he wrote in protest to Dr. Mary Lake Polan, the chief of the obstetrics and gynecology department.
The patient was a 74-year-old woman who had undergone extensive surgery for the removal of pelvic cancer, and Spirtos told Polan that the patient's cancer had spread so extensively that laparoscopic surgery would be useless.
''Certainly, (Nezhat) has no experience in this area (treating cancer), and it seems to me serious patient care issues are being placed on the back burner in your headlong rush to promote the Nezhats,'' he said in a 1993 letter to Polan.
Despite Spirtos' protests, Nezhat and Stanford cancer surgeon Dr. Nelson Teng went ahead with the operation.
The patient was on the operating table for seven hours and was hospitalized for seven days afterward. Her bladder and bowel were punctured during the operation, Spirtos said, and the doctors could not remove all the cancer. In his report to the university's ''quality assurance'' review committee, Spirtos charged that Nezhat, credentialed as a gynecologist, was performing cancer surgeries, a specialty that requires years of extra formal training. He also laid out four other Nezhat cancer cases for the quality assurance review committee.
''No other hospital would allow a gynecologist to perform (cancer) surgeries,'' said Spirtos.
But his hope for a quick review of the five cases soon faded. ''Stanford sat on those cases for years,'' he said.
NEZHAT'S AFFIDAVIT, 1994
Meanwhile, Mullen and her attorney continued to press for the release of the files on the 16 other women who had undergone the rectal procedure. And the Nezhats continued to refuse.
In a sworn 1994 affidavit, Camran Nezhat declared it would disrupt his practice for months if he were ordered to produce records demanded by Mullen's legal team.
He described a filing system with 20,000 patients, each listed only alphabetically, with no index, no computer database and no cross-referencing by type of treatment, surgery performed, or journal publication.
''I would . . . have to manually review every single patient record . . . to determine whether the record referenced a patient whose procedure was the subject of a journal article,'' he testified.
The affidavit shocked Nezhat's critics, who say it has cast a pall on the validity of the Nezhats' research ever since.
''I've been doing this kind of research for 25 years. There is a substantial problem if you cannot link patient records to publications,'' said Dr. David Grimes, former chief of obstetrics and gynecology at San Francisco General Hospital, who briefly served as a paid expert to Mullen's legal team.
How, asks Grimes, can the Nezhats publish extensive studies based on old charts and old data involving hundreds of patients over many years if those patients' files are not indexed or cross-referenced?
Grimes was not the first doctor to question the Nezhats' research. Long before they publicized their controversial bowel surgery, competitors and collaborators alike were skeptical of the brothers' claims of surgical firsts and problem-free procedures. In 1987, Dr. Harry Reich, a world-renowned laparoscopic surgeon at New York's Columbia-Presbyterian Medical Center, agreed to collaborate with Camran Nezhat on a surgical study of 105 tubal pregnancies.
But Reich was bothered by Nezhat's repeated failure to share his data on 40 patients to be included in their article in the Journal of Reproductive Medicine.
''So we had to delete the data from the paper,'' Reich recalled.
The Nezhats' lawyers say Reich never requested any data that were not provided.
In 1990, a Nezhat report in the journal Obstetrics and Gynecology also raised eyebrows. The Nezhats stated they had performed 4,000 laparoscopic surgeries without injuring a ureter, the tube connecting the kidney and bladder.
Their claim drew a sarcastic response from three Yale University doctors: ''The authors are to be congratulated. . . . Either these surgeons had other complications, perhaps as serious, or they possess an unbelievably high level of skill and judgment.''
Other articles in which the Nezhats claim to have reviewed thousands of old cases include:
-- A 1995 textbook article describing 214 complications among 6,949 cases in Atlanta and Stanford from 1982 to 1993.
-- A 1996 medical journal report of severe urinary tract endometriosis in 28 women among 2,226 treated for endometriosis from 1989 to 1994.
-- A 1997 study examining 5,300 surgeries dating back to 1988, counting up 11 hernias caused by insertion of the laparoscope.
Atlanta attorney Walbert scoffs at accusations of medical fraud. ''Many, many surgeons'' have conducted research with the Nezhats, he said. ''Those who have any knowledge have never claimed there was anything 'bogus' about any of the reports.''
Dr. Sally Tazuke, a Stanford reproductive endocrinologist who has worked with Camran Nezhat frequently, said his reported complications are low because he is exceptionally good at what he does - even while taking on the riskiest cases. ''If I were a patient, I would sign up with him. I'd send any family member,'' she said.
Skeptics say the stakes are high. Dr. Thomas Lyons, an Atlanta gynecological surgeon who believes the Nezhats have published journal articles with phony data, said medical fraud can lead unsuspecting doctors to hurt their patients.
''This is as dangerous a situation as you can run into in medicine, because people may be making medical decisions based on something that doesn't exist,'' he said.
If someone ever questioned the veracity of his own data, Lyons said, ''The first thing I would do is throw that data right in their face. . . . The best defense in the world is the truth.''
NEAL'S LETTER, 1995
In January 1995, Mullen's attorney, James Neal, wrote to Stanford, alerting the university to the allegations his legal team was making against the Nezhats. As a former hospital counsel himself, he said he thought they would appreciate a copy of the Mullen lawsuit.
''I feel that your institution should have the opportunity to evaluate these matters . . . given your understandable and overriding concern for the patients within your institution,'' Neal wrote.
But Stanford took no action.
Instead, Margaret Eaton, a university lawyer, forwarded the letter to Nezhat's attorney in Atlanta, with a note saying that ''we do not intend to respond to this letter, nor are further communications from Mr. Neal welcome.''
In June 1995 the Accreditation Council for Graduate Medical Education approved full accreditation to Stanford.
ALLEGATIONS, 1996
A year later, Neal sent Stanford a thick package of documents, laying out in more detail the charges against the Nezhats and asking Stanford to investigate.
Dr. Richard Popp, Stanford's senior associate dean for academic affairs, said Neal provided a ''massive amount'' of what he called ''disorganized'' information.
Popp finally opened an inquiry into the charge of scientific misconduct. But university officials contend that by that time, some of the allegations, including Neal's claim of medical journal fraud, had been thrown out by the Georgia courts.
Neal, who freely admits that he has become obsessed with exposing the Nezhats, was running up a list of legal setbacks. In his dogged pursuit of the Nezhats, he was building a reputation as a crank.
He was disqualified from the malpractice case by a Georgia judge in 1995 for ''unethical behavior'' and could no longer represent Mullen. After a federal judge last year tossed out his attempt, on behalf of another client charging malpractice, to use racketeering charges against the Nezhats, Neal was charged with contempt of court. The judge also assessed $384,000 in ''sanctions'' against the plaintiff and her remaining attorneys. The sanctions are on appeal.
Neal denies the unethical conduct allegation, and the contempt of court charge was recently dropped. The only thing he is guilty of, he says, is aggressively representing his clients against institutions willing to look the other way.
''These guys are bad doctors, some have even said evil, and they have to be stopped,'' he said.
WITNESS, 1996
Shortly after Dr. Tom Margolis joined Stanford as an assistant professor and chief of pelvic surgery, Farr Nezhat invited the newcomer to watch him perform a complex laparoscopic procedure.
During the operation, Nezhat cut the patient's ureter. Margolis, who had also served as director of urogynecologic/pelvic surgery at Northwestern University Medical School, assumed it was an accident, a known but unwelcome complication of the difficult surgical technique. He stepped in to assist Nezhat in repairing it.
But a short time later Margolis learned that, in a post-operative review session and the operative report, Nezhat described the cut as deliberate. He said he sliced the ureter to remove endometriosis that could have blocked urine flow.
Margolis was outraged. He said that he saw no endometriosis on the ureter and that the pathology report proved it.
''It was clear that Dr. Nezhat was performing an unnecessary procedure,'' he said in a sworn affidavit.
THE POLAN MEETING, 1996
More than two years passed before Stanford's quality assurance committee took up the review of the five cancer cases in which Spirtos had alleged improper surgeries by Camran Nezhat.
Just before the review committee was finally set to meet, Dr. Mary Lake Polan, chairman of obstetrics and gynecology, dropped by Margolis' office. He was one of the physicians reviewing the cases.
''We need to make sure that Nezhat is cleared on all these (cancer) cases,'' she told him, according to his affidavit.
Ultimately Margolis - and the other members of the quality assurance committee - voted in favor of Nezhat on all charges.
Polan said Margolis' allegations are false.
