Monday, May 4, 2009

Thank you, Wikipedia!

Without you I wouldn't be able to understand some of my Con Law cases.

Friday, May 1, 2009

Swine flu: an overrreaction or not getting the whole story?

At work we're supposed to have patients who are suspected of having swine flu (as well as everyone accompanying them) immediately put on a mask, then bring them right away into a designated room so they don't sit in the waiting room while waiting for their appointment. When our office manager called Infectious Disease at the hospital per their protocol immediately after our patient arrived, the first question she was asked was "does she need to be admitted?" Yet at the same time, we're supposed to treat the patients suspected of having swine flu exactly the same as we treat other patients suspected of having the regular flu. In other words, no special precautions beyond the mask and not having them wait in the waiting room.

This doesn't make sense to me. Any flu is a droplet infection, which means that anyone and anything within 3 feet is considered contaminated. In other words, anything you touch within those three feet can give you the flu if you then touch your mouth, eyes or nose. Either there's something special about the swine flu or there isn't. Either we treat it as something special or we don't, not this halfway stuff. The thing that makes me nervous is that the people dying in Mexico are in their 20s and 30s, which is what flu did during the pandemic of 1918.

Q&A: Why is swine flu such a big deal?
NBC’s Robert Bazell sorts the facts from the fears


By Robert Bazell
Chief science and health correspondent
NBC News
updated 8:01 p.m. ET, Sun., April 26, 2009

As new cases of swine flu emerge around the globe, from Ohio to Nova Scotia to New Zealand, the declaration of a "public health emergency" in the United States has further stoked fears and confusion.

NBC Chief Science and Health Correspondent Robert Bazell answers questions on the outbreak.

If this disease is like a mild flu, why is this being called a public health emergency? And why are officials in the United States concerned?

It's about the potential. It's not about what's happening right now. None of the 40 cases so far in the United States have been very serious. But the virus here is genetically identical to the strain of the virus that is killing people in Mexico.

This is a new virus so there's no natural immunity. It has the potential to spread very widely. That's what raises worries about a possible pandemic.

Don't thousands of people die from the regular flu? What's special this time around?

Generally, people who die from influenza are older people or those who already have respiratory problems. They end up dying of pneumonia. But this time around, the people who died in Mexico are younger. They are apparently healthy people in their 20s, 30s and 40s. That's a big deal. When a virus seems to preferentially affect healthy people, it suggests its a new virus and is causing an overreaction of the immune response. That's what happened with bird flu as well.

Influenza is virus that is always circulating between birds and pigs and people. Some have different genes that make them more or less infectious.

I have symptoms of the flu but haven’t recently been to Mexico? Should I go to the doctor?

You should go to the doctor if you have a fever or are really sick, for instance if you have difficulty breathing, even if you haven't been to Mexico.

The cases in the U.S. are not just among people who have been to Mexico. And the cases in the U.S. are so geographically dispersed and with no obvious connection to each other, that it seems this virus has already spread widely in the United States.

We shouldn’t start overwhelming emergency rooms or doctors' offices with every little sniffle or cough. But fever is the main thing. If you had the flu bad enough to start endangering you, you would feel so awful you would want to go to the doctor anyway.

You should also follow flu etiquette. If you are sick, you should stay home from work or school and limit contact with others.

Why is the disease so much more serious in Mexico than here?

Probably because it started in Mexico. That's going to become a big issue over time. There's supposed to be a pandemic prevention plan to contain a new flu virus by giving people in surrounding area Tamiflu. But it has obviously been spreading in Mexico for up to a month. The new strain of swine flu was discovered in California before the U.S. even knew about cases in Mexico. The virus could also be mutating.

Why is there so much uncertainty about what happens next?

Every epidemic has its own behavior. There's really no way of predicting. This could really just fade out or it could become very serious. Right now we are in a period of great uncertainty. In public health, that's the hardest thing.

