Mark Twain: A Man of His Time and of All Time
- Created on Thursday, 11 February 2016 02:49
My dear cousin Maria gave me The Autobiography of Mark Twain for Christmas. His life story is fascinating, and so is the history of his autobiography.
He started writing it in 1870- which was 40 years before he died. And before he began, he decided that he didn’t want it to be published until after he was dead. But, he was ambivalent about how many years after, ranging from as few as 50 to as many as 500. Yes, he actually contemplated having his autobiography held for half a millennium before being published. But, he wound up stipulating a 100 year wait. Yet, somehow, the first edition came out in 1958, which was 48 years after he died. Go figure.
Anyway, I think it’s pretty darn arrogant to assume that 100 years after you’re dead that people will want to read about your life- let alone 500 years. And all the more so when you consider that in 1870 when he started, he hadn’t even completed Tom Sawyer yet. So, he was very far from the pinnacle of his fame. However, on the other hand, he turned out to be correct in his prediction.
Another weird thing about the autobiography is that it was not written in chronological order. Randomly, he wrote about different times in his life, as the mood struck him, and he expected the book to be published that way, in this “stream of consciousness” style. But, the version that Maria got for me, which was edited by Charles Neider, is arranged mostly, although not completely, chronologically.
Mark Twain, whose real name was Samuel Clemens, was born in Florida, Missouri in 1835. Florida, by the way, means “land of flowers.” But, at age 8, his family moved to the larger town of Hannibal, Missouri to live with his uncle who owned a large farm there. And, since it was before the Civil War, the work on this farm was done by slaves. He told a very touching story about a slave boy named Sandy. Sandy liked to sing and hum. He did it all day long while he was working. But, Samuel didn’t like it, and he asked his mother to make Sandy stop. But fervently, his mother explained to him that Sandy had been torn away from his family in Virginia, and he was never going to see them again- all the people he loved. And if singing and humming provides him some relief from his sorrow, then she is glad for it, and she hopes he will continue, and Samuel should too. That had a huge effect on Samuel, and it changed his attitude towards Sandy and towards black people in general. He was never again bothered by Sandy’s singing. And, he wound up including Sandy as a character in Tom Sawyer. You recall the famous scene in which Tom finagles the other boys to paint the fence for him. Well, Sandy was one of the other boys, except that he doesn’t fall for it.
Both Tom Sawyer and Huckleberry Finn were based on Mark Twain’s childhood experiences in Missouri. And, another character from Tom Sawyer who was real is the second-most important character in the book: Injun Joe. There really was an Injun Joe; except that in the book, Injun Joe got trapped in a cave and starved to death, whereas in real life, Injun Joe got trapped in a cave but didn’t starve; after many weeks, he was rescued, having survived all that time on the flesh of bats.
Mark Twain had very little education. He never went to college. He just attended a little country school in Missouri, and it was 3 miles from his home. Year-round, he had to walk to school, and remember, they get some pretty serious winter in Missouri. Can you imagine a little kid having to wake up in the morning and then trudge through snow for 3 miles to get to school? And return home the same way? I’m thinking that there wasn’t too much childhood obesity back then.
Oh, and that reminds me: he wrote a lot about the food they ate on the farm, and he raved about it, all the incredible edibles they had. And he began by listing all the animals that they ate, including a lot of uncommon ones for our time, such as squirrels, possums, rabbits, ducks, geese, wild turkeys, wild hogs, deer, elk, even bears. It seems that the modern meat supply has contracted quite a lot in variety compared to back then, although being a vegetarian, I am unaffected.
I got the impression that Mark Twain was a real epicurean; he enjoyed his food and drink. He wrote this in the book:
“There are people who strictly deprive themselves of each and every eatable, drinkable, and smokable, which has in any way acquired a shady reputation. They pay this price for health. And health is all they get for it. How strange it is! It is like paying out your whole fortune for a cow that has gone dry.”
Now, that’s what I call a bad attitude about healthy living. Personally, I think there can be plenty of enjoyment in life even when one tries to live it healthily.
But, speaking of smoking, Mark Twain really loved his tobacco. He smoked like a fiend. Tobacco is what his uncle raised on the farm. Samuel started smoking at the age of 9. He became famous for brandishing his pipe, but he also smoked cigarettes and cigars. He also chewed tobacco. So, the fact that he lived to the age of 74, dying in 1910 of a heart attack, is quite amazing when you consider that average lifespan for men in 1910 was 50.
If you are wondering how Mark Twain got started writing, it’s simple. His older brother Orion had bought the local newspaper in Hannibal, and he got Samuel to come work for him. So, Samuel learned the ins and outs of newspaper printing, including typesetting and everything else. But, sometimes, they would be laying out the paper and realize that they needed another third of a page to fill it up. So, his brother would say, “write something” and Samuel did. And that is how he got started writing.
Eventually, the newspaper failed, not because it wasn’t popular but because his brother Orion was a lousy businessman who couldn’t balance the books and turn a profit. So, he sold it and moved to Iowa, and that’s when Samuel moved to St. Louis and got a job as a reporter for a newspaper. And that became his bread and butter, being a newspaper reporter.
But, very much like my cousin Gary, Mark Twain decided early in life that he wanted to travel; he wanted to see the world. And he did; he traveled to every continent except Antarctica. And often he got newspapers and magazines to pay for his trips with the understanding that he would write about it, and they would get to publish it. He told an interesting story about something that happened to him in India.
But first, let me say that he wrote a lot about all these girls and young ladies that he pined for in his youth. And from reading it, you get the impression that he wasn’t too successful with them, overall. There was this one, whom he called Mary although he admitted that it was not her real name, who was gorgeous, a real siren. She was a little older than he was, but he fell head over heels for her. She did not return the sentiment. But, decades later, when he was traveling in India, he was at a hotel, and he saw her. Well, he thought he saw her. He knew he couldn’t be seeing her because this was an attractive young girl he saw, probably in her teens. And he was in his mid-40s at the time. But, he thought there had to be a connection. So, he approached this girl and asked her about the girl he knew. Well, it turned out that this young girl was the granddaughter of the girl he knew, and that her grandmother was there, staying at the hotel. So, he went to see the grandmother, now a grey-haired old woman in her 50s, and they had a wonderful reunion. What were the chances of that?
He didn’t get married until 1870 at the age of 35. His wife, Olivia Langdon, was 22. Yet, he outlived her. He said that she was frail and beautiful. Their first child, a son named Langdon, lived just 22 months. Mark Twain held himself responsible for the boy’s death. It was winter, and he took him out for a carriage ride, but the boy was inadequately dressed for the cold, and he got sick and died. Actually, according to Mark Twain, the boy's leg actually froze. So, maybe he died of sepsis. Perhaps the boy needed an amputation.