''I adamantly deny the statements attributed to me and deny there has been any pressure to exonerate any physician during the quality of care committee process," she declared in a written response to The Chronicle.
Margolis' decision to vote to exonerate Nezhat would haunt him for more than a year, until finally he had to act.
THE SHUER LETTER, 1998
In April 1998, Margolis met with Dr. Lawrence Shuer, chief of staff of the medical center. He told Shuer about the cut ureter incident and the pressure Polan had allegedly exerted on him.
''He (Shuer) acutely and abruptly ended our conversation, and I was excused from his office,'' Margolis said.
More than a year later, when Shuer learned Margolis was still criticizing the Nezhats and Stanford, he sent a written warning:
''Rest assured that Stanford Hospital and Clinics intends to pursue its full legal remedies if these defamatory and libelous statement do not cease,'' Shuer wrote.
Furious, Margolis, who had left Stanford to practice with Spirtos at the Women's Cancer Center in Palo Alto and Los Gatos, wrote back, saying that Shuer's job as chief of staff was ''patient protection not doctor protection.''
''The data which (the Nezhats) have published, including the rectal eversion procedure, is fraudulent, yet their publications are being accepted as standards in the surgical community. Stanford, by not auditing this clinical data, has ignored the concerns of scores of surgeons,'' Margolis wrote.
STANFORD'S DUTY, 2000
Defenders of the Nezhats at Stanford dismiss both Spirtos and Margolis as jealous competitors. But other medical experts say Stanford should have demanded a review of the 16 cases and has shirked its responsibility to verify the Nezhats' research claims.
''Stanford has a duty to review this,'' said Dr. Warren Grundfest, chairman of Biomedical Engineering at UCLA and an expert in new medical technologies. ''Serious allegations have been made by credible people, but Stanford has played like an ostrich with its head in the sand.''
But Stanford officials contend they are not obligated to review the 16 patient records because the rectal surgeries were performed in Georgia before the Nezhats came to the West Coast. Shuer said the procedure in question has never been performed at Stanford.
It was appropriate for the Nezhats to leave Mullen's case out of the medical journal, according to Stanford, because she was ultimately found not to have rectal endometriosis like the other patients.
Stanford reviewers have never asked the Nezhats or Northside Hospital for the records to verify the accuracy of the other 16 cases. ''We have no right to the records and do not want to violate patient privacy,'' said Stanford's lawyer Debra Zumwalt.
The university also never interviewed Mullen or the 20 doctors who have expressed concern over the Nezhats' research.
According to Stanford, the appropriate institutions to investigate the Nezhats are Northside Hospital, the Georgia Medical Board and Mercer University, where the Nezhats were clinical professors at the time of the surgeries. ''Stanford will carefully review the conclusions of those investigations,'' said Popp.
But a spokesman for Mercer, a Macon, Ga., medical school founded in 1986, said the school has no investigation pending.
The Georgia Medical Board's investigation of the Nezhats is continuing. The board will not comment on its status.
Stanford attorney Zumwalt said Margolis' complaint to Shuer regarding the cut ureter incident was never put in writing. Shuer said he asked Margolis for more information, and none was provided, but the case has now been identified and is being investigated by the quality assurance committee.
The university said the Nezhats have been cleared of allegations that they operated outside their specialty. Officials would not comment, however, on any details of the five quality assurance cases because they are confidential.
''One thing I can point out,'' said Zumwalt, ''is that doctors and patients and their families can reasonably disagree as to how aggressive to be in treating terminal diseases.''
GEORGIA COURTROOM, 2000
Mullen has refused to engage in monetary settlement talks with the Nezhats and promises to continue her suit until the records of the 16 other women are made public.
''My life has been changed in a very horrible and profound way by the experiment (that) Camran Nezhat has conducted upon me without my knowledge,'' Mullen said in an affidavit. ''I despair that other women will be injured by well-meaning surgeons who believe Camran Nezhat's article that there were no complications from this new surgery.''
In November, after a battle spanning six years - and six judges - Superior Court Judge Melvin Westmoreland in Atlanta ordered a confidential release of the records to Mullen's lawyers, and in January, the Nezhats and Northside Hospital turned them over.
While the records remain sealed, medical experts hired by Mullen's legal team to review the documents have written Judge Westmoreland expressing their concern about what the records contain, and urging that they be unsealed, in the public interest. ..
William Carlsen can be reached at wcarlsen@sfgate.com. Sabin Russell can be reached at sabin@sfgate.com.
Thursday, November 06, 2008
Karen Steward writes "Autobiography" Is she confessing her love with Dr. Kruschinski after all?
FREE Karen Stewards' "NEW" Book! FREE
"The Bizarre FANTASY'S of a "Dysfunctional Texas MOTHER!"
Also listed under the tilte of:
"Doctors: Bound by Secrecy? Victims: Bound by Pain! "
"The Bizarre FANTASY'S of a "Dysfunctional Texas MOTHER!"
Also listed under the tilte of:
"Doctors: Bound by Secrecy? Victims: Bound by Pain! "
This book appears to be the "autobiography" of a VERY dysfunctional Texas Mother - Karen Steward!
IHRT'S REVIEW of Karen Steward's:
Check it out in IHRT!
Tuesday, October 28, 2008
Fact or Fiction?
DNA connects a mad scientist of today to one from the past!
In the movies, scientists are quite often "mad," and have been so since the silent movies.
The things they do, however, have been fairly consistent. They tend to be smarter than the “normal” human being, and wittier, often of a boastful nature. A surprising number can play Bach's Toccata and Fugue from memory. They will persevere despite repeated failures. These are usually on human subjects whose remnants, living or dead, are stored in commodious basements. Often unreliable technical equipment, anatomical parts and/or lab assistants plague these scientists.
What is it that we love about the mad scientists in our movies and history? Is it because their probing of the unknown piques our curiosity? Is it their seeming superiority to the common herd? Or is it that they -- at least for a while -- get away with more than we can?
They do so in many realms of knowledge. Some of them are practical, and quest for better things for the human race. Others are decidedly less practical. One of their most prominent technologies has been advanced medicine. Filmic mad scientists of the 1930s and 1940s led the vanguard in such efforts as keeping organs alive outside the body, cryogenics, new methods of surgery, robotic parts for humans, and new serums. Others harnessed electricity for all sorts of uses, but mostly to bring dead flesh back to life (always a useful ability), or to power advanced robots and death rays. It is the potential for cutting-edge science that makes fictions about the subject relevant.
These “mad scientists” are enthusiastic about their work, perhaps even carried away with it. They will let no one get in their way, especially those who call them insane, and start -- but do not finish -- going for the authorities. Generally their creations, be they mechanical or living, go out of control. Until the climax, that is, when they turn on their creator(s) and soon destroys them. This is usually due to “fate” or "God," which restores the status quo against the blaspheming mad scientist. And it is this last motif that connects the various aspects of the subject together: the "god-like" man who rejects the accepted ways and pursues the unknown, running into trouble as a result.
Few really believe in vampires, monsters and witches, but these enduring characters of Halloween have a basis in real life that is often more interesting than the fantasy.
Think of Halloween and your mind conjures images of ghosts, vampires, witches and monsters.
Our modern versions of them have largely been crafted by popular literature and, more influentially, the movies. But like many fantastic characters of myth and lore, they have a basis in reality.
Sometimes the true stories of these creatures that haunt our imaginations are just as weird and amazing as their fictional incarnations.
IHRT Presents for Your Halloween Entertainment
“The REAL Monsters of Halloween”
ENTER IF YOU DARE!
Castle Frankenstein –Darmstadt Bavaria Germany
The castle is perched atop a bluff of rock, a Gothic array of towers and pinnacles looming over the Rhine valley and once home to a troop of medieval knights. The hilly Oldenwald, which lies to the south of Darmstadt, is an area of little villages, rustic farms and Gothic churches.
The hilltops are crowned with thick forest while the valleys are framed with flower-studded meadows. The drive to Castle Frankenstein from Darmstadt station, takes 20 minutes.
First, you will cross the pancake-flat Rhine valley with its patchwork of asparagus and potato fields, then the road suddenly swings upwards and you are hurtle around a series of tight, vertiginous bends towards your destination. A 'Welcome to Castle Frankenstein,' sign greets you when your stomach-churning drive finally ends. The year, 2004!