© 2009 msnbc.com Reprints

Justice Souter to retire

Souter known as low-key, fierce defender of individual rights

WASHINGTON (CNN) -- David who? was the initial reaction of Americans to a little-known judge from New Hampshire named in 1990 to sit on the nation's highest court. Even the nominee didn't know what to think when President George H.W. Bush called him with the news, telling supporters, "I was in a state of virtual shock."
Conservatives say Supreme Court Justice David Souter, nominated by a Republican, was a dissapointment.

Conservatives say Supreme Court Justice David Souter, nominated by a Republican, was a dissapointment.

David Hackett Souter had only been on a federal appeals court bench for a few months when he was tapped to replace liberal lion William Brennan, a choice many Republicans hoped would move the high court rightward and reshape American law.

"I think that is good news for all of us who are committed to the Constitution of the United States," said President Bush. "He'll be a superb justice for the Supreme Court."

In reality, Souter was in many ways a typical, old-fashioned Yankee Republican -- a moderate with an independent, even quirky streak. Whether he became more liberal in his views after joining the Supreme Court, as many conservatives believe, may depend on your politics.

"Justice Souter will never escape the label of having been an enormous disappointment, a traitor to the right," said Thomas Goldstein, a Washington appellate attorney and founder of Scotusblog.com. "It instead created the opportunity to entrench a series of more liberal rulings. So he became the right's greatest failure and we will forever hear the mantra 'No More Souters' from conservatives."

Colleagues dismiss suggestions that liberal colleagues on the bench helped move Souter to the left.

"I find that incredibly unbelievable," said Rebecca Tushnet, a former Souter law clerk and professor at Georgetown Law Center. "He was faced with different issues on the Supreme Court than he was as a state official. A Supreme Court justice requires you to make different decisions, ones that aren't always consistent with your politics. And remember the Republican Party of Nixon is a different party than the one we have today, and we have a number of judges who came out of that earlier Republican Party who may not be in line with the priorities of people in power in Republican circles today."

The stealth candidate

Souter had a long career in public service. He was New Hampshire's attorney general and a trial judge who later sat on the state's supreme court.

Senate confirmation hearings to the high court were a breeze, because his federal experience was brief and his public stance on hot-button issues like abortion remained fuzzy.
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* Justice Souter to retire

"I have not got any agenda on what should be done with Roe v. Wade if that case were brought before me," he told senators. "I will listen to both sides of that case. I have not made up my mind."

That didn't stop women's rights groups from sounding the alarm. At rallies during his confirmation, abortion rights activists held up signs opposing Souter and chanted, "This is nobody's body but mine."

Similar concern came from movement conservatives. "At the time, he was called the 'stealth candidate,' " said Douglas Kmiec, a law professor at Pepperdine University who worked on high court nominations in the Reagan and Bush administrations. "So it was tabula rasa when he showed up at the bench and it was a surprise thereafter."

One of the first "surprises" came in 1992 when the Supreme Court reaffirmed the fundamental right to abortion in "Planned Parenthood v. Casey." Souter was part of a three-justice coalition that ultimately decided the case. In doing so, the "no undue burden" legal test was established when states were considering limiting a woman's access to abortion.

"What was clear to me was that he hadn't decided that case before he heard it" at oral arguments, recalled Peter Rubin, one of Souter's law clerks that term. "The law for him, unlike many of his conservative colleagues, was not an abstract set of rules totally divorced from its effect in the real world. It wasn't just an intellectual puzzle for him."

One puzzle for Souter was technology. He famously told Congress he would allow cameras in his courtroom only "over my dead body."

He shunned cell phones and pagers, and wrote drafts of his opinions in longhand, while a court-issued computer gathered dust in his chambers. Friends laugh recalling that for years he owned only an old black and white TV that was never plugged in.

So it surprised many when in 2005 Souter wrote a landmark cyber-age ruling in the so-called "Grokster" case. The court made software companies liable for misusing their file-sharing services and allowing copyrighted material to be easily and illegally downloaded.