Mark Twain never forgave himself, and he suffered a severe depression. And I had read elsewhere that he had long bouts of depression in his life. Don’t you find it ironic that a humorist should suffer with depression? Shades of Robin Williams? Or perhaps I should say that Robin Williams was a shade of Mark Twain. And I think the following passage is evidence of his depression. He was talking about the “maddening repetition of the stock incidents of our race’s fleeting sojourn here, which has oppressed human minds from the beginning.”
“A myriad of men are born; they labor and sweat and struggle for bread; they squabble and scold and fight; they scramble for little mean advantages over each other. Age creeps upon them; infirmities follow; shames and humiliations bring down their prides and their vanities. Those they love are taken from them. Misery grows heavier, year by year. At length, ambition is dead; pride is dead; vanity is dead; longing for release is in their place. It comes at least- the only unpoisoned gift Earth ever had for them- and they vanish from a world where they were of no consequence; where they achieved nothing; where they were a mistake and a failure and a foolishness; where they have left no sign that they have existed- a world that will lament them for one day and then forget them forever. Then, another myriad takes their place and copies all they did and goes along the same profitless road and vanishes as they vanished- to make room for another and another, and a million other myriads to follow the same arid path through the same desert and accomplish what the first myriad and all the myriads that came after it accomplished- nothing!”
Now, that’s what I call depressed.
His wife Olivia went on to bear three more children, all daughters, the first of whom was Suzy. Oh, did he love Suzy. He wrote so much about her and practically nothing about his wife. He would just mention that his wife went with him somewhere, but he had little to say about her otherwise, and little to say about his other two daughters either. But, he went on and on about Suzy. She was bright, observant, and sharp as a tack. At the age of 15, she took to writing her own biography of her father, and he included an excerpt of it in the book. And, it was very good writing too, and I mean for anybody, let alone a 15 year old.
Oh, but tragedy struck again. While he and his wife were in England where he was receiving some award, they got word by telegraph that Suzy had fallen ill. Then, meningitis set it. And remember: there were no antibiotics in those days. And at the tender age of 22, Suzy gave up the mortal coil. He and his wife weren’t even there to be with her, though her sisters were and other relatives. Mark Twain really turned a phrase when he wrote of Suzy: “She was our wonder and our worship.”
There is a lot in the book about his friendships with famous people, including General Ulysses S. Grant. He explained that even after he was President, that Grant preferred the title of “General” to “President.” And, I learned an interesting fact: that Mark Twain handled the publication of Grant’s memoirs. Grant was racing to finish them before he died, and he knew he was dying. He had all kinds of ailments- he was such an alcoholic. And, he actually finished it barely in time and promptly died. But, Mark Twain got it published, and he delivered the royalties to Grant’s widow, which came to half a million dollars. Now try to think about what half a million was worth in 1870s dollars. How many millions would it be today? I'm thinking maybe ten million.
It’s ironic that Twain and Grant should have become close friends when you consider that Mark Twain fought briefly for the Confederate Army in the Civil War. But actually, he was never in battle, and actually, he only served briefly. He essentially deserted- although he didn't use that term. And what he did was head west, first to Virginia City, Nevada, where he got a job as a reporter, and then on to San Francisco, where he did the same thing. And that’s where he came up with one of his most famous lines, “The coldest winter I ever spent was a summer in San Francisco.”
He also had close friendships with other prominent authors, such as Rudyard Kipling and Robert Louis Stevenson.
Another close friendship was with the Serbian electrical genius and inventor, Nikola Tesla. Twain was fascinated with science and technology, and he spent much time with Tesla in his laboratory.
Twain’s wife Olivia died in Florence, Italy in 1904, and again, he blamed himself because he was the one who was dragging this delicate woman of frail constitution all around the world because of his yen to travel.
And then, in 1909, the year before he died, his youngest daughter Jean died of typhoid fever. Therefore, his wife and all his children except for one, his daughter Clara, died before he did. Oh, the grief that that man must have suffered.
And towards the end of 1909, he announced to his remaining family and friends that he would be dying himself the next year, in 1910. But, he made an amusing story out of it. He said that he was born in 1835, which was the year of Haley’s Comet. And astronomers were predicting that Haley’s Comet would revisit Earth’s skies again in 1910, and they were right. So, Mark Twain said that it’s fitting for two freaks of Nature to come and go together. He died of a fatal heart attack on April 21, 1910.
Mark Twain is considered the greatest American humorist of the 19th century, but William Faulkner took it further. He said that Twain was “the father of American literature.” His best-loved books are The Adventures of Tom Sawyer, The Adventures of Huckleberry Finn, The Prince and the Pauper, and A Connecticut Yankee in King Arthur’s Court.
It is quite amazing that he made it to 74, considering how heavily he smoked. But, I don’t think he had any regrets about that.
In Cancer Screening, why not tell the truth?
- Created on Tuesday, 19 January 2016 21:13
This is an article by John Mandrola, MD which was published in Medscape on January 18, 2016. I am reproducing it here in whole. He argues that if you really look at the evidence that there is no increased life expectancy from all the cancer screening that is being done. That includes mammography for breast cancer, colonoscopy for colon cancer, chest x-rays for lung cancer, etc. His conclusion is based partly on the recognition that the only thing that really matters is overall mortality, not disease-specific mortality. And it makes sense because staying alive is the thing; it's the goal; it's the reason for doing anything. If the whole medical process which begins with screening and then goes on to definitive testing and then treatment, often radical treatment, is not going to result in you staying alive longer, what's the point? If a man can live just as long with untreated prostate cancer as he can by having it treated and going through the trauma, the pain, the disability, and often the impotence that results from treatment, why not just leave it be? Even just ignore it, although I'm not really recommending that. I think there are nutritional and lifestyle measures that can influence the course of prostate cancer a lot. But, let me put it this way: for a man my age or older (65) who is feeling fine, who is urinating fine, who has good sexual function, and is not in any pain, I certainly wouldn't let anyone cut on my prostate. What for? I am going to die anyway, but if there is no evidence that I am likely to live one day longer by operating, why do it? They say that 80% of men get some cancer in their prostate before they die anyway, and that if a man lives long enough, he's almost sure to get it. But, prostate cancer is usually very slow-growing and non-invasive. Operating just for good measure isn't necessarily a good measure.
So, read this article by Dr. Mandrola. I salute him because it took a lot of guts to write this.
Dr. John Mandrola:
An unpleasant emotion caused by the belief that something is dangerous. This is fear. This is cancer.
The motivation to screen for cancer, therefore, is easy to understand.
The problem: cancer screening has not worked. Recent reviews of the evidence show that current-day screening techniques do not save lives. Worse, in many cases, these good-intentioned searches bring harm to previously healthy people.