You feel anxious as you near the huge doors that will take you into unknown areas of the castle, and as you enter, you see the first of two medieval towers built in the 16th century by Sir George Frankenstein. The towers are dimly lit by the fires of torches placed high in sconces set deep into the stone walls, walls that seem to reach forever skyward. As you continue to walk down the dusky, damp halls through the towers you realize that the foreboding halls of this impregnable fortress guarding the Rhine are consuming you and you start to think that you might never see the outside world again. Your fear heightens your every sense as you search shadowy crevices and gaze into the darkness with more anxiety then eager curiosity.
You smell terrible smells, hear terrible sounds, everything is so confusing, moving to fast to be real, your feeling weak, scared, and with each step you seem to be taken back in time; then you see it, a door, and it is opening, someone is coming toward you, it’s a man, a, a Dr. and he is dressed in period clothing from the 18th century!
This can’t be! All of a sudden your mind is filled with the thoughts of the experiments of the mad scientist, Italian physician Luigi Aldini, who in 1760 had injected a current of electricity into the head of a newly executed murderer, causing an array of horrible spasms, one of which opened the corpse's left eye! As this oddly dressed Dr. comes toward you, he is smiling as though you were a long lost relative. You do not recognize him, yet there IS something familiar about that smile, but what is? Your heart is racing with fear, your head swims and then…..your world goes black!
You wake in a sweat to find yourself strapped on a cold hard table in one of the castle's inner chambers, the same room in which a boy was born of refugee parents from Poland in 1673. In later life that boy turned man, would sign himself von Frankenstein in recognition of his birthplace. But he was never a nobleman, nor a blood relation of the Frankenstein family.
The dates, the years, the similarities of then and now are all merged into one blur in your mind as you are wheeled into a modern operating room in a foreign country.
Eyes that look like yours are everywhere, eyes behind masks, eyes everywhere looking at you, then voices, lots of words but in a language you don’t understand. The Dr., that smile, it is one and the same, how can that be in this modern age, but you will get no answer to that question, as once again your world goes black, and the experiments begin!
Johann Konrad Dippel (1673-1734)
The Frankenstein Monster
Our story starts out with the birth of an 18th century mad scientist who was born in 1673 in Germany at - believe it or not - Castle Frankenstein! Johann Konrad Dippel (1673-1734) was born to immigrants to Germany, and has no “blood” relationship to the Frankenstein’s of Noble German decent!
Dipple, a man of great pride, felt no limitations to his intellect and was interested in pursuing the great mysteries of life. When he registered at the University of Giessen (sixty miles north of the real Castle Frankenstein near Darmstadt, Germany), he registered as "Franckensteina." Some three years later he completed his dissertation. As it was a skeptical work -- whose title De Nihilo meant "On Nothing" -- it outraged many of his superiors. Dipple flaunted that he was smarter than the “normal” human being, and wittier, and was often of a boastful nature, and with an attitude that gave one the impression he could care less what others thought of him!
Educated as a physician, Dippel set up a laboratory at Castle Frankenstein where he would be free to conduct his bizarre experiments. There's no record of whether or not he had a hunchbacked assistant named Igor, but Dippel (who often went by the name Konrad Frankensteina) spent a lot of his time with his hobby of alchemy - a popular pursuit of the day. Alchemy(1) is a kind pseudoscientific experimentation with the elements - crazy chemistry - whose ultimate challenge was to be able to turn lead into gold. Dippel was also fascinated by the possibility of immortality through scientific means.
Though a brilliant scientist, Dipple got caught up in the dark world of alchemy and body snatching. He really did use the parts of butchered animals and exhumed human corpses in his vain attempt to "engender life in the dead," in his own words. He claimed to have the secret of the “philosopher's stone,”(2) as well as the ability to create life.
Unlike his literary and cinematic "decedents," Dippel did not rig up the body parts to elaborate lightning-powered gizmos and spark generators. Rather he boiled everything - skin, muscle, bone, blood, hair and organs - in large vats. When the surrounding community got wind of what Dippel was up to, maybe they didn't storm his castle with torches, shovels and rakes, but they did kick him out of town.
Dipple returned to Guessen hoping for a fellowship there, but meeting with a cold reception there, he went to Wittenberg, where his fortunes proved no better. At Strasburg, his views made it impossible for him to establish any connection with that university, but he did do some lecturing on astronomy and palmistry, preaching frequently in a spirit that soon led him to be dismissed. Dipple had developed a lifestyle
That ultimately forced him back to his native place, a fugative from his collectors!
Finding a new faith, Dipple entered into it with a fierce pace that led him to fame. In less then two years he 14 controversial writings on the theme of morals verses dogma, among other subjects, and like everything else he ever did, he went to extremes, which subjected him to persecution from the clergy and even from the mob, by whom his life was threatened.
By 1704 Dipple had moved to Berlin and devoted his researches to alchemy and deluded at one time that he had solved the problem of transmutation! He was driven out of Berlin and fled to Kostrits, thence moved on to Holland, where he lived for some time near Amsterdam. In 1711 he practiced medicine in Leyden, and wrote a number of papers on theology and in 1714 had his papers published. In this same year he relocated to Altona, in Sleswick-Holstein where an imprudent incursion into politics aroused the hatred of high officials, and in 1719 he was condemned to perpetual imprisonment. Though the full sentence was never carried out, Dipple did live for 7 years in semi-confinement on the island of Bornholm. Released in 1726, he went to Sweden where he became the physician to King Frederick I. Once again he aroused the clergy there and was banished from the country.
Returning to Germany, he took up residence in Liebenberg, near Goslar, and
Continued his studies in alchemy. Though he abstained entirely from theological controversy, the clergy compelled him to flee, and he found refuge with the Count of Wittgenstein-Berleburg. His last years were largely taken up by violent controversy with Zinzendorf over the nature of the Atomement.
Once again, fleeing persecution, Dipple returned to “Frankenstein Castle” in Bavaria, Germany where rumors circulated that he was again collecting body parts to assist in the making of a formula that Dipple claimed would allow him to live to the age of 135. On the morning of April 24th, 1734, Dipple’s body was found in his laboratory by one of his friends. It is believed that he died by drinking his own potion.
After a tumultuous and lonely life, Johann Konrad Dippel became another legend in the history of Frankenstein, though he would never be recognized for his scientific abilities, instead he became known as "Dipple the Alchemist".
They say that all the spirits of those who were experimented on during Dipple’s time haunt the “Frankenstein Castle” yet today, but the haunting does not stop there. A “ NEW” kind of “haunting” out of the “Frankenstein Castle” reveled itself over 233 years later in the birth of another boy born to parents of Polish decent! A direct descendent of the late Johann Konrad Dippel, this boys life will bear an astonishing similarities to that of his infamous relative!!
Revealing the true life experiments of
"Dr. Dipple Hook" aka "Dr. Daniel Kruschisnki"
Daniel Marion Konrad Kruczinsky (1958 - Present)
Madness At The Edge Of Science
Daniel Kruczinsky was born in 1958 in Poland. In 1969 he moved with his family to Munich Germany after his father was released from the Auschwitz concentration camp in Poland. His upbringing was tumultuous and lonely as he strived to live up to his father’s expectations, unrealistic expectations that no human being could ever really live up to. Daniel’s boyhood days would be filled with a cold harshness that could only have come out of someone who spent years in a concentration camp, and years where every human emotion was drained from the very core of the prisoner’s body.
With his life missing the essentials necessary for a child to grow strong in self esteem and character, Daniel soon found himself empty of both and not feeling any self worth or value to anyone, he became soon became void of emotions as well.
Early in his youth he started to “create” identities that he thought would give him the recognition and love he always craved, but never received growing up. Though he had a mother, it was the love, attention and respect from his father that he craved throughout his childhood, thus his mother became a non-entity in his life, and continues to be that yet today. Daniel not only created multiple identities, he perfected lies about himself to the point that he became what is known today as a, “pathological liar” in which the liar actually starts to believe their own lies, not being able to tell truth from fiction.
As he moved out into the world, Daniel Kruschinski changed the Polish spelling of his name hoping that he would be better accepted by his peers, and possibly out of feelings that he was not worthy to carry that name having failed receiving respect and love from his father.
He began his medical studies at Düsseldorf University in October 1979, and finished in November 1985. For the dissertation entitled "Selective histochemical zinc presentation in testis of the Wistar rat", carried out at the Anatomical Institute of Düsseldorf University under Prof. H.G. Goslar, he was awarded his doctorate in September 1986 with the mark "Summa cum laude". As his dissertation was a skeptical piece of work, many of his superiors were not surprised as throughout his time at the university, Daniel was seen as being rather, freaky.” Kruschinski flaunted that he was smarter than the “normal” human being, and wittier, and was often of a boastful nature, and with an attitude that gave one the impression he could care less what others thought of him!
