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1
Socratic Method / Re: Legal Reasoning
« on: January 22, 2009, 12:41:03 PM »

The explicit rejection of the dominant consumer culture, in addition to the waste and war associated with it, and the celebration of eroticism and "outlawed" forms of enjoyment. But how is it possible to imagine that the working class -- exploited, brutalized, largely-uneducated, and kept in severe deprivation by the capitalist system -- can take on such a mission?

The theory of reification, which is built upon Marx's notion of "the fetishism of commodities" argues that the capitalist labor process has a profound impact on the way in which workers experience the world around them. These changes transform the individual worker into a cog in the machine, an insignificant bit-player, spending the working day either on the mechanized assembly line of the factory, or in the immense office system of a business or government bureaucracy. From the standpoint of the individual, these twin, highly-rationalized systems of production appear to have a life of their own, that is, they appear to exist as powerful agents capable of determining the fate of the living, breathing person. The vast factory system and the corporate and bureaucratic structures are inanimate things that appear to be alive and that transform human beings into things obedient to their laws. At the same time when the theory of reification was worked out within the Marxist theory, Franz Kafka, in his novels of the 1920s, "The Trial" and "The Castle," gave the most telling and poignant representation ever conceived of a world of fully reified social relations. Lukacz argued that the reification of the worker was necessarily incomplete because the human life process could never be fully incorporated into the abstract forms of the business and bureaucratic systems. There would be always a residue appearing in misery, hunger, and the sense of injustice capable of inspiring revolutionary aspirations under the right conditions.

As a seller of labor power the worker was the embodiment of the capitalist category of the commodity, the "self-consciousness of the commodity." But this self-consciousness was fraught with contradiction. The quantitative differences in exploitation which appear to the capitalist in the form of quantitative determinants of the objects of his calculation, must appear to the worker as the decisive, qualitative categories of his whole physical, mental and moral existence. Simply put, for the capitalist lowering the cost of labor is a matter of business, while for the worker, to be "worth" just so and so much an hour, is to be "hungry." An experential revolt against the confining forms of a mechanical civilization. What makes this possible is the immense contrast between the possibilities for a better life sustained by modern technology and the perpetuation of competition, poverty, and war by a class system that cannot realize that potential without itself going under. The tension between the two dimensions has been recorded in art for millennia, but now it is no longer a question of abstract possibilities and idle hopes for a distant future.


Marcuse wrote that Heidegger's work seemed to indicate a turning point in the history of philosophy: the point where bourgeois philosophy transcends itself from within and opens the way to a new 'concrete' science. Marcuse applied the "concrete science" to understanding the passivity of the working class in the revolutionary situation at the end of the war. What is more, the idea of authenticity suggested a way of completing Marxism with a new theory of revolutionary consciousness. Traditional Marxism had failed because it relied on the motivating force of economic self-interest when in fact revolutions are not made for simple economic reasons. Marcuse now had a far more powerful instrument for analyzing the "radical act" in which individuals "exist" through transforming their world. Marcuse's fundamental objection concerned Heidegger's basic concept of the world. Heidegger had attempted to uncover ultimate structures of the world as such, leaving the particulars of specific worlds to the side as sociological details. When in the later parts of "Being and Time" Heidegger did refer to these communities of meaning, carriers of tradition. Marcuse argued that in so doing, Heidegger obscured the divisions within communities. Indeed, from a Marxist standpoint, class divisions are ultimately more significant than nationality since modern capitalism destroys tradition and replaces it with a society based on self-interest. Authenticity in this situation becomes a matter of seizing the historical moment along with one's class in the affirmation of human possibilities against the deadening routines of the existing society.