I realize this sounds shocking. It did to me, too. Millions of women and men have had their breasts squished, veins poked, lungs irradiated, and bowels invaded in the name of "health" maintenance. I've been scolded for forgoing PSA tests and colonoscopy — "you should know better, John."
I know what you may be thinking. We have all heard the anecdotes — cases that are often celebrated in local news reports and hospital marketing material. People saved by early detection, and the opposite: the unscreened felled by late-stage disease.
Anecdotes, however compelling, are not evidence. When you pull up a chair, open your computer, take a breath, suspend past beliefs, and look for the evidence that screening saves lives, it simply isn't there.
One reason that this many people (doctors and patients alike) have been misled about screening has been our collective attachment to the belief that if screening lowers disease-specific death rates, that would translate to lower overall mortality. That is: breast, lung, and colon cancer are bad diseases, so it makes sense that lowering death from those three types of cancer would extend life.
It is not so.
Facts, Not Fear
In a comprehensive review of the literature published in the BMJ, Drs Vinay Prasad (Oregon Health Sciences University, Portland) and David Newman (School of Medicine at Mount Sinai, New York), along with journalist Jeanne Lenzer, find that disease-specific mortality is a lousy surrogate for overall mortality. They report that when a screening technique does lower disease-specific death rates, which is both uncommon and of modest degree, there are no differences in overall mortality.
The authors cite three reasons why cancer screening might not reduce overall mortality:
Screening trials were underpowered to detect differences. I'm no statistician, but doesn't the fact that a trial requires millions of subjects to show a difference, mean there is little, if any, difference?
"Downstream effects of screening may negate any disease-specific gains." My translation: harm. Dr Peter Gøtzsche (Nordic Cochrane Center, Copenhagen) wrote in a commentary that "screening always causes harm. Sometimes it also leads to benefits, and sometimes these benefits outweigh the harms." To understand harm resulting from screening, one need only to consider that a prostate biopsy entails sticking a needle through the rectum, or that some drugs used to treat breast cancer damage the heart.
Screening might not reduce overall mortality because of "off-target deaths." An illustration of this point is provided by a cohort studythat found a possible increased risk of suicide and cardiovascular death in men in the year after being diagnosed with prostate cancer. People die — of all sorts of causes, not just cancer.
Let's also be clear that this one paper is not an outlier. A group of Stanford researchers performed a systematic review and meta-analyses of randomized trials of screening tests for 19 diseases (39 tests) where mortality is a common outcome. They found reductions in disease-specific mortality were uncommon and reductions in overall mortality were rare or nonexistent.
Drs Archie Bleyer and H Gilbert Welch (St Charles Health System, Central Oregon, Portland) reviewed Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 and concluded that "screening mammography has only marginally reduced the rate at which women present with advanced cancer and that overdiagnosis may account for nearly a third of all new breast cancer cases." Likewise, a Cochrane Database Systematic review of eight trials and 600,000 women did not find an effect of screening on either breast cancer mortality or all-cause mortality. This evidence caused the Swiss medical board to abolish screening mammography.
These are the data. It's now clear to me that mass cancer screening does not save lives. But I'm still trying to understand how this practice became entrenched as public-health gospel. It has to be more than fear.
How We Say It Matters
Dr Gerd Gigerenzer (Max Planck Institute, Berlin, Germany) offered a clue in his editorial accompanying the recently published literature review and analysis by Prasad and colleagues. He pointed to language and the ability of words to persuade. Instead of saying "early detection," advocates might use the term "prevention." This, Dr Gigerenzer says, wrongly suggests screening reduces the odds of getting cancer. Doesn't looking for cancer increase the odds of getting the diagnosis of cancer?
Gigerenzer noted two other ways language is used to emphasize screening benefits over harms:
The reporting of benefits in relative, not absolute terms.
The equating of increases in 5-year survival rates with decreases in mortality.
I would add to this list of word misuse, the practice of referring to women sent to mammography screening as patients. They are not patients; they are well people.
Dr Gigerenzer agreed with the commonsense notion that overall mortality should be reported along with cancer-specific mortality. His editorial included a fact box on breast cancer early detection using mammography provided by the Harding Center for Risk Literacy. I challenge you to tell me why such text boxes should not be shown to people before they undergo screening,
Fixing a Public-Health Problem
Given these revelations, I conclude that we have a massive public-health problem. Any expert in problem solving will tell you the first step of getting out of hole is to stop digging. I see three obvious next steps:
The first action healthcare experts should take is to spread the word that there is nothing about the mass screening of healthy people for cancer that equates to health maintenance. Embrace clear language. Saying or implying that screening saves lives when there are no data to support it and lots to refute it undermines trust in the medical profession.
The second action healthcare experts should take is to stop wasting money on screening. If the evidence shows no difference in overall mortality, why pay for it? I'm not naive to the fact that use of clear language will decrease the number of billable procedures. I am not saying this will be easy. One first move that would be less painful would be to get rid of quality measures or incentives that promote screening.
I want to be clear; I'm not saying all cancer screening is worthless. People at higher baseline risk for cancer, such as those with a family history of cancer or environmental exposures, might derive more benefit than harm from screening. Prasad, Lenzer, and Newman say this group of patients would be a good place to spend future research dollars. That sounds reasonable. I also acknowledge that some people, even when presented with the evidence, will want to proceed with screening. We can argue about who should pay for non–evidence-based medical procedures.
The most important action that all of us (patients, nurses, doctors, and healthcare writers) should take is to learn from this revelation. There's nothing bad about the fact that current-day screening tests don't save lives. Cancer is a tough disease, and in some ways, it may be the natural order of cell biology. What's bad about this medical reversal has been our blindness to the evidence.
We let what we believe become what we know. In clinical medicine, that should be a never event.
Time to stop statin treatment!
- Created on Tuesday, 12 January 2016 03:32
The above title actually isn't mine. It's that of Dr. Uffe Ravnskov, from his most recent newsletter. Uffe is a Swedish internist and nephrologist (kidney specialist) who has made it his mission to expose the truth about statin drugs and cholesterol. The news about statin drugs has always been bad because there has never been any clearcut evidence of benefit. The only thing clearcut about them is that they do harm, increasing the risk of cancer and diabetes. But now, the latest research shows that they are virtually of no value in preventing heart disease. You might as well take a placebo. But, it's even worse than that. Some of the research is showing that statins actually increase the risk of heart attack and heart disease. What follows is from Dr. Ravsnkov's latest newsletter:
"Do you know that on average statin treatment is unable to prolong your life by more than a few days? This was what Danish researchers found out after having analysed all statin trials, where the authors had recorded the total number of deaths. You can read more about it in Canada Free Press. The very article is freely available in BMJ Open."