In what seemed to be a hasty change of mind from a future in the area of research, Kruschinski turned his education to the area of gynecology and obstetrics at the gynecology clinic of the Franzkiskus-Hospital in Bielefeld under the direction of Prof. Dr. med. J.D. Schnell and continued at the gynecology clinic of Minden Hospital under Prof. Dr. med. H. Wagner. Educated as a physician now, Kruschinski set up practices in private centers where he would be free to conduct his bizarre experiments. There's no record of whether or not he had a hunchbacked assistant named Igor, but “Doc. Kru” (who often went by that name on his Internet message boards) did have an assistant who he said was a nurse, but in reality, she was only his mistress, never having been trained as a nurse, yet working side by side with him in his operating room during these experimental procedures!
From 1990 to 1995, Dr. Kruschinski worked at the Clinic and Polyclinic for Obstetrics of Johannes Gutenberg University Mainz under Prof. Dr. med. P.G. Knapstein. Here he established the center for minimally invasive surgery and was in charge of consulting hours for plastic surgery of the breast. After this, Dr. Kruschinski was attending physician at the University Gynecology Clinic at the Knappschaftskrankenhaus Bochum-Langendreer under Prof. Dr. med. A. Jensen. And then in February 1998 he established a surgical office in Alzey, focusing mainly on minimally invasive surgery. Following consultation here, he treated his patients in the Kirchheimbolanden Hospital. Finally, on admission as faculty member to the faculty of medicine of the private Witten / Herdecke University he was made head of the Institute for Endoscopic Gynecology. Little did he know that he would continue to “run” from Klinik to Klinik, and move between some of the same cities that his relative, Johann Konrad Dippel had done for so many years, and for the same reasons as his ancestor had! To name a FEW: Schärding-Austria, Offenbach, Eilenriedeklinik Hannover, Klinik am Zuckerberg Braunschweigm, Emma Klinik, Seligenstadt, Passua, Rotthalmünster, Bavaria, Bochum-Langendreer, Mainz, Bielefeld, WittenGermany!
Dr. Kruschinski went on to create a world that he was certain would evolve into his wildest dreams, one of fame, fortune and world domination! He created, “EndoGyn® - Institute for Endoscopic Gynecology,” and that move would lead him into the dark world of human experiments, extremes in surgeries, obsessions with surgical techniques, surgical instruments and procedures, pushing things to the limits and beyond. Not seeming to care who got hurt by his extremes, he continued to harvest patients to his operating rooms with lies, deceit, and “charisma!”
His whole life would be filled with short -lived relationships! His peers would continue to find him, “freaky” and “odd” to be around. He started to drink heavy, remaining in his offices day and night! He would write controversial paper’s, which only served to anger those in the scientific world of research, as he wrote them without any proof of validating research associated with them. Time and again, his scientific writings would be proven false in content!
As in keeping with the times, Dr. Kruschinski used the Internet as a means to make himself known, and unfortunately, to make his fortune! For a brief time it seemed as though he would accomplish his dream of becoming a famous International surgeon, a “savior” of sorts. He would even publicly compare himself to “Einstein,” and to “God!” “Doctors from EndoGyn® are now performing surgery in many locations and hospitals. The idea of franchising endoscopic surgery is getting reality” he would say over and over again, seeming only to be fooling him-self!
Dr. Kruschinski made lots of money from performing operations on people from all over the world, people who had to pay him cash if they wanted HIS special 100% proven surgery that he promised would cure them! And pay they did, for a while that is!
Soon these patients were NOT getting well, and many of them were returning to his operating room time and again, and paying cash each time! Some of these patients were almost cut in half in operations were he called himself a “reconstructive surgeon,” yet not ever having had that training! Others were placed on a “hook” that suspended them into the air like beef hanging in the slaughterhouse! Time and again he overused this “hook” apparatus, causing severe damage to those he used it on, and left many of them in horrible, non-reversible pain and disabling symptoms!
“Doc. Kru” even gave discounts to some if they would keep the secret that he did not make them well, let alone cure them! And some patients did this so they could come back and let him try again to heal them, only to find themselves once again on the “hook!”
It soon it became apparent to him that he could no longer “scam” patients over the Internet, and he lost money, causing him to fall into bankruptcy, losing his hospital affiliations time and again, and soon he found himself a fugitive from his collectors! What he did seem to accomplish through his use of the Internet was the cult like followers who, no matter if he had injured them in a surgery, insulted them in a public manner by calling them drug addicts and alcoholics, they continue to praise him! They praise him even after he confessed that he did in fact perform experiments on his patients and then boldly published a paper on it!
Dr. Kruschinski was so void of ethics and morals, that he would deny his Jewish birth when it benefited him, then used it when it benefited him, and at times, he even professed to be a Catholic in order to be “accepted” into a community of Christians at a Klinik he was hoping to infiltrate!
Though Dr. Daniel Kruschniski has lost everything that would associate him to being a Dr., and fleeing from one area of Germany to the other, at ties calling upon patients and colleges to let him sleep in their homes, he lives on, surfacing now and then on the Internet! It is apparent that “Doc. Kru” has reverted back to the original opinion of himself, which is an empty shell of a human being, he uses posts on the Internet as if he is gasping for a breath, as it will only come in the words of praise from those who are as dysfunctional as he is, yet, this IS all that is left of his life.
Soon his Internet web site will shut down, moneys due it not forthcoming and Endogyn will be gone, and as “Doc Kru” said in his own words, “I am Endogyn, and Endogyn is me. Where it is, I am, and so be it!” As he desperately posts his last words, and there is no way to send them across the Internet, he will breath his last breath before he slides into the murky, darkness of his ways. He will cease to exist! Because of his upbringing, he saw himself as a failure, an empty shell, a “nothing” and in this, he was finally right!
Kru will drown from an emotion he wasn’t even aware that he had. No, it is not guilt of what he did to others, as he is void of that emotion, but from his own inability to be able to be someone he created, and even in that, he failed!
Though unlike his ancestor, Johann Konrad Dippel, Daniel Kruschinski “lives” but he lives as a “nothing.” Dr. Daniel Kruschinski, like his ancestor, Johann Konrad Dippel, after a tumultuous and lonely life, became another legend in the history of Frankenstein, though he too would never be recognized for his scientific abilities, instead he has became known as "Kruschinsky the Phsycho-Surgeon" who experimented on his unsuspecting patients from 2003-2006 and admitted it to the world!”
Where will he surface next? Where YOU one of his victims?
Do YOU know who is performing YOUR surgery?
"Happy Halloween"
(1) “Alchemy” hovered between worlds. It emerged in a time-between-times, after a Dark Age had brightened but before a Renaissance had dawned. It came from Arab and Greek sources, but it flourished in theWest. It lay between faith and philosophy; it still dreamed of heaven, but it focused on the Earth.
(2) The “Philosopher's Stone,” in Latin lapis philosophorum, is a mythical substance that supposedly could turn inexpensive metals into gold and/or create an elixir that would make humans younger, thus delaying death.
Friday, October 03, 2008
Are you registered and ready to Vote!
VoterForChange. com lets you do it all -- check your registration status, register to vote, request an absentee ballot, or even find your early vote location or polling place.
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Thursday, October 02, 2008
Healthcare and social security McCain vs. Obama
Barack Obama
Barack Obama and Joe Biden's Plan
On health care reform, the American people are too often offered two extremes - government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.
The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.
Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.
If you don’t like your health insurance, or you don’t have health insurance, you will have a choice of new, affordable health insurance options.
Make Health Insurance Work for People and Businesses - Not Just Insurance and Drug Companies.
Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.
Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
Ensure everyone who needs it will receive a tax credit for their premiums.
Reduce costs and save a typical American family up to $2,500 as reforms phase in:
Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market
Require hospitals to collect and report health care cost and quality data
Reduce the costs of catastrophic illnesses for employers and their employees.
Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.
The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.
A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.
For More Information about the Obama-Biden Plan
(these are extensive and informative PDF files)
Read the Plan
Read the Frequently-Asked Q and A
Read the Speech
Read the HIV/AIDS Agenda
Read the Cancer Agenda
Elderly and Social Security
At a Glance
Protect Social Security
Strengthen Retirement Savings
Affordable Health Care
Protect and Honor Seniors
The Problem
Insecure Retirement Savings: Retirement savings are near a historic low and 75 million working Americans lack employer-based retirement plans. Too many companies have dumped their pension obligations, leaving workers in the cold.
