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 Day 19

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Dissenting Opinions

Cancer, Politics and Capitalism

by LOUIS PROYECT

After working for a series of unsavory financial institutions for 15 years, I accepted a position as a database administrator at Memorial Sloan-Kettering Cancer Center (MSKCC) in 1983 with an eager sense of anticipation. Finally I would be doing something professionally that was more in sync with my political values. Instead of using my skills to keep track of pension trust portfolios, I would be creating a data infrastructure for patient care.

For more than a year I worked on developing a data model based on “normalized” relationships that sought to eliminate redundancies and provide a reliable foundation for applications development. A few months after I presented the model to management, I learned that all my work was in vain. The hospital had decided to buy a package from SMS, inc. that was considered nonpareil when it came to debt collection. As happened too often, a loved one would check into the hospital for a couple of months of very expensive and painful treatments that came to an end with the patient’s death. Since the survivors often had a tendency to ignore the astronomical bills that went along with such an exercise in futility, the hospital decided to purchase a system that was very good at dunning if nothing else. That decision left me feeling deflated. Once again money ruled.

When I received an invitation to review “Second Opinion: Laetrile at Sloan-Kettering”, a documentary described as “the remarkable true story of a young science-writer at Memorial Sloan-Kettering Cancer Center, who risked everything by blowing the whistle on a massive cover-up involving a promising cancer therapy”, I knew that this was one I could not miss. (The film opens at Cinema Village in NYC on August 29, and at Laemmle Music Hall in LA on September 5. A national release will follow.)

Directed by Eric Merola, the film is made up primarily of Ralph W. Moss, the aforementioned young science-writer now 71, describing the events that took place when he was working at MSKCC in the mid-70s filled with the same sense of idealism I brought with me 8 years later. Like me, Moss was soon disillusioned but for another set of reasons.

Although I wasn’t aware of it at the time, my first encounter with Moss was when I worked at MSKCC, through the intermediary of a book he wrote titled “The Cancer Industry”. As I noted in a May 2012 article about MSKCC’s purchase of the SMS software, Moss’s book was a good introduction to the slimy realities of cancer care under capitalism:

When I was working at Sloan-Kettering, I read a terrific book titled “The Cancer Industry” that along with “The Cancer Wars” is essential reading for those with a class analysis. To this day, I remember what the book said about Hubert Humphrey’s stay at Sloan-Kettering. I don’t have the book handy but these paragraphs from a 1990 review should suffice:

Among the horrors stories in The Cancer Industry is the case history of Senator Hubert Humphrey, who was operated on by a team of surgeons at Memorial Sloan-Kettering on October 6, 1976. His surgeon appeared before the press and television cameras to announce that the senator was cured by the operation, but as a preventive measure, to “wipe out any microscopic colonies of cancer cells that may be hidden in the body, treatment would begin with experimental drugs.” Moss describes the aftermath:

“Within about a year, Senator Humphrey was dead. In that short time he had withered from a vigorous middle-aged man to an old, balding and feeble cancer victim. Humphrey himself blamed chemotherapy … calling it `bottled death’ and refusing in the end to return to Memorial Hospital for drug treatment.”

Hired to work in the PR department for his writing ability and enthusiasm, Moss had an unsettling introduction. On the very week he started, he was shocked to discover that one of the hospital’s top researchers had been caught perpetrating a major fraud. After announcing to the world that he had completed an experiment that successfully transplanted skin from a black mouse to a white mouse, William Summerlin became an MSKCC super-star. Since the mice were of different species and the transplant had not been rejected, this could lead to major breakthroughs in human organ transplants. When a lab assistant discovered quite by accident that Summerlin had simply used a black magic marker to draw a patch on a white mouse’s back, the hospital looked incompetent. Lewis Thomas, the hospital’s director, explained the incident as one caused by Summerlin’s “severe emotional disturbance”. I would have called it greed.begging slogans3

(I should add that Lewis Thomas is not one of my favorite people. He is the author of an essay titled “The Iks” that makes the case that this hunting and gathering society living in the Ugandan wilderness were “an irreversibly disagreeable collection of unattached, brutish creatures, totally selfish and loveless.” Remembering Thomas’s essay from high school, filmmaker Cevin Soling traveled to Ikland to find out for himself whether this was true. Suffice it to say that Thomas’s essay was a bogus as Summerlin’s painted mouse.)