"In 2004 new penal regulations on clinical trials came into effect in the EU. It was decided that no drug trial could be published unless the trial directors had reported about it before its start. In figure 1 of the paper by Okayama and coworkers the authors have shown that although the trials reported that statins were effective in lowering LDL-C, no significant benefits were observed in the trials published after 2004. The only conclusion from that finding must be that the drug companies have only published trials with a positive outcomes."
Trends in Prescription drug use in the USA
- Created on Tuesday, 24 November 2015 21:22
I received this from Medscape. It concerns changes in prescription drug use among Americans from the turn of the century to 2012. As you might have anticipated, prescription drug use went up, way up. Why would that be? A big reason, I suspect, is that prescription drugs are now advertised directly to consumers- in newspapers, magazines, and particularly on television.
The percentage of adults taking prescription drugs has risen to 59%, but realize that is an average, where it is lower among young adults and rises to 90% among seniors age 65 and older.
The bestselling prescription is still a statin drug to lower cholesterol: simvastatin otherwise known as Zocor. I agree with Dr. Uffe Ravnskov of Sweden who says that very few if any patients should be taking this drug or others like it. The statin craze is mostly just a racket. That's what he says, and I agree with him. I am lucky to have corresponded with Dr. Ravnskov, and he sends me his monthly newsletter. Dr. Ravnskov, who is a board-certified internist and nephrologist, is a medical maverick of the highest caliber.
Statins definitely do more harm than good, and it's not clear that they do any good at all. They increase the risk of both diabetes and cancer, and that's proven. There are big class action lawsuits going on right now over statins, including Zocor.
The next best-selling drug, lisinopril, an ACE inhibitor, which is usually given for high blood pressure, but I don't like it either. It is a dangerous drug. Right now, there are class action lawsuits being organized concerning liver damage and liver failure from lisinopril- where people have to get liver transplants.
There are better ways to lower blood pressure than taking that stuff.
The next drug, levothyroxine, is actually beneficial, and millions need it. It is thyroid replacement. The fact is that millions of people reach the point in life, sooner or later, in which they need thyroid hormone replacement. So, I'm not opposed to it. However, I think the natural desiccated thyroid, such as Armour, is superior because it contains T3 as well as T4, plus it's closer to bio-identical than the synthetic. It's also cheaper. Levothyroxine (Synthroid) is outrageously expensive, especially for a drug that has been around for as long as it has.
Next on the list is metropolol, which I do not like at all. It's a beta blocker, and they give it for high blood pressure. Do you really want to lower your blood pressure by weakening your heart? I don't know about you, but I want my heart to be as strong as possible, as strong as it can be. Yes, inhibiting the contractile strength of your heart may lower the stroke output and reduce your blood pressure a little, but so what. It's not worth it. By the way, people also take this drug for "social anxiety" and "performance anxiety" such as by musicians. It's actually very popular with musicians, but not with this musician.
Next on the list is metformin, which is the best drug in all of Modern Medicine. It is the best and safest diabetes drug- by far. And, it has widespread health benefits beyond that with very low risk of harm. The risk/reward profile of metformin is outstanding. Metformin lowers the risk of diabetes, cancer, and heart disease- the three biggest killers. I'm sure there are many thousands of people taking metformin who aren't even diabetic- just to get the anti-aging/life-extending benefits that are quite proven. So yes, metformin is good.
Next is hydrochlorothiazide which is a diuretic. Diuretics are given for all kinds of reasons including to lower blood pressure. Whenever there is excess fluid anywhere they prescribe a diuretic. But, taking it does not remove the cause of the fluid retention. So, it's just a symptomatic treatment. I am very negative about diuretics. There may be emergencies where people have no choice, such as if your lungs are full of fluid and you can't breathe, but there is altogether too much prescribing of diuretics in this country. I wrote an article about it years ago that is very well read, and I actually hear from people from all over the world who have seen and read this article:
Next on the list is omeprazole, which is a proton pump inhibitor for acid reflux. Nexium. I don't like it. I don't like it for its side effects, and I don't like it for its intended effect of killing stomach acid. You need your stomach acid. Everybody does. You need it to digest your proteins, and it protects you from infection. Think of the acid like a sterilizer for your stomach. So, I reject that drug too. There are other ways to deal with heartburn that don't involve destroying your stomach acid.
Next is amlodipine which is a calcium channel blocker, among the most dangerous of hypertension drugs. I don't like it. It's actually been shown to increase the risk of heart attack. Again, there are class action lawsuits going on over this drug. I do not feel good about it, and I would never take it- even if I had high blood pressure, which I don't.
The next bestseller is atorvastatin (Lipitor) which used to be the best-selling statin, but they refused to lower the price, so Zocor is outselling it. Lipitor is even stronger than Zocor. You should read: Lipitor: Thief of Memory by Dr. Duane Graveline, a NASA physician.
And finally, the tenth best-seller is albuterol, which is definitely necessary. Asthmatics use it as a broncho-dilator, to open up their airways. It does have problems, and in the long run, it may actually worsen asthma. So, asthmatics should definitely try to minimize their use of it. However, I don't dispute the need for it. When you gotta breathe, you gotta breathe.
So, that's the top 10 list of best-selling prescription drugs in America, and most of them I disdain. But fortunately, there are a few exceptions and two of them: thyroid replacement (which I prefer in the natural porcine form) and metformin are truly outstanding.
What follows is the article as I received it from Medscape:
In this study, researchers retrospectively analyzed the National Health and Nutrition Examination Survey database to determine if the prevalence of prescription drug use changed from 1999-2000 to 2011-2012. Household interviews with approximately 38,000 people were included. During the interviews, people were asked if they had taken prescription drugs over the prior 30 days and, if they answered yes, were asked to show the medication containers.
The main findings include:
The percentage of adults reporting use of any prescription drugs increased from 51% in 1999-2000 to 59% in 2011-2012.
The use increased as people became older. For example, for those aged 40-64 years, the use of one or more prescription medications increased from 57% in 1999-2000 to 65% in 2011-2012, whereas the use increased from 84% to 90%, respectively, in those older than 65 years.
Polypharmacy (use of five or more prescription drugs) increased from 10% to 15% among those 40-64 years old and from 24% to 39% for those over 65 years.
There was increased use of antihypertensives (from 20% to 27%); antihyperlipidemics (6.9% to 17%), primarily driven by statins; and antidepressants (from 6.8% to 13%), especially selective serotonin-norepinephrine reuptake inhibitors and selective serotonin reuptake inhibitors.
Narcotic analgesic use increased from 3.8% in 1999-2000 to 5.7% in 2011-2012.
Among those interviewed, 4.6% took antidiabetic agents in 1999-2000, which increased to 8.2% in 2011-2012, mainly due to greater use of biguanides, insulin, and sulfonylureas.