Income Security: With skyrocketing health care, energy and housing costs, and the risk of being defrauded by insurance companies, too many seniors do not have the resources to live comfortably.
Barack Obama and Joe Biden's Plan
Protect Social Security
Obama and Biden are committed to ensuring Social Security is solvent and viable for the American people, now and in the future. Obama and Biden will be honest with the American people about the long-term solvency of Social Security and the ways we can address the shortfall. Obama and Biden will protect Social Security benefits for current and future beneficiaries alike. And they do not believe it is necessary or fair to hardworking seniors to raise the retirement age. Obama and Biden are strongly opposed to privatizing Social Security. As part of a bipartisan plan that would be phased in over many years, they will ask those making over $250,000 to contribute a bit more to Social Security to keep it sound.
Obama does not support uncapping the full payroll tax of 12.4 percent rate. Instead, he and Joe Biden are considering plans that would ask those making over $250,000 to pay in the range of 2 to 4 percent more in total (combined employer and employee).
Strengthen Retirement Savings
Reform Corporate Bankruptcy Laws to Protect Workers and Retirees: Current bankruptcy laws protect banks before workers. Obama and Biden will protect pensions by putting promises to workers higher on the list of debts that companies cannot shed; ensuring that the bankruptcy courts do not demand more sacrifice from workers than executives; telling companies that they cannot issue executive bonuses while cutting worker pensions; increasing the amount of unpaid wages and benefits workers can claim in court; and limiting the circumstances under which retiree benefits can be reduced.
Require Full Disclosure of Company Pension Investments: Obama and Biden will ensure that all employees who have company pensions receive detailed annual disclosures about their pension fund's investments. This will provide retirees important resources to make their pension fund more secure.
Eliminate Income Taxes for Seniors Making Less Than $50,000: Obama and Biden will eliminate all income taxation of seniors making less than $50,000 per year. This will provide an immediate tax cut averaging $1,400 to 7 million seniors and relieve millions from the burden of filing tax returns.
Create Automatic Workplace Pensions: The Obama-Biden retirement security plan will automatically enroll workers in a workplace pension plan. Under their plan, employers who do not currently offer a retirement plan, will be required to enroll their employees in a direct-deposit IRA account that is compatible to existing direct-deposit payroll systems. Employees may opt-out if they choose. Experts estimate that this program will increase the savings participation rate for low and middle-income workers from its current 15 percent level to around 80 percent.
Expand Retirement Savings Incentives for Working Families: Obama and Biden will ensure savings incentives are fair to all workers by creating a generous savings match for low and middle-income Americans. Their plan will match 50 percent of the first $1,000 of savings for families that earn less than $75,000. The savings match will be automatically deposited into designated personal accounts. Over 80 percent of these savings incentives will go to new savers.
Prevent Age Discrimination: Obama and Biden will fight job discrimination for aging employees by strengthening the Age Discrimination in Employment Act and empowering the Equal Employment Opportunity Commission to prevent all forms of discrimination.
Affordable Health Care
Provide Cheaper Prescription Drugs: Our seniors pay the highest prices in the world for brand-name drugs. To lower drug costs, Obama and Biden will allow the federal government to negotiate for lower drug prices for the Medicare program, just as it does to lower prices for our veterans. They also support allowing seniors to import safe prescription drugs from overseas, and will prevent pharmaceutical companies from blocking cheap and safe generic drugs from the market.
Protect and Strengthen Medicare: Obama and Biden are committed to the long-term strength of the Medicare program. They will reduce waste in the Medicare system, including eliminating subsidies to the private insurance Medicare Advantage program, and tackle fundamental health care reform to improve the quality and efficiency of our healthcare system. They support closing the "doughnut hole" in the Medicare Part D prescription drug program.
Provide Transparency to Medicare Prescription Drug Plans: Many seniors are enrolled in Medicare prescription drug plans that are actually more expensive for them than other available plans. Obama and Biden will require companies to send Medicare beneficiaries a full list of the drugs and fees they paid the previous year to help seniors determine which plans can better reduce their out-of-pocket costs and improve their health.
Strengthen Long-Term Care Options: As president, Obama will work to give seniors choices about their care, consistent with their needs, and not biased towards institutional care. He will work to reform the financing of long term care to protect seniors and families. He will work to improve the quality of elder care, including by training more nurses and health care workers.
Protect and Honor Seniors
Ensure Heating Assistance: Obama and Biden will increase funding for the Low Income Home Energy Assistance Program (LIHEAP) which helps low-income citizens — many of them seniors — pay their winter heating and summer cooling bills.
Support Senior Volunteer Efforts: Retired Americans have a wide range of skills and knowledge to contribute to local and national public service efforts. Obama and Biden will engage more interested seniors into public service opportunities by expanding and improving programs like Senior Corps to connect seniors with quality volunteer opportunities.
Barack Obama's Record
Social Security and Pensions: In the midst of the 2005 debate over Social Security privatization, Obama gave a major speech at the National Press Club forcefully arguing against privatization. He also repeatedly voted against Republican amendments that aimed to privatize Social Security or cut benefits. Obama has also voted to force companies to properly fund their pension plans so taxpayers don't end up footing the bill.
Medicare: Obama has supported a number efforts to strengthen Medicare, including voting for legislation to allow Medicare to negotiate for cheaper prescription drug prices and to extend the enrollment period for low-income beneficiaries.
Protecting Seniors: After reports that lobbyists, but not the American people, received information about the most unsafe nursing homes in the country, Barack Obama demanded the Department of Health and Human Services release that information to the public. Following Obama's letter, the names of the four Iowa care facilities cited for unsafe care were released to the public. Obama's efforts follow his successful efforts in Illinois to make nursing home information public and strengthen elder abuse laws.
For More Information about Barack Obama and Joe Biden's Plan
Read the Speech
Disability
Barack Obama and Joe Biden's Plan
Barack Obama and Joe Biden's comprehensive agenda to empower individuals with disabilities fits in with the campaign's overarching message of equalizing opportunities for all Americans. In addition to reclaiming America's global leadership on this issue by becoming a signatory to -- and having the Senate ratify -- the UN Convention on the Rights of Persons with Disabilities, the plan has four parts, designed to provide lifelong supports and resources to Americans with disabilities. They are as follows: First, provide Americans with disabilities with the educational opportunities they need to succeed. Second, end discrimination and promote equal opportunity. Third, increase the employment rate of workers with disabilities. And fourth, support independent, community-based living for Americans with disabilities.