Around the same time, a more serious experiment was taking place at MSKCC. An octogenarian Japanese scientist named Kanematsu Sugiura, who had published 250 papers in a distinguished career, had begun treating mice with laetrile. The substance, also called amygdalin, was extracted from apricot pits. His findings: the mice that received laetrile benefited from injections. They were not cured of cancer but were able to live longer than non-treated animals. Most importantly, the tumors did not metastasize in the treated mice. Trained to be cautious, Sugiura thought the drug had palliative value. The implication, needless to say, was that further research was needed.

As word of Sugiura’s experiments filtered up to the MSKCC brass, they assigned Moss to cover them from a PR angle but just as much to snoop on the senior researcher. Not only did Moss fail to detect any irregularities, he became upset when he learned that the hospital had become convinced that Sugiura’s experiments were flawed and that research should be abandoned.

Convinced that he needed outside help to make the case for Sugiura’s experiments, Moss hooked up with Science for the People, a radical group that came out of the 1960s student movement. Working with a physician-activist named Alec Pruchnicki and without the knowledge of his superiors, Moss began publishing a newsletter called Second Opinion that was distributed outside of MSKCC just like most agitprop was in pre-Internet days. The newsletter soon became a sounding board for every kind of grievance at the hospital, including working conditions and patient treatment.

When the hospital called a press conference to disassociate itself from laetrile, Sugiura said that he stood by the hospital’s decision as well as his own findings. When asked by reporters how he could hold mutually opposed positions, he handled himself gracefully while standing his ground.

In a fascinating Science magazine article from December 23, 1977, Nicholas Wade—the NY Times reporter whose recent book on genetic inheritance most critics regard as a painted mouse—was loath to get on the anti-laetrile bandwagon despite the newspaper’s strong agreement with the top brass’s dismissal of Sugiura’s findings. Wade quotes Robert Good, the top immunologist at MSKCC: “If we had published those early positive data, it would have caused all kinds of havoc. The natural processes of science are just not possible in this kind of pressure cooker.”

In a phone conversation with Ralph Moss shortly after I viewed the film, I was struck by his unwillingness to assume the stance of a pro-laetrile activist even though he was obviously convinced that Sugiura’s experiments were valid. The film is making the case for considering alternatives to costly and often toxic medications that are making big pharma rich. He mentioned Avastin, a drug that generated $2.11 billion in sales in 2011. That, he added, was more than the GDP of many third world countries. The spirit of Science for the People continues in the work of Ralph W. Moss. See this film for a riveting account of the conflicts between corporate power and the public good.

Several weeks before I watched “Second Opinion”, I made a point of reading George Johnson’s recently published The Cancer Chronicles in order to get up to speed on current thinking about the disease. As I mentioned above, when I worked at MSKCC, I read Samuel Epstein’s “The Politics of Cancer”, a book that ties what was perceived at the time as a cancer epidemic to environmental toxins, especially pesticides. It was very much in the spirit of Barry Commoner’s “The Closing Circle” and amenable to my Marxist opposition to corporate indifference to our health and safety.

About ten years after reading “The Politics of Cancer”, I read Robert Proctor’s “The Cancer Wars” that backtracked from Epstein’s findings. Although very much a man of the left, Proctor warned his readers that finding a direct correlation between pollutants and cancer is very difficult.

With Proctor’s warnings in the back of my mind, I was not completely surprised by Johnson’s treatment of the environmental question. In chapter seven, titled “Where Cancer Really Comes From”, Johnson amasses some statistics of the sort that pro-industry hacks might repeat. For example, epidemiology studies conclude that cancer cases in the immediate vicinity of Love Canal were no greater than that in the rest of New York State even though there was a spike in birth defects.

In referring to cancer clusters, such as the supposed breast cancer epidemic in Long Island, Johnson concludes that they are “statistical illusions”. It is not so much that Johnson denies that there is a connection between cancer and the environment; it is that they are exceedingly difficult to prove.