"I am willing to bet Justice Souter had never seen a file-sharing application," said Tushnet, who is also an expert on cyber-age legal issues. "I would stake my life he had never used one, and would never use one. And yet his opinion reflected an understanding of how it works on the technical level, and how it affects a legal analysis of whether or not the supplier of the program should be held liable for what the people who use it do with it."

Man behind the robes

Souter's personality made him stand out on the Supreme Court, despite all efforts to avoid the spotlight. A lifelong bachelor, he lived alone in a tiny Washington apartment, escaping often to his family farm in rural New Hampshire.

He kept comfortably to routine, bringing a daily lunch of an apple and yogurt in a plastic grocery bag, eating alone in his chambers. Friends -- and he had few close associates -- say his favorite pastimes were reading, jogging and hiking in the New Hampshire mountains, activities he almost always did by himself.

The thrifty Souter shunned the trappings of power and privilege that came with being a Supreme Court justice.

"People didn't know him," said Goldstein. "He didn't go to parties, he didn't do speaking events. David Souter was really an isolated individual very much by choice."

Colleagues dismiss reports Souter was ready to quit the court after the 2000 Florida ballot disputes handed the presidency to George W. Bush. But they privately confirmed what a personal blow the rulings had on the integrity of the court he loved.

"He was very aggrieved by December 12, 2000," said Ralph Neas, former director of the liberal advocacy group People for the American Way. "He believed it was the ultimate politicization of the Supreme Court."

To critics, Souter siding with the liberal bloc only reaffirmed their view of him as a disappointment.

"He has not made a name for himself in any large body of jurisprudence," said former top White House lawyer Kmiec. "He's been kind of a go-along guy, in the context of the liberal or progressive side of the court. I think George Bush wanted more out of his judicial nominee than that, but that's what he got."

But others think history will judge Souter in kinder terms:

"A judge's judge," said Tushnet, "someone with deep respect of the institution and a deep faith in the ability of Americans in all branches to work things out."

Former law clerk Rubin remembered, "That sense of responsibility, that kind of care in deciding each individual's case is a hallmark of Justice Souter, of the man and his jurisprudence."

As for Souter, a man of few words, his brief remarks at a public White House ceremony after he was sworn in as a Supreme Court justice offer a capsule of his outlook on life and the law.

"What we try to do is pass it on, to make the gifts and kindnesses that come to us the kind of human currency that goes on traveling," he said. "I will try to preserve it, transmit it, I hope refreshed, to another generation of the American republic, which is the inheritance of us all."

Thursday, April 30, 2009

Does anybody else feel like we're living through the first chapter of The Stand?

Just Monday, for the first time ever, the World Health Organization raised the influenza pandemic alert to level 4. Today (well, technically yesterday since it's just after midnight) they raised it to level 5. Here's the level and link to the statement by the WHO's director-general, Dr. Margaret Chan:

Statement by WHO Director-General, Dr Margaret Chan
29 April 2009

Swine influenza


Ladies and gentlemen,

Based on assessment of all available information, and following several expert consultations, I have decided to raise the current level of influenza pandemic alert from phase 4 to phase 5.

Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world.

On the positive side, the world is better prepared for an influenza pandemic than at any time in history.

Preparedness measures undertaken because of the threat from H5N1 avian influenza were an investment, and we are now benefitting from this investment.

For the first time in history, we can track the evolution of a pandemic in real-time.

I thank countries who are making the results of their investigations publicly available. This helps us understand the disease.

I am impressed by the work being done by affected countries as they deal with the current outbreaks.

I also want to thank the governments of the USA and Canada for their support to WHO, and to Mexico.

Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour.

WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.

WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels.

The results of these ongoing assessments will be issued as public health advice, and made publicly available.

All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.

At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.

This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions should now be undertaken with increased urgency, and at an accelerated pace.

I have reached out to donor countries, to UNITAID, to the GAVI Alliance, the World Bank and others to mobilize resources.