For More Information about Barack's Plan
Read the Full PlanRead the plan on Autism Spectrum Disorders
January 29 Conference Call with Rep. Jan Schakowsky and Disability Policy Committee
Read the Transcript from the Captioned Call
All information from the senators official website, click below to read all of senator Obama's take on various issues
http://www.barackobama.com/index.php
____________________________________
John McCain
Straight Talk on Health System Reform A "Call to Action" John McCain believes we can and must provide access to health care for every American. He has proposed a comprehensive vision for achieving that. For too long, our nation's leaders have talked about reforming health care. Now is the time to act.Americans Are Worried About Health Care Costs. The problems with health care are well known: it is too expensive and 47 million people living in the United States lack health insurance. John McCain's Vision for Health Care Reform John McCain Believes The Key To Health Care Reform Is To Restore Control To The Patients Themselves. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need. Health care should be available to all and not limited by where you work or how much you make. Families should be in charge of their health care dollars and have more control over care.Making Health Insurance Innovative, Portable and AffordableJohn McCain Will Reform Health Care Making It Easier For Individuals And Families To Obtain Insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.John McCain Will Reform The Tax Code To Offer More Choices Beyond Employer-Based Health Insurance Coverage. While still having the option of employer-based coverage, every family will receive a direct refundable tax credit - effectively cash - of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.John McCain Proposes Making Insurance More Portable. Americans need insurance that follows them from job to job. They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.John McCain Will Encourage And Expand The Benefits Of Health Savings Accounts (HSAs) For Families. When families are informed about medical choices, they are more capable of making their own decisions and often decide against unnecessary options. Health Savings Accounts take an important step in the direction of putting families in charge of what they pay for.A Specific Plan of Action: Ensuring Care for Higher Risk Patients John McCain's Plan Cares For The Traditionally Uninsurable. John McCain understands that those without prior group coverage and those with pre-existing conditions have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need.John McCain Will Work With States To Establish A Guaranteed Access Plan. As President, John McCain will work with governors to develop a best practice model that states can follow - a Guaranteed Access Plan or GAP - that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.John McCain Will Promote Proper Incentives. John McCain will work with Congress, the governors, and industry to make sure this approach is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.A Specific Plan of Action: Lowering Health Care CostsJohn McCain Proposes A Number Of Initiatives That Can Lower Health Care Costs. If we act today, we can lower health care costs for families through common-sense initiatives. Within a decade, health spending will comprise twenty percent of our economy. This is taking an increasing toll on America's families and small businesses. Even Senators Clinton and Obama recognize the pressure skyrocketing health costs place on small business when they exempt small businesses from their employer mandate plans.CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.CHRONIC DISEASE: Providing Quality, Cheaper Care For Chronic Disease. Chronic conditions account for three-quarters of the nation's annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs. We should dedicate more federal research to caring and curing chronic disease.COORDINATED CARE: Promoting Coordinated Care. Coordinated care - with providers collaborating to produce the best health care - offers better outcomes at lower cost. We should pay a single bill for high-quality disease care which will make every single provider accountable and responsive to the patients' needs. GREATER ACCESS AND CONVENIENCE: Expanding Access To Health Care. Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets.INFORMATION TECHNOLOGY: Greater Use Of Information Technology To Reduce Costs. We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines.MEDICAID AND MEDICARE: Reforming The Payment System To Cut Costs. We must reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement.SMOKING: Promoting The Availability Of Smoking Cessation Programs. Most smokers would love to quit but find it hard to do so. Working with business and insurance companies to promote availability, we can improve lives and reduce chronic disease through smoking cessation programs.STATE FLEXIBILITY: Encouraging States To Lower Costs. States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.TRANSPARENCY: Bringing Transparency To Health Care Costs. We must make public more information on treatment options and doctor records, and require transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and recording treatments and outcomes.Confronting the Long-Term Challenge John McCain Will Develop A Strategy For Meeting The Challenge Of A Population Needing Greater Long-Term Care. There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are pioneering approaches for delivering care to people in a home setting. Seniors are given a monthly stipend which they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.Setting the Record Straight: Covering Those With Pre-Existing ConditionsMYTH: Some Claim That Under John McCain's Plan, Those With Pre-Existing Conditions Would Be Denied Insurance.FACT: John McCain Supported The Health Insurance Portability And Accountability Act In 1996 That Took The Important Step Of Providing Some Protection Against Exclusion Of Pre-Existing Conditions. FACT: Nothing In John McCain's Plan Changes The Fact That If You Are Employed And Insured You Will Build Protection Against The Cost Of Any Pre-Existing Condition.FACT: As President, John McCain Would Work With Governors To Find The Solutions Necessary To Ensure Those With Pre-Existing Conditions Are Able To Easily Access Care.Combating Autism in America John McCain is very concerned about the rising incidence of autism among America's children and has continually supported research into its causes and treatment. Click here to learn more.
Source:
http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm
Social Security
Search
Search this site:
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No documents were found.
This was found in the "economy" section of Mcmains website
Reforming Entitlement Programs For The 21st Century
Reform Social Security: John McCain will fight to save the future of Social Security, and he believes that we may meet our obligations to the retirees of today and the future without raising taxes. John McCain supports supplementing the current Social Security system with personal accounts - but not as a substitute for addressing benefit promises that cannot be kept. John McCain will reach across the aisle to address these challenges, but if the Democrats do not act, he will. No problem is in more need of honesty than the looming financial challenges of entitlement programs. Americans have the right to know the truth and John McCain will not leave office without fixing the problems that threaten our future prosperity and power. Control Medicare Growth: The growth of spending on Medicare threatens our fiscal future. John McCain has proposed comprehensive health care reforms that will reduce the growth in Medicare spending, improve the quality of care, protect seniors against rising Medicare premium payments, and preserve the advancements in medical science central to providing quality care.
Disability
No direct plan but a seach of the site johnmccain.com turned up these 7 documents:
Remarks By John McCain To The Members Of The Veterans Of Foreign Wars (VFW) [Thank you. It is an honor to be here today. I'm always grateful to be in the company of Americans who have had the burden of serving our country in distant lands, and the honor of having proved your patriotism in difficult circumstances...] Read More
82.4% 4/7/2008
Veterans [America owes its liberty, its prosperity, and its future to our veterans who have dedicated their lives to protecting our great country. John McCain has fought to honor our national commitment to our veterans who have given their careers and livelihoods to ensuring our freedom...] Read More
82.4% 4/12/2007
It's Time For Action Tour: Day Three [Today, John McCain will continue his "It's Time for Action Tour" by traveling to Inez, Kentucky. On the third day of his tour, John McCain is visiting communities that have been forgotten and left behind but where hope, innovation and local solutions are helping to lift these communities up...] Read More
82.0% 4/23/2008
Remarks By John McCain On Memorial Day [John McCain will deliver the following remarks as prepared for delivery at the New Mexico Veterans Memorial in Albuquerque, New Mexico, ARLINGTON, VA -- U.S. Senator John McCain will deliver the following remarks as prepared for delivery at the New Mexico Veterans Memorial in Albuquerque, New Mexico, today at 10:30 a...] Read More
82.0% 5/26/2008
John McCain's Economic Summit In Wisconsin [John McCain Will Hold An Economic Summit With Business Leaders To Discuss Today's Economic Challenges. The Economic Summit is an opportunity for John McCain to meet business leaders and talk to them about the challenges and opportunities of doing business in the U...] Read More
81.6% 4/16/2008
Technology [John McCain has a broad and cohesive vision for the future of American innovation. His policies will provide broad pools of capital, low taxes and incentives for research in America, a commitment to a skilled and educated workforce, and a dedication to opening markets around the globe...] Read More
80.5% 8/14/2008
Early Childhood Education [ .issues_rightsidemenu1 {font-family: Georgia, 'Times New Roman', Times, serif; color: #FFFFFF; text-decoration: none; font-smooth: always; font-size: 13px; font-weight: bold; line-height:22px; margin-left:4px;} ...] Read More
For more information on the senators position on various issues
please visit:
http://www.johnmccain.com
All of this information was found at Mr McCains official website, above
Barack Obama and Joe Biden's Plan
On health care reform, the American people are too often offered two extremes - government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.
The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.
Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.
If you don’t like your health insurance, or you don’t have health insurance, you will have a choice of new, affordable health insurance options.
Make Health Insurance Work for People and Businesses - Not Just Insurance and Drug Companies.
Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.
Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
Ensure everyone who needs it will receive a tax credit for their premiums.
Reduce costs and save a typical American family up to $2,500 as reforms phase in:
Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market
Require hospitals to collect and report health care cost and quality data
Reduce the costs of catastrophic illnesses for employers and their employees.
Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.
The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.
A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.
For More Information about the Obama-Biden Plan
(these are extensive and informative PDF files)
Read the Plan
Read the Frequently-Asked Q and A
Read the Speech
Read the HIV/AIDS Agenda
Read the Cancer Agenda
Elderly and Social Security
At a Glance
Protect Social Security
Strengthen Retirement Savings
Affordable Health Care
Protect and Honor Seniors
The Problem
Insecure Retirement Savings: Retirement savings are near a historic low and 75 million working Americans lack employer-based retirement plans. Too many companies have dumped their pension obligations, leaving workers in the cold.
Income Security: With skyrocketing health care, energy and housing costs, and the risk of being defrauded by insurance companies, too many seniors do not have the resources to live comfortably.
Barack Obama and Joe Biden's Plan
Protect Social Security
Obama and Biden are committed to ensuring Social Security is solvent and viable for the American people, now and in the future. Obama and Biden will be honest with the American people about the long-term solvency of Social Security and the ways we can address the shortfall. Obama and Biden will protect Social Security benefits for current and future beneficiaries alike. And they do not believe it is necessary or fair to hardworking seniors to raise the retirement age. Obama and Biden are strongly opposed to privatizing Social Security. As part of a bipartisan plan that would be phased in over many years, they will ask those making over $250,000 to contribute a bit more to Social Security to keep it sound.
Obama does not support uncapping the full payroll tax of 12.4 percent rate. Instead, he and Joe Biden are considering plans that would ask those making over $250,000 to pay in the range of 2 to 4 percent more in total (combined employer and employee).