Prescription proton-pump inhibitors increased from 3.9% to 7.8% and anticonvulsants from 2.3% to 5.5%.
The 10 most commonly used individual drugs in 2011-2012 were simvastatin, lisinopril, levothyroxine, metoprolol, metformin, hydrochlorothiazide, omeprazole, amlodipine, atorvastatin, and albuterol.
All of the reported increases from 1999 to 2012 were not explained by changes in the age distribution of the population.
Lana: A life dramatic enough for a movie
- Created on Sunday, 18 October 2015 20:18
After reading her autobiography, I have to wonder why they never made a movie about the life of the 1940s legendary screen goddess Lana Turner.
She was born way up in the remote Idaho panhandle in 1921 as Julia Turner, and her circumstances could not have been more disadvantaged. That was mining country, and her father was a miner. but, they always struggled financially. It seems her parents only married because of her conception, and they had no other children. They separated when she was 9, and she and her mother moved to San Francisco. But, it was such a struggle for her mother, that she had to place Lana in foster care briefly, which Lana hated. Her father, who remained in Idaho, died in a knife fight over a card game. She was just 11 at the time, but, she had only good memories of her father.
After that, her mother and she moved to Los Angeles- in fact, Hollywood- where her mother sought work as a beautician. More devoted to her, her mother could not have been, and that was true for life. Her mother never remarried, and she lived for Lana.
When she was 16, Lana was discovered in a Hollywood ice cream parlor drinking a Coke. Taken with her beauty, the man who discovered her was the publisher of a Hollywood magazine, and he referred her to Zeppo Marx- one of the Marx brothers who, by then, had become a Hollywood talent agent. Reportedly, she, herself, chose the name “Lana.” That year (1937) she was cast in her first film as a sexy tight “sweater girl” who wound up a murder victim. Then, she signed a contract with MGM for $100 a week, which was a lot of money in those days. And from then on, her mother’s career became that of mother of Lana Turner. In other words, from then on, she lived off Lana, but believe me, she earned it.
From the very beginning, Lana Turner became synonymous with sex, even though she was only 16. She defined “sultry.” She soon starred in a Mickey Rooney movie in which she played the bad girl offsetting Judy Garland’s good girl, and there is a famous photo of the three of them together doing schoolwork on the set, as required by law, which enabled Lana to finish high school.
And speaking of sex, there were two revelations that Lana made at the start of her autobiography. The first was that she was terribly shy, and her greatest fear was public speaking. Like many stars, she contributed to the war effort during WW2, and in her case, it meant visiting the troops, including on some of the Bob Hope tours, but also on tours to sell war bonds, where she was expected to get up and speak as Lana Turner. Well, she could do it easily enough as somebody else, a character, but not as Lana Turner. But, the second revelation was that she never really enjoyed sex that much, that in real life, she wasn’t sultry and sexy like her characters. She said she enjoyed romance and tenderness and courtship, but sex itself was no big thrill for her. And her most enduring quote is: “A gentleman is just a patient wolf.”
But, if I had to characterize her 1982 autobiography, written 12 years before her death, I would say it oscillated between her movie career, film by film, and her marriage career, husband by husband. And, there were 7 in total.
But, oddly enough, the man whom she declared to be the “love of her life” was one she never married but almost did, the actor Tyrone Power. Today, he is remembered for being bisexual, although she claimed to never see any inkling of that side of him.
Her first marriage at the age of 19 was to band-leader Artie Shaw, but that was undertaken so compulsively (after one date) that it was doomed from the start. Her second marriage was to businessman Stephen Crane, and it was with him that she had her one and only child, Cheryl Crane. Husband number three was a millionaire socialite whom she wasn’t even attracted to, and it wouldn’t be a stretch to say that she married him for his money. Next came an actor who played Tarzan in the movies several times, Lex Barker. Daughter Cheryl would later write in her memoir that Barker sexually abused her during their marriage, but, that wasn’t mentioned in Lana’s autobiography.
That marriage was followed by Lana’s harrowing relationship with mobster Johnny Stompanado. He was a real-life monster who beat her and abused her, and she literally feared for her life. She went to England to make a movie with Sean Connery, and Stompanado followed her there and stormed on the set, where Sean Connery had to physically subdue him. Then, they got Scotland Yard to deport him back to the US. And when Lana returned, it was Oscar time, which she attended with her mother and her daughter. Lana had been nominated for her role in Peyton Place, although she stood no chance of winning. (I should mention that Lana’s mother is the one who really raised Cheryl. Lana set them up in a house with another older woman who was like a second grandmother to Cheryl. Lana paid for everything, but she was more like a doting aunt than a mother.) But, that night, after the Oscars, Johnny stormed into her house, enraged that she didn’t take him to the Oscars. That resulted in a severe beating, and while she was being beaten, Lana kept worrying that 14 year old Cheryl, who was staying over that night, would be awakened in the next room. Well, Cheryl was awakened, and she did come into the room, but not before going into the kitchen and getting a carving knife. When she entered, she saw her mother bloody, battered, and bruised, and she saw Stompando approaching her mother with a wooden clothes hanger in his raised hand. It looked to Cheryl like he was about to hit her mother again. So, she shoved the knife into his belly. The blade really didn’t go in that far, but as luck would have it, it hit the abdominal aorta, and he bled out very fast. (Was that good luck or bad? I’d say good.)
The first thing Lana did was call a doctor friend. He came over and tried to resuscitate Stompanado, unsuccessfully. Next, she called her lawyer, who came right over. And that’s when they called the police.
The legal system never came down very hard on Cheryl. She did have to remain in custody for several weeks until the grand jury hearing. But even by then, Lana still had bruises left from the beating Stompanado had given her, which she displayed to the jury. And mercifully, they declared it a “justifiable homicide.” However, the judge, rather wisely in my opinion, didn’t let Lana off so easy. He pointed out that she’s the one who put Cheryl in that deplorable situation. So, he removed Lana’s parental rights and made Cheryl a ward of the state. But, he also made Lana’s mother Cheryl’s court-appointed guardian. So, nothing really changed in regard to the living situation. But, it involved regular probation visits for Cheryl, and court-ordered psychiatric visits for both Cheryl and Lana, which they did. Lana was so grateful that Cheryl got off without prison that she didn’t care about the rest. She gladly cooperated.
Lana’s next husband was a rather nice guy, compared to the others: the actor Fred May. And she was a little vague as to why they divorced, although she did say that him dipping into her money had something to do with it. But, they remained lifelong friends, and she always spoke well of him. But, the last two marriages which followed were awful; expensive and awful; including one to a much younger man who was serially unfaithful, a pathological liar, and an out-of-control spendthrift with her money, and the last one to a nightclub hypnotist who stole from her- cash, jewelry, whatever he could get his hands on. And that did it. After that, Lana finally stopped getting married. Thank God.