I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production.

I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.

The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?

It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.

From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.

No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.

Above all, this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.

As I have said, we do not have all the answers right now, but we will get them.

Thank you.



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Wednesday, April 29, 2009

The single most important thing you can do to prevent the spread of swine flu (or other respiratory diseases)

other than frequently and vigorously washing your hands with soap and warm water for at least 20 seconds each time, that is:

WHEN YOU COUGH OR SNEEZE, DO IT INTO YOUR ARM INSTEAD OF YOUR HANDS OR A TISSUE!

Your arm rarely comes into contact with commonly touched items such as door handles or money. Coughing or sneezing into your arm is the most effective and easiest thing to do to help prevent the spread of the flu (or colds, etc). PLEASE spread the word! At least those of us who care about not infecting others will help slow the spread of disease. As for those selfish bastards who cough or sneeze without covering their mouths at all, I say we make them wear masks. By force if necessary. Hey, we're at war with the swine flu. Anything goes. ;)

On a more serious note, though, there has been one fatality in the US, a 23 month old child who had come to the US from Mexico for treatment. Also, the CDC has confirmed cases in the following states:
Arizona
California
Indiana
Kansas
Massachusetts (two children in Lowell)
Michigan
Nevada
New York City
Ohio
Texas.
In Massachusetts you can dial 211 for information about the swine flu.


As of yesterday, the World Health Organization has reported confirmed cases of swine flu in 7 countries:
United States
Mexico
Canada
New Zealand
United Kingdom
Israel
Spain

(on an interesting side note, Blogspot considers both "Zealand" and "Blogspot" as spelling errors)

Friday, March 27, 2009

Law school pops up in the weirdest places sometimes

Like when I was doing a search for shuttle flights between Boston and NY. I found this on yelp.com:

"Lease and tenant at will question"

Sarah "Bull in a china shop" D. says:

"My lease ends April 30th and it states that it becomes tenant-at-will immediately after that. Today my landlord sent me a notice to leave by April 30th. However I thought that she would need to give me notice 30 days after the tenant-at-will started.

The landlord definitely isn't someone that respects tenants that much to begin with since she wrote into the lease that she could live with us for the first month we were here. That was hell since she's extremely selfish, doesn't respect other people's property and is generally pretty annoying.

Any help would be really appreciated!"



If I hadn't gotten literally 4 hours of sleep since Wednesday morning I might even try to answer her question. Here's a tip for those of you who are thinking about going to law school. Don't accidentally make spring your heavier semester of the year. Ugh.... Five classes???? On top of full-time work and a three hour commute to class and back? The semester's almost done and I'm still wondering what I was thinking. :(

Tuesday, January 20, 2009

It's a brand new day!

I had to see it for myself. I taped both CNN and CNBC. I'm not sure why.

For some reason, the radio station we have at work in my little area acted like nothing was happening. And unfortunately I was so busy today that it wasn't until I went to go talk to one of the other nurses about something that I realized what was happening today. I heard Barack Obama's inauguration speech coming through on her radio, and I realized that "the moment", as CNN has been calling it, had come and gone. We had a new president. But I was so busy that it didn't really register.

Overjoyed as I have been all day that Bush is no longer president, it wasn't until just now, as I was watching President Obama take the oath of office on CNN, that it finally felt like we have a new president. That he is now President Obama, he is now the President of the United States.

The chorus "Oh, happy day!" keeps running through my head.

What a great new day it is today!

Monday, January 19, 2009

At last...

today is the last day of the worst presidency in American history. Tomorrow, the first day of hope in a long, long time.

My Con Law professor knows someone who took Con Law from Barack Obama when he was still teaching. One day, as an example of the greatness of this democracy, Obama said to his class "Hey, one day even I might be president!" The class' response? To laugh. Obama was probably feeling a little hurt when he asked why they were laughing. No one really had an answer.

Can you imagine tomorrow being one of those students who laughed at the idea of Barack Obama being President of the United States?