Since I have like most people on the left become convinced that there is a connection between carcinogens in the water, soil and air and the incidence of cancer, I emailed Johnson with my concerns and referred him to a study of cancer clusters near heavily polluted rivers in China. Showing a grace uncommon to most well-established journalists, Johnson took the trouble to write back:

Thanks very much for your email. I appreciate the kind words about my book. I hadn’t seen that particular study and will make a point of reading it. Of course many industrial chemicals are carcinogenic, and it seems very possible that concentrations have been high and chronic enough in China’s water to expose the general population to levels known to cause cancer in the workplace. Nailing that down is very tricky though, especially in developing countries where epidemiological studies are just getting underway. Most of the research in China seems to concentrate on air pollution and lung cancer. Since the focus of my book was on cancer in the developed world, I may write a column in the future comparing the situation with China, India, etc.

Making the case about pollution—a negative indicator—is difficult but just as much so with positive indicators. Nutritionists are always urging us to eat fruits and vegetables, especially those with anti-oxidant properties such as blueberries and cabbage but there has never been a rigorous study of diet and cancer. This has a lot to do with the near impossibility of conducting a demographically representative study of the effects of eating “good” food and bad. Since cancer can take many decades to show up, tracking its roots and development is a near impossible task.

“The Cancer Chronicles” was motivated in part by his wife’s illness. Showing the difficulty of establishing a unilinear connection between diet and the disease, Nancy Johnson was something of a health nut given to daily exercise and a large intake of the very anti-oxidant fruits and vegetables nutritionists advise. Chapter four begins:

She always ate her vegetables. Obsessively, it sometimes seemed. Breakfast, lunch, dinner, throughout the day she would keep mental count. Never mind if it was 10:30 p.m., halfway through a Simpsons episode or a DVD. If she hadn’t consumed two or three servings of vegetables (some green, some yellow) and three or four servings of fruits, nuts, grains—whatever the food pyramidologists were recommending—she would slice up an apple or open a bag of carrots.

Confronted by the sheer anomaly of a person with such a lifestyle being susceptible to cancer, Johnson sets out on a trek that takes him to conferences and labs all around the USA when he is not accompanying his wife on her frequent chemotherapy sessions. His goal was to understand the basic biology of humanity’s oldest disease.

Indeed, it is not just ours. The dinosaurs suffered from cancer as well. In a trip to western Colorado, Johnson visits the site where six tons of Brontosaurus bones were discovered in 1901, including one that was the oldest one known to have contained a tumor. Using prose that has been polished over a long and distinguished career in science journalism, he reports on what he saw:

Viewed head-on, the fossil measured 6.5 by 9.5 inches. Lodged inside its core was an intrusion, now crystallized, that had grown so large it had encroached into the outer bone. Bunge [a museum curator] suspected osteosarcoma—he had seen the damage the cancer can do to human skeletons, particularly those of children. Oval in shape and the size of a slightly squashed softball, the tumor had been converted over the millennia into agate.

Johnson’s book is one of the finest on science that I have read in a very long time, perhaps in my life. As I told Marxmail subscribers, if I had run into such a book when I was in high school, I probably would have majored in biology at Bard College rather than religion (don’t try to get me to explain that choice.)

Johnson’s book ranges from medicine to physics, and from physics to philosophy without missing a beat. At the risk of sounding like one of those people who write the blurbs on book jackets, I would describe “The Cancer Chronicles” as a powerful examination of the biology of the human cell, including those that mutate into the most dreaded disease we face.

Between 2008 and 2012, three men died of cancer all within just about two years of each other. The first to go was Peter Camejo, who was responsible for helping me to understand what went wrong with the Socialist Workers Party. Peter, who succumbed to lymphoma, attributed his illness to pollutants he had been exposed to over a lifetime.

Next to go was Harvey Pekar, the comic book author who persuaded me to work on a memoir with him. Peter Camejo was a character in the memoir, as well as number of other colorful characters I got to know over a lifetime in politics and the bohemian underground. Like Peter, Harvey died from lymphoma or at least a system weakened by the disease.