Strengthen Retirement Savings
Reform Corporate Bankruptcy Laws to Protect Workers and Retirees: Current bankruptcy laws protect banks before workers. Obama and Biden will protect pensions by putting promises to workers higher on the list of debts that companies cannot shed; ensuring that the bankruptcy courts do not demand more sacrifice from workers than executives; telling companies that they cannot issue executive bonuses while cutting worker pensions; increasing the amount of unpaid wages and benefits workers can claim in court; and limiting the circumstances under which retiree benefits can be reduced.
Require Full Disclosure of Company Pension Investments: Obama and Biden will ensure that all employees who have company pensions receive detailed annual disclosures about their pension fund's investments. This will provide retirees important resources to make their pension fund more secure.
Eliminate Income Taxes for Seniors Making Less Than $50,000: Obama and Biden will eliminate all income taxation of seniors making less than $50,000 per year. This will provide an immediate tax cut averaging $1,400 to 7 million seniors and relieve millions from the burden of filing tax returns.
Create Automatic Workplace Pensions: The Obama-Biden retirement security plan will automatically enroll workers in a workplace pension plan. Under their plan, employers who do not currently offer a retirement plan, will be required to enroll their employees in a direct-deposit IRA account that is compatible to existing direct-deposit payroll systems. Employees may opt-out if they choose. Experts estimate that this program will increase the savings participation rate for low and middle-income workers from its current 15 percent level to around 80 percent.
Expand Retirement Savings Incentives for Working Families: Obama and Biden will ensure savings incentives are fair to all workers by creating a generous savings match for low and middle-income Americans. Their plan will match 50 percent of the first $1,000 of savings for families that earn less than $75,000. The savings match will be automatically deposited into designated personal accounts. Over 80 percent of these savings incentives will go to new savers.
Prevent Age Discrimination: Obama and Biden will fight job discrimination for aging employees by strengthening the Age Discrimination in Employment Act and empowering the Equal Employment Opportunity Commission to prevent all forms of discrimination.
Affordable Health Care
Provide Cheaper Prescription Drugs: Our seniors pay the highest prices in the world for brand-name drugs. To lower drug costs, Obama and Biden will allow the federal government to negotiate for lower drug prices for the Medicare program, just as it does to lower prices for our veterans. They also support allowing seniors to import safe prescription drugs from overseas, and will prevent pharmaceutical companies from blocking cheap and safe generic drugs from the market.
Protect and Strengthen Medicare: Obama and Biden are committed to the long-term strength of the Medicare program. They will reduce waste in the Medicare system, including eliminating subsidies to the private insurance Medicare Advantage program, and tackle fundamental health care reform to improve the quality and efficiency of our healthcare system. They support closing the "doughnut hole" in the Medicare Part D prescription drug program.
Provide Transparency to Medicare Prescription Drug Plans: Many seniors are enrolled in Medicare prescription drug plans that are actually more expensive for them than other available plans. Obama and Biden will require companies to send Medicare beneficiaries a full list of the drugs and fees they paid the previous year to help seniors determine which plans can better reduce their out-of-pocket costs and improve their health.
Strengthen Long-Term Care Options: As president, Obama will work to give seniors choices about their care, consistent with their needs, and not biased towards institutional care. He will work to reform the financing of long term care to protect seniors and families. He will work to improve the quality of elder care, including by training more nurses and health care workers.
Protect and Honor Seniors
Ensure Heating Assistance: Obama and Biden will increase funding for the Low Income Home Energy Assistance Program (LIHEAP) which helps low-income citizens — many of them seniors — pay their winter heating and summer cooling bills.
Support Senior Volunteer Efforts: Retired Americans have a wide range of skills and knowledge to contribute to local and national public service efforts. Obama and Biden will engage more interested seniors into public service opportunities by expanding and improving programs like Senior Corps to connect seniors with quality volunteer opportunities.
Barack Obama's Record
Social Security and Pensions: In the midst of the 2005 debate over Social Security privatization, Obama gave a major speech at the National Press Club forcefully arguing against privatization. He also repeatedly voted against Republican amendments that aimed to privatize Social Security or cut benefits. Obama has also voted to force companies to properly fund their pension plans so taxpayers don't end up footing the bill.
Medicare: Obama has supported a number efforts to strengthen Medicare, including voting for legislation to allow Medicare to negotiate for cheaper prescription drug prices and to extend the enrollment period for low-income beneficiaries.
Protecting Seniors: After reports that lobbyists, but not the American people, received information about the most unsafe nursing homes in the country, Barack Obama demanded the Department of Health and Human Services release that information to the public. Following Obama's letter, the names of the four Iowa care facilities cited for unsafe care were released to the public. Obama's efforts follow his successful efforts in Illinois to make nursing home information public and strengthen elder abuse laws.
For More Information about Barack Obama and Joe Biden's Plan
Read the Speech
Disability
Barack Obama and Joe Biden's Plan
Barack Obama and Joe Biden's comprehensive agenda to empower individuals with disabilities fits in with the campaign's overarching message of equalizing opportunities for all Americans. In addition to reclaiming America's global leadership on this issue by becoming a signatory to -- and having the Senate ratify -- the UN Convention on the Rights of Persons with Disabilities, the plan has four parts, designed to provide lifelong supports and resources to Americans with disabilities. They are as follows: First, provide Americans with disabilities with the educational opportunities they need to succeed. Second, end discrimination and promote equal opportunity. Third, increase the employment rate of workers with disabilities. And fourth, support independent, community-based living for Americans with disabilities.
For More Information about Barack's Plan
Read the Full PlanRead the plan on Autism Spectrum Disorders
January 29 Conference Call with Rep. Jan Schakowsky and Disability Policy Committee
Read the Transcript from the Captioned Call
All information from the senators official website, click below to read all of senator Obama's take on various issues
http://www.barackobama.com/index.php
____________________________________
John McCain
Straight Talk on Health System Reform A "Call to Action" John McCain believes we can and must provide access to health care for every American. He has proposed a comprehensive vision for achieving that. For too long, our nation's leaders have talked about reforming health care. Now is the time to act.Americans Are Worried About Health Care Costs. The problems with health care are well known: it is too expensive and 47 million people living in the United States lack health insurance. John McCain's Vision for Health Care Reform John McCain Believes The Key To Health Care Reform Is To Restore Control To The Patients Themselves. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need. Health care should be available to all and not limited by where you work or how much you make. Families should be in charge of their health care dollars and have more control over care.Making Health Insurance Innovative, Portable and AffordableJohn McCain Will Reform Health Care Making It Easier For Individuals And Families To Obtain Insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.John McCain Will Reform The Tax Code To Offer More Choices Beyond Employer-Based Health Insurance Coverage. While still having the option of employer-based coverage, every family will receive a direct refundable tax credit - effectively cash - of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.John McCain Proposes Making Insurance More Portable. Americans need insurance that follows them from job to job. They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.John McCain Will Encourage And Expand The Benefits Of Health Savings Accounts (HSAs) For Families. When families are informed about medical choices, they are more capable of making their own decisions and often decide against unnecessary options. Health Savings Accounts take an important step in the direction of putting families in charge of what they pay for.A Specific Plan of Action: Ensuring Care for Higher Risk Patients John McCain's Plan Cares For The Traditionally Uninsurable. John McCain understands that those without prior group coverage and those with pre-existing conditions have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need.John McCain Will Work With States To Establish A Guaranteed Access Plan. As President, John McCain will work with governors to develop a best practice model that states can follow - a Guaranteed Access Plan or GAP - that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.John McCain Will Promote Proper Incentives. John McCain will work with Congress, the governors, and industry to make sure this approach is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.A Specific Plan of Action: Lowering Health Care CostsJohn McCain Proposes A Number Of Initiatives That Can Lower Health Care Costs. If we act today, we can lower health care costs for families through common-sense initiatives. Within a decade, health spending will comprise twenty percent of our economy. This is taking an increasing toll on America's families and small businesses. Even Senators Clinton and Obama recognize the pressure skyrocketing health costs place on small business when they exempt small businesses from their employer mandate plans.CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.CHRONIC DISEASE: Providing Quality, Cheaper Care For Chronic Disease. Chronic conditions account for three-quarters of the nation's annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs. We should dedicate more federal research to caring and curing chronic disease.COORDINATED CARE: Promoting Coordinated Care. Coordinated care - with providers collaborating to produce the best health care - offers better outcomes at lower cost. We should pay a single bill for high-quality disease care which will make every single provider accountable and responsive to the patients' needs. GREATER ACCESS AND CONVENIENCE: Expanding Access To Health Care. Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets.INFORMATION TECHNOLOGY: Greater Use Of Information Technology To Reduce Costs. We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines.MEDICAID AND MEDICARE: Reforming The Payment System To Cut Costs. We must reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement.SMOKING: Promoting The Availability Of Smoking Cessation Programs. Most smokers would love to quit but find it hard to do so. Working with business and insurance companies to promote availability, we can improve lives and reduce chronic disease through smoking cessation programs.STATE FLEXIBILITY: Encouraging States To Lower Costs. States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.TRANSPARENCY: Bringing Transparency To Health Care Costs. We must make public more information on treatment options and doctor records, and require transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and recording treatments and outcomes.Confronting the Long-Term Challenge John McCain Will Develop A Strategy For Meeting The Challenge Of A Population Needing Greater Long-Term Care. There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are pioneering approaches for delivering care to people in a home setting. Seniors are given a monthly stipend which they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.Setting the Record Straight: Covering Those With Pre-Existing ConditionsMYTH: Some Claim That Under John McCain's Plan, Those With Pre-Existing Conditions Would Be Denied Insurance.FACT: John McCain Supported The Health Insurance Portability And Accountability Act In 1996 That Took The Important Step Of Providing Some Protection Against Exclusion Of Pre-Existing Conditions. FACT: Nothing In John McCain's Plan Changes The Fact That If You Are Employed And Insured You Will Build Protection Against The Cost Of Any Pre-Existing Condition.FACT: As President, John McCain Would Work With Governors To Find The Solutions Necessary To Ensure Those With Pre-Existing Conditions Are Able To Easily Access Care.Combating Autism in America John McCain is very concerned about the rising incidence of autism among America's children and has continually supported research into its causes and treatment. Click here to learn more.