And how fitting that he would prove them all wrong the day after Martin Luther King Day.

Monday, January 12, 2009

Rev. Gene Robinson to deliver first invocation of Obama's inauguration!!!!

Although I grew up Catholic, I decided a long time ago that I no longer wanted to be Catholic anymore. Nothing against my particular Church or anything, but I was looking for a slightly more open-minded Church. The first time I went to an Episcopal service, it was for a U2charist. I knew there was something about the Episcopal Church I liked. :) Then I realized that the first gay priest, the one all the fuss was about, was a Bishop in the Episcopal Church here in NH. Between that and the experience of going to an Episcopal mass, I was completely and totally sold on the Episcopal Church. And now Rev. Robinson is going to give the first invocation at Barack Obama's inauguration!


January 12, 2009
Openly gay bishop to deliver first inauguration event invocation
Posted: 06:44 PM ET

From CNN Associate Political Editor Rebecca Sinderbrand
Robinson became the U.S. Episcopal church’s first openly gay bishop in 2003.

(CNN) — The first openly gay priest ordained by a major Christian denomination will deliver the invocation at the kickoff inauguration event Sunday at the Lincoln Memorial.

The Rev. Gene Robinson, Episcopal bishop in New Hampshire, has accepted an invitation issued by the Obama team prior to the announcement of the Rev. Rick Warren’s selection to deliver the invocation at the president-elect’s swearing-in, Politico reported Monday.

Robinson had been a critic of Warren’s role, calling his inclusion in the event “really, really unfortunate” because of the California minister's support for California's Prop. 8, which barred same-sex marriage.

“It's about this particular venue and the role that he has in praying for all of America, and I'm just not sure he'd pray to God the same way I would,” Robinson told Beliefnet last month.

“…This particular choice [of Warren] is not about having everyone at the table for a discussion or some sort of general forum. Every choice related to who does what at the inauguration is highly symbolic, and I think the transition team failed to ask the question of what, symbolically, this might say to some of our citizens.”

Robinson said at the time his disappointment would not affect his plans to attend President-elect Obama’s inauguration.

Monday, January 5, 2009

It's the waiting that gets you

I don't know about you, but I'm guessing you also have to wait for your grades to pop up on Campus Cruiser or some other kind of internet program. Back in undergrad we got the old-fashioned report cards. Although you had to wait seemingly forever for them, at least you got your grades all at once.

At Suffolk our grades were to begin being posted at 5pm today. However, the deadline for the professors to turn in those grades was 3pm. Today. Which means that if the professor even if the professor turns in their grades on time, the school somehow expects to post all of the grades for all of the classes in two hours, which rarely happens. As a result, I received one of my grades tonight at about 9:15pm, but I still haven't received the other. This is torture! What's interesting is that I got the highest grade I've gotten so far in "The Exam". Maybe the dexedrine (and ability to study better) really helped after all.

By the way, did you hear that Harvard Law did away with grades altogether? And although Suffolk has a frustrating B- curve (making our grades look worse in comparison to the other law schools in Boston), Harvard is sort of well known for it's cushy--albeit unofficial--B+ curve. It seems to be common knowledge in Boston that the hardest part of Harvard Law is getting in. Not that HLS students don't deserve credit for that, because it really is something to be proud of. However, from then on it's apparently hard not to get a good grade (check out exhibit A--an article by Andrea Saenz from the Harvard Law Record dated 3/6/08, in which she says "It is common knowledge that grades are inflated at Harvard Law as compared to most other law schools, and that professors have at least some constraints on the distribution of grades they must give to large classes. Students often repeat that classes are "curved on a B+", and that A+s and grades below B- are discretionary.")

Now they're going to an essentially pass-fail system. I have to admit, I've never really been jealous of Harvard Law students, other than the fact that they were able to get in. :) As I've said before, I'm very happy with and proud of the education I'm getting at Suffolk. But having a pass-fail system of grading? THAT makes me jealous.