Finally, two years later, I learned of Alexander Cockburn’s death. Alexander was a kind of bookend to Peter. When I quit the Trotskyist movement in 1979, I intended to put politics behind me and return to the bohemia of my youth. In an attempt to keep up with the NYC underground, I began reading the Village Voice. But the only writing that made any kind of impression on me was Alexander Cockburn’s weekly columns that lacerated the high and mighty. It was his writing that moved me to return to politics, the only damned thing I am good at.

The more our lives become entwined with the Internet, and social media in particular, the closer we become to people even if we never meet in person. Over the past few years, I have been at the virtual bedside of two people who I have enormous respect for. Using Facebook for both support and ventilation, Ed Douglas and Kristin Kolb have kept their friends abreast on their encounters with life-threatening illnesses. Additionally both were able to raise funds through the Internet, a necessity given the lack of adequate health care in the USA. Ed, a founding member of New York Film Critics Online—the group I have been part of for 15 years, developed an acute case of leukemia some years ago that ultimately required a bone marrow transplant. Fortunately he is in remission now and doing well. Kristin, a CounterPunch contributor of great distinction, is going through the final stages of chemotherapy for breast cancer. We who contribute to and read CounterPunch offer our support for her getting past this ordeal.

If the origins of cancer and its ultimate cure are shrouded in mystery, the same cannot be said about the need for adequate and affordable care. If it were not for the generosity of Ed and Kristin’s friends and admirers, their road would have been a lot more difficult.

Mike Marqusee, another long-time CounterPunch contributor, made the wise choice to relocate to Britain in 1971 where health care is free.

Around the time I started reading Johnson’s “The Cancer Chronicles”, I learned that Marqusee has been dealing with multiple myeloma for a number of years. He wrote a book recently that touches on his illness as well as Britain’s socialized medicine. Available from OR Books, “The Price of Experience: Writings on Living with Cancer” is both a personal history as well as a sharp-eyed analysis of the benefits of socialized medicine—as one would expect from a long-time Marxist.

You will notice that just above I refer to Marqusee “dealing” with cancer rather than the hackneyed term “battling”. As might be expected from an antiwar activist (Marqusee was on the steering committee of the Stop the War Coalition in Britain), Marqusee has little use for military metaphors. He writes:

Obituaries routinely inform us that so-and-so has died “after a brave battle against cancer.” Of course, we will never read that so-and-so has died “after a pathetically feeble battle against cancer.” But one thing that I have come to appreciate since being diagnosed with multiple myeloma (a cancer of the blood) two years ago is how unreal both notions are. It’s just not like that.

The emphasis on cancer patients’ “bravery” and “courage” implies that if you can’t “conquer” your cancer, there’s something wrong with you, some weakness or flaw. If your cancer progresses rapidly, is it your fault? Does it reflect some failure of will-power?

Like one of the characters in Michael Moore’s “Sicko” who lives a country not befouled by big pharma and the insurance industry, Marqusee describes a system that is geared to human need rather than private profit. For all the years he has been receiving treatment at Barts, the nickname for St. Bartholomew’s, a London hospital founded in 1123 (!), he has never had to pay a penny. Despite the fact that it is free, the treatment has been equal to some of the premiere hospitals in the USA.

But the same forces that have imposed Obamacare on us are conspiring to privatize and/or reduce the level of treatment in Britain. Showing the same sense of worker and patient solidarity that Ralph Moss’s newsletter sought to imbue at MSKCC nearly 40 years ago, Marqusee writes and we conclude:

I hope staff at Barts resist this attack on their jobs, and on the essential, life-sustaining services they provide. It’s often seemed to me that Barts survives on their good will alone. They’ve already been hammered by a steady fall in real wages, and there is a sad fatalism among most, not helped by the patchiness of the union presence across the Trust. What’s vital is that they understand that what’s happening now is not about failings at Barts; it’s a manifestation of the general crisis in the NHS, a crisis brought about by cuts, fragmentation, and privatisation, and one that can only be addressed through a mass movement that forces a radical redirection in government policy.

Louis Proyect blogs at http://louisproyect.org and is the moderator of the Marxism mailing list. In his spare time, he reviews films for CounterPunch.