I won’t go into her movies too much because I want to focus on her health. But, I will point out that one of her early roles was Ziegfeld Girl in which she played a Broadway star who rises fast but then falls hard to alcoholism. But, in the movie, there was a song written for her by Nacio Herb Brown, You Stepped out of a Dream, which became Lana Turner’s theme song for the rest of her life. Whenever she entered a club or walked on stage, they played that song, and it is a fabulous song. Her most celebrated movie is The Postman Always Rings Twice, also considered her most sultry role. In Peyton Place, she played the single mother of a lone daughter- which mirrored her real life. Although she was nominated for Best Actress, it was really more of a supporting role than a leading role. The Bad and the Beautiful with Kirk Douglass was and is very highly acclaimed, but I’ve never seen it. And Imitation of Life was about a white woman who climbs to the top as an actress while raising her only daughter, while also living with a black woman who also had an only daughter. So, the relationship among the four of them is the story of the movie. And it was a very important project for Lana Turner because it was the first movie she made after the Stompanado killing, when it was uncertain whether her movie career would survive at all.
But now, let’s talk about her health because there are some interesting observations I can make.
First I want to point out how interrelated health and beauty are, how dependent beauty is on good health. Sparkling eyes, peaches and cream complexion, lustrous hair, svelte tone, etc. are the products of good health. And since her beauty was her stock in trade, you would think that health would have been a top priority for her, but it wasn’t. Lana Turner was a smoker; a heavy smoker, and she started young. In fact, she got in trouble for smoking on the sets as a teenager, and she complained bitterly about it because she wanted to smoke, and she felt she had as much right as anybody. There are quite a few photos of Lana Turner holding a cigarette, but, I learned that there would have been quite a few more if they hadn’t airbrushed them out.
She also drank. In the book, she played down her drinking, saying that she was more of a “sipper” than a “drinker”. But, others said otherwise. Most of her husbands were big drinkers, and she drank with them. Often, her husbands would get mad if she didn’t drink as much as they did. But, the fact is that women cannot handle alcohol as well as men. The female liver does not process alcohol as fast- doesn’t convert ethyl alcohol into acetaldehyde as rapidly. The result is - that for a given amount of alcohol- women experience a higher blood level of alcohol than do men, and it persists for a longer period of time. It is true across the races; women of all races cannot handle alcohol as well as men. And in the book, she admitted that she often self-medicated with alcohol. For instance, during the time that she was tormented by Johnny Stompanado, she drank heavily. And others who knew her said that she was, in fact, a big drinker and at times an alcoholic.
The only other drug she mentioned in the book as one she took was marijuana, but that was mainly during her brief marriage to Artie Shaw because he was a big pot smoker. But, like many people, she often took sleeping pills.
Regarding her diet, it wasn’t very good. Just the standard American diet, with an emphasis on meat. In the book, she mentioned steaks, chops, burgers. Fried chicken was mentioned as a favorite. Otherwise, it was the usual things; they had a barbecue; they had a birthday cake; they ate doughnuts on the set, etc. etc. Not a single fruit or vegetable was mentioned as being a favorite of hers.
Lana Turner developed appendicitis at the age of 17 and underwent surgery. But, that surgery was botched, and she had to undergo a second surgery for it at the age of 18 to fix it. Realize that people don’t develop appendicitis for no reason. It isn’t normal. It really shouldn’t happen to anybody. There has to be a morbid and abnormal condition in the digestive tract for appendicitis to happen, and it’s due, of course, to faulty diet: specifically: not enough fruits and vegetables; not enough fiber; and too much meat.
Lana Turner was lucky in that she had a nice figure, a nice shape, with dazzling proportions (36-23-36, reportedly) despite conventional eating habits. But, she was physically active; she enjoyed tennis and swimming; and it’s fair to say that she was naturally athletic.
But, she kept having miscarriages, so what does that tell you? She had at least 3, and she may have had more. That is, she may have had some miscarriages without knowing it- before she realized she was pregnant. So, all was not well inside her. It’s a bad sign if a young woman can’t carry a baby to term. She also had two abortions. The first was with first her husband Artie Shaw, but she didn’t realize she was pregnant until after they split up. It was a back alley thing because abortion was illegal then, and she almost died. The second abortion resulted from her relationship with Tyrone Power, but at least that one went well without complications.
I had read previously that Lana Turner really didn’t age well in the face, that the luster faded from her rose early, meaning in her 30s, and that what kept her going was one thing: makeup. And, she kind-of alluded to it in the book. She said that she brought her own makeup person on the sets to work with the studio’s. But, she said that there were instances in which, because of stress, lack of sleep, too much drinking, etc., they just couldn’t capture her look. They would try different angles, different lighting, but in the end, they just had to shut down production for the day because Lana Turner was nowhere to be found.
And it was the same way in her private life. She said that during her marriage to Fred May, what irked him about her is how long it took her to get ready to go somewhere. And he got sarcastic about it. He would tell her: “Now look: we’re going out with friends tonight at 6 PM, and I want you to be ready. It’s 10 AM, so you should get started: hair, nails, make-up, clothes; whatever. Just be ready by 6.” Invariably, she wasn’t.
But, it was the 1980s that her health really started falling apart. She was in her 60s and still acting some- not in movies, but on television and in live theater, when she started losing weight and getting very weak. Her weight plummeted to 95 pounds. I don’t know that she was diagnosed at that time, but for the first time, she stopped what she was doing and started focusing on her health. She spent much time at a health retreat in Hawaii where her daughter Cheryl was living. And she claimed to undergo a spiritual awakening that involved her renewing her faith as a Roman Catholic. She recovered well enough to return to the public eye, but mainly at charity functions and award presentations. Then, in 1992, at the age of 71, she was diagnosed with throat cancer- which was surely the result of a lifetime of smoking and drinking. She quit doing both, but it was too late. And, the last three years of her life were miserable, preoccupied with debilitating radiation treatments and chemotherapy. She really clung to life- she wanted to live- but it was to no avail. Her weight sank to 85 pounds, and she died, skin and bones, on June 29, 1995 at the age of 74.
Lana Turner hasn’t enjoyed the spectacular posthumous career that Marilyn Monroe has. But, I think Lana was lucky to make it to 74 considering how she lived and all the stress she had. It’s a shame that she was so unlucky in love. Her memoir does not speak well for the male gender, and I’ll point out (since it’s public knowledge) that her daughter Cheryl became a lesbian. Hmm. I wonder if it was because of what she saw and heard and experienced at the hands of the men in her mother’s life. I just have to hope that Lana Turner has found more peace in the next life than she found in this one.