For Hegel and Marx the future is a collective project that emerges from social tensions that themselves reflect different projects borne by different social groups. The progressive projects realize potentials in the present that reflect developing human capacities. This notion of potential became the basis for Marcuse's later theory of "two dimensions" of society, the dimension of everyday facts and the dimension of transcending possibilities that lead on to higher stages of historical and human development. With this reinterpretation of Hegel, Marcuse prepared his new concept of revolution adequate to the crisis of twentieth-century German society. Astonishingly, this interpretation of Hegel came close to anticipating aspects of Marx's own early unpublished writings. In 1932 a previously unknown text emerged from the archives. These "Economic and Philosophical Manuscripts" revolutionized the image of Marx. Capitalism alienated workers from their essential nature as creatures capable of building a world through labor that "objectifies" their needs and powers. But this world does not belong to them. Instead it is appropriated by the capitalist and turned against its creators, perverting their whole existence into a debased struggle for survival. Marx attacks the destruction of the "human essence" in an economic system that reduces the worker to nothing but the abstract capacity for "labor-power" -- abstract because in the early factory system labor was stripped of all particular qualities of skill and creativity and was measured solely in quantitative units of time. In a number of passages Marx makes surprising claims that distinguish his concept of nature from that of the natural sciences and bring it closer to the phenomenological concept of experience. Marcuse did not have to stretch the point in treating Marx's affirmation of the unity of human being and nature as an intentional correlation of subject and object, a kind of being-in-the-world. What is more, like Husserl and Heidegger, Marx grants this experential unity a supreme ontological significance. But unlike these phenomenologists, Marx's version of being-in-the-world has a radical historical character. He argues that the objectification of human faculties through labor under socialism creates a humanized nature in which we can finally be at home. 

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General Board / Re: Doctors exploited; patients suffer, too
« on: January 22, 2009, 12:37:51 PM »

No doubt about it, besame. Even moreso if we'd be talking about foreign doctors looking to practice in the US. A government program to address a national health care crisis by placing foreign doctors in America's rural towns and inner cities is being undermined by employers - mostly U.S. doctors who profit by exploiting the physicians and diverting them from the patients who need them. Stories of abuses within the program, which receives little government oversight, are whispered among foreign doctors in hospital corridors, reported online and heard by colleagues in foreign medical schools. And the abuse appears to be a primary reason that fewer of them are participating in the program. Some of the foreign doctors are cheated financially and worked to dangerous levels of exhaustion, and they can't easily escape the jobs because the employers sponsor their visas. The doctors are sharing their experiences with colleagues back home - in places such as Ghana, Haiti, India and Pakistan - who are now finding other paths to U.S. residency to avoid being bullied and treated as indentured servants.

The dire consequences of the program's problems may be no clearer than in the Nevada town of Beatty, population 1,154, "the gateway to Death Valley." The community is about to lose its only doctor, who is from the Philippines. She has fulfilled her commitment under the government program, and the non-profit organization that runs the clinic, Nevada Health Centers, has had no luck finding a replacement. Nevada Health Centers by all accounts treats the doctors fairly and as intended under the law. Several years ago, it was receiving about 100 applications a month from foreign physicians for openings at its 27 clinics. But now it gets no applications and recruiting efforts have been fruitless. The government program, adopted by Congress, is known both as the J-1 visa waiver program and the Conrad 30 program, for its author, Sen. Kent Conrad, D-N.D. It makes immigration concessions for foreign medical school graduates who are nearing the end of their medical residency training in the United States. The foreign doctors hold J-1 visas, which require them to return home when they finish their residency. If they return home, they must stay there for at least 2 years, and if they want to return to the United States, they must start the immigration process all over again.

Rather than go home after their medical training, foreign physicians can qualify for J-1 waivers to stay in the United States as long as they commit to at least 3 years of service in a federally designated physician shortage area - usually a rural or blighted urban area. And at the end of the term, these J-1 doctors can begin the U.S. residency process. About 3,100 foreign doctors participate in the program, a number that is declining year by year. Nationally, doctors who come from foreign medical schools say they are forgoing the J-1 visa for what they consider a more attractive option, called the H-1 visa. The H-1 visa takes more steps to acquire and limits where a doctor can do residency training, but it leads more quickly to a "green card." The downside for rural and inner city America is that the H-1 visa, unlike the J-1 visa, does not require foreign doctors to return home for 2 years after they finish their training. That eliminates any motive for foreign doctors to commit to 3 years of service in a medically underserved area. Nationwide, the numbers of J-1 visas and requests for waivers to work in underserved areas are plummeting, according to the statistics available.