Source:
http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm
Social Security
Search
Search this site:
Required
No documents were found.
This was found in the "economy" section of Mcmains website
Reforming Entitlement Programs For The 21st Century
Reform Social Security: John McCain will fight to save the future of Social Security, and he believes that we may meet our obligations to the retirees of today and the future without raising taxes. John McCain supports supplementing the current Social Security system with personal accounts - but not as a substitute for addressing benefit promises that cannot be kept. John McCain will reach across the aisle to address these challenges, but if the Democrats do not act, he will. No problem is in more need of honesty than the looming financial challenges of entitlement programs. Americans have the right to know the truth and John McCain will not leave office without fixing the problems that threaten our future prosperity and power. Control Medicare Growth: The growth of spending on Medicare threatens our fiscal future. John McCain has proposed comprehensive health care reforms that will reduce the growth in Medicare spending, improve the quality of care, protect seniors against rising Medicare premium payments, and preserve the advancements in medical science central to providing quality care.
Disability
No direct plan but a seach of the site johnmccain.com turned up these 7 documents:
Remarks By John McCain To The Members Of The Veterans Of Foreign Wars (VFW) [Thank you. It is an honor to be here today. I'm always grateful to be in the company of Americans who have had the burden of serving our country in distant lands, and the honor of having proved your patriotism in difficult circumstances...] Read More
82.4% 4/7/2008
Veterans [America owes its liberty, its prosperity, and its future to our veterans who have dedicated their lives to protecting our great country. John McCain has fought to honor our national commitment to our veterans who have given their careers and livelihoods to ensuring our freedom...] Read More
82.4% 4/12/2007
It's Time For Action Tour: Day Three [Today, John McCain will continue his "It's Time for Action Tour" by traveling to Inez, Kentucky. On the third day of his tour, John McCain is visiting communities that have been forgotten and left behind but where hope, innovation and local solutions are helping to lift these communities up...] Read More
82.0% 4/23/2008
Remarks By John McCain On Memorial Day [John McCain will deliver the following remarks as prepared for delivery at the New Mexico Veterans Memorial in Albuquerque, New Mexico, ARLINGTON, VA -- U.S. Senator John McCain will deliver the following remarks as prepared for delivery at the New Mexico Veterans Memorial in Albuquerque, New Mexico, today at 10:30 a...] Read More
82.0% 5/26/2008
John McCain's Economic Summit In Wisconsin [John McCain Will Hold An Economic Summit With Business Leaders To Discuss Today's Economic Challenges. The Economic Summit is an opportunity for John McCain to meet business leaders and talk to them about the challenges and opportunities of doing business in the U...] Read More
81.6% 4/16/2008
Technology [John McCain has a broad and cohesive vision for the future of American innovation. His policies will provide broad pools of capital, low taxes and incentives for research in America, a commitment to a skilled and educated workforce, and a dedication to opening markets around the globe...] Read More
80.5% 8/14/2008
Early Childhood Education [ .issues_rightsidemenu1 {font-family: Georgia, 'Times New Roman', Times, serif; color: #FFFFFF; text-decoration: none; font-smooth: always; font-size: 13px; font-weight: bold; line-height:22px; margin-left:4px;} ...] Read More
For more information on the senators position on various issues
please visit:
http://www.johnmccain.com
All of this information was found at Mr McCains official website, above
Monday, September 22, 2008
News you can use ARDvark Blog
Gut Bacterium Linked To Colon Cancer
Written by Catharine Paddock, PhD
US scientists found that a common bacterium found in the gut could play a role in the development of colon cancer by producing a fermentation byproduct that damages DNA and affects signalling pathways used by colon cancer...[read article]Gut Bacterium Linked To Colon Cancer
Introducing NEW Voltarol Pain-eze® Tablets - A New And Effective Way Of Treating Body Pain Voltarol® Launches First Ever OTC Diclofenac Tablet
Pelvic Disorders Affect Large Number Of Women
Stateline.org Examines State Ballot Measures Related To Health Care
Introducing NEW Voltarol Pain-eze® Tablets - A New And Effective Way Of Treating Body Pain Voltarol® Launches First Ever OTC Diclofenac Tablet
Gordon Brown Praises NHS Staff On Reductions In C. Difficile And MRSA Infections, UK
Vaginal Brachytherapy Versus External Beam Pelvic Radiotherapy For High-Intermediate Risk Endometrial Cancer - Randomised PORTEC-2 Trial
Could An Absorption Enhancer Be More Convenient And Helpful For Colitis Patients?
Editorial: Where's The Data? Association Of Faculties Of Medicine Of Canada
In Crohn's Disease A Case Of False Positive Octreoscan
Canadian Scientists Report On Pain Research At NIDCR's 60th Anniversary Symposium
Montreal Water Treatment Plants Dumping As Much As 90 Times The Critical Amount Of Estrogen Products Into The River
Suppressing Hunger Hormone Could Be As Effective As Bariatric Surgery
What Impact Does "Fertility Tourism" Have On The NHS?
Discovery Of Master Switch In The Brain That Regulates Appetite And Reproduction
Written by Catharine Paddock, PhD
US scientists found that a common bacterium found in the gut could play a role in the development of colon cancer by producing a fermentation byproduct that damages DNA and affects signalling pathways used by colon cancer...[read article]Gut Bacterium Linked To Colon Cancer
Introducing NEW Voltarol Pain-eze® Tablets - A New And Effective Way Of Treating Body Pain Voltarol® Launches First Ever OTC Diclofenac Tablet
Pelvic Disorders Affect Large Number Of Women
Stateline.org Examines State Ballot Measures Related To Health Care
Introducing NEW Voltarol Pain-eze® Tablets - A New And Effective Way Of Treating Body Pain Voltarol® Launches First Ever OTC Diclofenac Tablet
Gordon Brown Praises NHS Staff On Reductions In C. Difficile And MRSA Infections, UK
Vaginal Brachytherapy Versus External Beam Pelvic Radiotherapy For High-Intermediate Risk Endometrial Cancer - Randomised PORTEC-2 Trial
Could An Absorption Enhancer Be More Convenient And Helpful For Colitis Patients?
Editorial: Where's The Data? Association Of Faculties Of Medicine Of Canada
In Crohn's Disease A Case Of False Positive Octreoscan
Canadian Scientists Report On Pain Research At NIDCR's 60th Anniversary Symposium
Montreal Water Treatment Plants Dumping As Much As 90 Times The Critical Amount Of Estrogen Products Into The River
Suppressing Hunger Hormone Could Be As Effective As Bariatric Surgery
What Impact Does "Fertility Tourism" Have On The NHS?
Discovery Of Master Switch In The Brain That Regulates Appetite And Reproduction
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