Alcohol: Ups mortality risk; ups cancer risk; no net benefits
- Created on Saturday, 26 September 2015 04:24
That’s the title of a new research report that was recently published on Medscape. Just think: after all those years, all those decades, of saying that alcohol was good for you, that it protected your heart, prevented heart disease, and helped you live longer, it turned out that it was all lies.
It turns out that Dr. Herbert Shelton was right when he called alcohol a “protoplasmic poison” meaning that it’s poisonous to all forms of life.
How can alcohol be used as an antiseptic? Because it kills bacteria.
So, how did they get it wrong for all that time? It’s because they started with the objective of looking for benefits from alcohol. They were severely biased.
And who do you think paid for those pro-alcohol studies? If you think it was the alcohol industry, you are partly right. But, they’re not the biggest one. The biggest one was: the US government.
Why would the US government want to promote the health benefits of alcohol?
It’s because the US government has got this War on Drugs going on- in earnest for the last 60 years- and they have to have a way to justify it.
After all, if one guy gets home from work and likes to relax by drinking a glass of wine, that’s OK; it’s legal. But, if another guy prefers to smoke a marijuana cigarette, that’s not OK. That’s a crime for which he could be made to forfeit his whole life.
Keep in mind that I’m not interested in doing either one. I don’t want the wine, and I don’t want the marijuana. But, I’m sane enough to recognize the utter insanity of saying that one is criminal and the other is not.
So, to justify their persecution of Americans for doing what they want to do, which is to indulge in recreational drugs (a popular pastime) they had to create this false dichotomy that: drugs bad/alcohol good. How else could they justify throwing potheads in prison?
How did they do it with the research? One of the tricks they resorted to was to classify former drinkers, including those who drank so much it led to complete ruin of their health, as non-drinkers. That helped produce the numbers they were trying to generate.
I don’t drink alcohol at all, and I advise you to avoid it completely. If you can’t avoid it completely, then avoid it as much as you possibly can. Don’t nurse the popular delusion that a moderate amount of alcohol is good for you. Nobody is getting away with that on my watch. Here’s the report:
Black-eyed peas - for survival
- Created on Tuesday, 22 September 2015 03:09
Do you live someplace that gets good and hot in the summer? It doesn’t have to be a particularly long summer; a couple months of hot weather will suffice. And do you have a small plot of land? It doesn’t have to be particularly rich land, in fact, less rich is better for what I have in mind- so long as it has good sun exposure.
What I have in mind is growing black-eyed peas because black-eyed peas are n incredible garden vegetable.
That’s right, I mean a vegetable. I’m not talking about drying them into a dried bean- although you’ll want to do that with a few to generate seeds for the next year. But, believe me, it happens automatically because you’ll miss more than a few, which you’ll fail to harvest.
I mean eating them like a green bean, where you eat it pod and all. Yes, you can do that with black-eyed peas. In fact, even the leaves are edible. You can cook them like spinach or put them in a salad like spinach. Either way, they’re edible. But, I’m mainly interested in eating that green black-eyed pea, pod and all.
They are very tasty and very nutritious. What I do is just steam them for about 20 minutes, and then I dress them with extra virgin olive oil and little bit of sea salt. That’s it. And they are good eating.
They are loaded with protein, minerals, vitamins- even some alpha linolenic acid- the plant-based EFA. Of course, they are also high in fiber. There is very little that your body needs that can’t be found in a green black-eyed pea.
The beauty is that they are very easy to grow. I’ve been doing it every summer for over 20 years, and I haven’t had a crop failure yet. They love the heat, and once established, they don’t need a lot of water. If they have any plant diseases, they haven’t happened to my guys. And I haven’t had any insect problems either. I have grown them organically the whole time.
In fact, it’s important NOT to fertilize them too much- even with organic fertilizer. That’s because fertilizer stimulates them to grow foliage at the expense of fruit, the fruit being the black-eyed pea. Really, it’s a fruit because it develops from a very pretty white blossom. And they bear more heavily when the soil isn’t too rich.
And the other great thing is that, like all legumes, they increase the fertility of the soil because they set nitrogen.
For me, it’s a summertime ritual, and I wound up with a lot of seed this year, more than I intended. If you lived close, I’d give you some.
But, think about growing black-eyed peas next summer. They’re also called cowpeas. Because you never know: having some home-grown food may turn out to be crucial someday. The nutritional density of black-eyed peas and the ease of growing them make them an excellent choice for your home garden- whether or not you think of it as a survival garden.
- Created on Friday, 21 August 2015 17:38
That is the title of a biography I have just read of Vivien Leigh by Alexander Walker. Even young people know her as the actress who played Scarlet O’Hara in Gone with the Wind, arguably the most celebrated and iconic female role in movie history. But, the highs and lows of her own life, including her health problems, were as dramatic as any role she played.
In 1913, she was born Vivian Hartley of British nationals who lived in India. But ethnically, she was mostly Irish and French, and, it is rumored that she had a little Indian blood in her from her mother’s side which contributed to her exquisite beauty. Her parents were well-off, and she was an only child, and her early years were very pleasant and comfortable. But, her mother was a very devout Roman Catholic, and she wanted Vivian to attend a convent school. So, when she was of school age, they returned to England so that Vivian could attend the Convent of the Sacred Heart in London. Let’s just say that her easy, breezy, lazy days of summer were over.
But, Vivian was bright. She was a good student. She became fluent in French and Italian. And she became very proficient in literature, including Shakespeare. (Most Americans don’t realize that Vivien Leigh was also a great Shakespearean actress.) She later attended other posh boarding schools on the European continent. But, from the beginning, all she ever wanted to do was become an actress.
So in 1931, at the age of 18, she persauded her parents to let her attend the Royal Academy of Dramatic Arts in London. But, a year later, she met a lawyer who was 13 years her senior, Leigh Holman, and she fell in love. They married, and she immediately got pregnant with their daughter Suzanne, and Vivian temporarily abandoned her dreams of becoming an actress. But, after Suzanne was born, there were servants and nannies galore to do the infant care, and Vivian resumed her quest for stardom with even greater intensity than before.
She found an agent who right away decided that her last name had to go. The name they settled on, Leigh, was of course, derived from her husband’s first name, although actually it was his middle name. And the change in spelling of her first name from Vivian to Vivien was done by one of her first stage directors, and it stuck.
So, she started getting parts, at first bit parts, in both British plays and movies, and she was noticed favorably by the already famous Laurence Olivier. He sought her to star with him in the film Fire Over England in 1937, and there was no stopping the romance between them even though they were both married. But, from the beginning, Olivier noticed that she had sudden, severe mood swings, although they did not disrupt her performances.