J-1 doctors say that because of the buzz around the program in the international physician community, some medical residents are waiting longer for H-1 visas or, if they can get only a J-1 visa, are returning home for 2 years instead of taking a waiver to work in an underserved area. Dr. Wahab Brobbey, a J-1 doctor in Iowa who told the Sun he was exploited by his previous employer in Tennessee, said he advised his cousin and other medical school classmates to avoid the J-1 visa. The cousin is now doing his residency on an H-1 visa. "And they tell their brothers, and they tell their friends - there are lots of us," said Brobbey, who is from Ghana. Brobbey said the exploitation has gone on for so long, with no accountability for employers, that the J-1 visa waiver program is "basically dead." "The boat has sailed already," Brobbey said. "I don't know anyone who will do J-1 now." Given the Internet chatter, the problems with the J-1 waiver are widely known in the medical community, and the jobs carry a stigma. Some of the participating doctors refer to themselves as "J-1 positive" as if they're afflicted with a disease. It is unknown whether J-1 doctors have been sexually abused, though one doctor reported she had been sexually harassed. Many factors could explain why more foreign residents are pushing for H-1 visas over J-1 visas said Greg Siskind, a superstar immigration lawyer, but it's possible some foreign doctors who know about the "real and perceived problems" are deciding to "vote with their visa" by choosing the H-1.

In 2005, the American Medical Association adopted a resolution saying the foreign doctors often find themselves "in abusive and intolerable" employment situations and should be able to transfer to other employers without being forced to restart their three-year commitment in an underserved community. An AMA official said anecdotal accounts are heard frequently of J-1 doctors working unfair call schedules, suffering pay and salary disparities and having the terms of their contracts switched against their will. The J-1 doctors are in a "vulnerable position," said the AMA official, who because of association policy was not allowed to be quoted by name. "They know it's a privilege to be in our country. They don't want to make any waves, but they're totally being abused and taken advantage of." Employers who adhere to the J-1 waiver guidelines say they've heard the reports of other bosses flouting the J-1 laws. Saul Blair, executive director of the Phoenix region of IPC, a company that provides doctors to hospitals, employs 17 J-1 doctors, including several who came to him after being exploited by employers in other states. No one monitors where the doctors work or whether "I'm paying them 10 cents or $100,000," Blair said. It would be easy to audit a company's medical records to confirm that J-1 doctors are treating federally designated underserved patients, Blair said, but the government has not. J-1 doctors feel conflicted about staying in the United States. "If I had known about this I would have never done it here," one foreign doctor said. "I advise everyone I know not to come here on J-1. Go to Australia."


I am a foreign doctor (originally from Iraq) who was laid off several years back by my employer who sponsored my J-1 visa (I won the lottery fortunately that is how I got the residency) I remember it very well how hard it was to find employment - any type of employment - I guess it was because of my language skills that I got a job to survive during those hard years (I was employed by a contractor in need of translation services from Dari to English - Dari is the name given to classical Persian poetry and court language, as well as to Persian dialects spoken in Afghanistan. Various dialects of Dari are also spoken by a few people in Iran and by many in Pakistan.


J-1 doctors refer to themselves sarcastically as J-1 positive -- that's how horrible is to be on such a visa.

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DEPRESSION (di-pres/en) -- a lowering of vital energy (Webster's Dictionary)

Depression is a broad term used to refer to a range of different diseases recognized by the medical field. We also use the term to refer to temporary and minor negative feelings (i.e. I'm depressed because the Pacers lost last night or the post-holiday blues.) Depressive illnesses include major depression, the bipolar disorders, dysthymia, cyclothymia, and variations of these based on timing of the onset (i.e. seasonal or post partum), duration of symptoms, or severity of symptoms. These illnesses impact over 19 million adults in America each year. Depression is frequently seen as a complicating factor in heart attack, stroke, diabetes and cancer patients. In fact, depression increases one's risk of having a heart attack. Almost anyone who kills him or herself suffers from a mental disorder, most often a form of depression or substance abuse or both.

The key factor in diagnosing most of these illnesses is the presence of a major depressive episode. To be diagnosed with a major depressive episode your symptoms must last at least 2 weeks. The symptoms must also appear to be a change from previous functioning. There are people who resemble Winnie the Pooh's Eyre their whole life but are not depressed. The symptoms of a major depressive disorder include:

  • Depressed mood.
  • Diminished interest or pleasure in most activities.
  • Significant weight loss or gain without effort or loss of appetite.
  • Difficulty sleeping or sleeping too much.
  • Psychomotor agitation or retardation.
  • Fatigue.
  • Feelings of worthlessness or excessive or inappropriate guilt.
  • Diminished ability to think or concentrate, or indecisiveness.
  • Recurrent thoughts of death, suicidal ideation, or a suicide attempt or plan.