But, they became inseparable, and though it took time, they did eventually obtain divorces from their spouses so that they could marry, which happened in 1940. Each had a young child; Oliver’s was a son. And even though neither had custody of their child, they did have them enough of the time for Suzanne Holman and Tarquin Olivier to bond as siblings. Vivien reportedly had two miscarriages during her marriage to Olivier.
But, in 1945, during her marriage to Olivier, Vivien contracted her first case of pulmonary tuberculosis, which laid her up in bed for months. The very fact of that tells you that her health wasn’t good.
Regarding her habits, she both smoked and drank, but they all did in those days, and especially actors and musicians. At times, she smoked heavily, such as during the making of Gone with the Wind. I think it’s amazing that a woman whose acting career got launched solely because of her great beauty should smoke, but in those days, few realized how harmful and destructive smoking is.
But, she recovered from that bout of tuberculosis and went promptly back to the lifestyle that provoked it: smoking, drinking, late nights, and woefully inadequate rest.
Regarding her food, she ate a regular British diet, with its emphasis on animal protein and cream and butter, but not nearly enough fresh produce. Also, sweets were mentioned as a favorite of hers. She was always slim and petite, but realize that sometimes ill-health can keep a person slim.
Her manic episodes included severe hypersexuality, which manifested, at first, as increasing demands on her husband (for sex). But, by that time, Laurence Olivier was a man in his 40s who was working very hard, and although he tried to oblige her as best and as often as he could, it just wasn’t enough. As you know, a woman can always oblige a man with sex even if she is not in a responsive state, but a man’s lack of responsiveness is not something that he can hide or circumvent. And that led to her seeking sexual satisfaction outside the marriage.
The young actor Peter Finch became her long-term lover, with Olivier’s awareness. It was during the making of the movie Elephant Walk filmed in Sri Lanka and Los Angeles that Vivien was deeply involved with Finch (her co-star) when she had a complete nervous breakdown. It was in L.A. that Vivien was dragged away by the men in white coats, and Elizabeth Taylor was brought in to reshoot the movie, although they left in some distant scenes which included Vivien.
In those days, the main and only treatment for manic depression was electro-convulsive therapy: shock treatments. It is still used today but not nearly as much as before and usually only when drugs aren’t working. Vivien Leigh had a great many shock treatments. Over the years, it may have been over 100. And everyone, including Vivien, tried to recognize, in advance, when an attack was coming on so that she could go in for a treatment. The symptoms included the hypersexuality, which led her to have incredibly brazen and sudden flings, such as going to bed with a taxi driver, an elevator attendant, or just someone she met in the street. Another symptom was shopping addiction. Another was the loss of discretion in how she spoke to people. She was always rather blunt and unrestrained in her language- inclined to say shockingly candid things. But, it got much worse during her episodes. Many claimed that playing the role of the disturbed Blanche DuBois in Streetcar Named Desire worsened her own mental illness.
Her marriage to Olivier, which had deteriorated badly, finally ended, and it was his doing. He had fallen for another actress, Joan Plowright, whom he wanted to marry. But regardless of Joan, he had taken all that he could bear from Vivien. Their marriage ended in 1960, although for all practical purposes it was over before that. But, at the end, Vivien tried very hard to talk him out of it. Despite all her betrayals, which were induced by her mental illness, she felt a deep and close bond to him, which endured to the end. She never spoke badly of him. And, the same was true of her first husband, Leigh Holman, whom she stayed close to and spent time with even after their divorce.
But, Vivien’s best relationship may have been with her last lover, actor Jack Merivale. For many years, he was a friend- to her and Olivier. And when their romance blossomed, Jack felt obliged to inform his friend Laurence Olivier, who gave his blessing. Why shouldn’t he have when he was happily married? It’s interesting that Joan Plowright had nowhere near the beauty of Vivien Leigh. In fact, Joan wasn’t beautiful at all, in my opinion. But, Olivier was looking for something else.
Jack Merivale proved to be great for Vivien because he was keenly aware of her mental problems and always on the lookout for trouble and ready to steer her into treatment at the first sign of crisis. Apparently, the shock treatments did provide some relief. But, they both had busy careers, often on different continents, so they were separated a lot. But, when they were apart, she wrote to him frequently (daily) and some of her letters to him were published in the book. She was always intensely romantic in how she wrote to him, and it was very beautiful and also very youthful, considering that she was a grandmother of three at the time. She certainly had a fire for romance.
One of the last things she did in her life was visit India, the country of her birth. Not Jack Merivale, but other friends traveled with her. And then she almost made a trip to Russia because she was very popular in Russia, although not for Gone with the Wind which was forbidden in the Soviet Union for being too bourgeois.
But, after the India trip, she started coughing up blood, and it was soon discovered that her tuberculosis had recurred again, and virulently. She was ordered to bed and to stop smoking, neither of which she did completely. Jack was with her, although he was working at the time. She died alone. It’s believed that her lungs filled up with fluid and she suffocated. Jack had checked on her early in the evening, and she was doing OK. But then he had to go perform and when he checked on her a few hours later, she was sprawled on the floor, face down, dead. He tried giving her mouth-to-mouth but to no avail. He called her doctor. And then he called Olivier. Ironically, Olivier was in the hospital at the time for prostate cancer, but he checked himself out and took a taxi to her house. Jack let him be with Vivien alone in her room for a while. Olivier wrote in his memoir: “I stood and prayed for forgiveness for all the evils that had sprung up between us.” Vivien Leigh was 53 when she died in 1967.
It was very interesting to read about how she got the role of Scarlett O’Hara in Gone with the Wind. It was the most coveted female role in the world at the time. Vivien traveled from London to Los Angeles to audition for it. David Selznick refused to pay her way because she was practically unknown outside of England at the time. But, when he saw her and interacted with her, he soon realized that she came closest to Margaret Mitchell’s description of Scarlett in the book, down to the luscious green eyes. And, she also had the same dominant, willful, assertive personality of Scarlett O’Hara. And that’s what did it.
Could life have been different for Vivien Leigh in terms of her longevity? Of course. I have to think so. With better nutrition, better habits, and better self-care, she could have lived a lot longer. But, I am saying that in reference to her TB. I can’t make any claims regarding her manic depression, which may have been her destiny regardless. And, it may have been her mania that drove her to pursue her acting career the way she did, so who knows: without it, she may have had a very different life. It may have been a necessary part of her genius. Would she have been happier without it? Very possibly. I happen to think that when it comes down to extreme highs and extreme lows, as she had, that the lows hurt a lot more than the highs fulfill. So, I wouldn’t wish that kind of life on anyone. But, when I try to imagine watching Gone with the Wind with anyone else but Vivien Leigh playing Scarlett O’Hara, it is a very depressing thought indeed.