Thankfully, most people do not experience all of the symptoms. To be diagnosed with a major depressive episode one must experience at least 5 of the above symptoms and 1 of the 5 must be either depressed mood or diminished interest or pleasure in most activities. If one meets several of these symptoms, but less than 5, there are milder depressive disorders that can still be diagnosed. It is important to remember that each person will experience a different set of symptoms with their depression and that the symptoms will look different with different people. No two people will experience depression in exactly the same manner. There are, however, some common themes that do repeat themselves, particularly in lawyers. In lawyers the most common symptoms are closely related to the work we are trying to do. Reduced ability to concentrate is one of the most bothersome symptoms for attorneys. They may have had trouble sleeping and a poor appetite for some time but attorneys often seek treatment when they realize that their ability to concentrate and get their work done is compromised. When you add together reduced ability to concentrate with fatigue and loss of interest in most all activities it is highly likely that the attorney's work is going to suffer at least in quantity if not in quality. In addition, attorneys in this condition often try to remedy the problem by working longer hours to keep up on the quantity of their work. In doing so they reduce contact with significant, supportive people in their life, reduce the amount of time they spend on exercise, hobbies, and other stress reducing activities, and cut back further on what is most likely already inadequate sleep. In their attempts to solve the problem they are doing the opposite of what they need and falling deeper into the hole of depression.

If you have a strong family history of depression you may decide that it is best to stay on medication for some time. On the other hand, if you have no family history and your depression occurred during the year that your divorce was final, your mother died, and you lost your job, you might have more of an acute and situational depression and might not be on medication very long. Regardless, the skills you learn in therapy are what will help you to avoid future episodes of depression. This is critical because it is generally accepted in the psychiatric field that if you have one episode of depression there is a 50% chance that you will have a second episode. If you have a second episode of depression there is a 70% chance that you will have a third episode and if you have a third episode there is a 90% chance that you will have yet another episode. Clearly, it is worthwhile to do all you can to treat a first episode of depression to increase the chances that it will be your only experience with depression.


Erand, marvellous post!


It does not say what the best treatment for severe depression is: ECT. Electroconvulsive Therapy has a higher success rate for severe depression than any other form of depression treatment. ECT has received some bad press as a result of what the treatment used to be. Dr. Demitris Popolos sheds some light on the issue. It can be life-saving and produce dramatic results. It is particularly useful for people who suffer from psychotic depressions or intractable mania, people who cannot take antidepressants due to problems of health or lack of response and pregnant women who suffer from depression or mania. A patient who is very intent on suicide, and who would not wait 3 weeks for an antidepressant to work, would be a good candidate for ECT because it works more rapidly. In fact, suicide attempts are relatively rare after ECT. ECT is usually given 3 times a week. A patient may require as few as 3 or 4 treatments or as many as 12 to 15. Once the family and patient consider that the patient is more or less back to his normal level of functioning, it is usual for the patient to have 1 or 2 additional treatments in order to prevent relapse. Today the method is painless, and with modifications in technique it bears little relationship to the unmodified treatments of the 1940s.

The patient is put to sleep with a very short-acting barbiturate, and then the drug succinycholine is administered to temporarily paralyze the muscles so they do not contract during the treatment and cause fractures. An electrode is placed above the temple of the nondominant side of the brain, and a second in the middle of the forehead (this is called unilateral ECT); or one electrode is placed above each temple (this is called bilateral ECT). A very small current is passed through the brain, activating it and producing a seizure. Because the patient is anesthetized and his body is totally relaxed by the succinycholine, he sleeps peacefully while an electroencephalogram (EEG) monitors the seizure activity & an electrocardiogram (EKG) monitors the heart rhythm. The current is applied for one second or less, & the patient breathes pure oxygen through a mask. The duration of a clincally effective siezure ranges from 30 seconds to sometimes longer than a minute, and the patient wakes up 10 to 15 minutes later. Upon awakening, a patient may experience a brief period of confusion, headache or muscle stiffness, but these symptoms typically ease in a matter of 20-60 minutes. During the few seconds following the ECT stimulus there may be temporary drop in blood pressure. This may be followed by a marked increase in heart rate, which may then lead to a rise in blood pressure. Heart rhythm disturbances, not unusual during the period of time, generally subside without complications. A patient with a history of high blood pressure or other cardiovascular problems should have a cardiology consultation first.

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General Board / Re: Dumped Anyway
« on: January 22, 2009, 12:30:15 PM »

Why divorce her! The guy should have divorced her right from the moment he understood she's sabotaging him!


He was not in a position financially to divorce her! It was her that could and did divorce him!

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