Elections have consequences

I came across this piece, and I agree.

Back in 2008, when then-candidate Obama promised Joe the Plumber and the rest of America that he intended to spread the wealth around, most democrat and liberal voters embraced the notion of wealth redistribution under the guise of equality. A universal health care plan, that would be free for all Americans, was the promise from the candidate of hope and change.

Tens of millions of Americans jumped on the bandwagon waving their
flags, fainting at his appearances, and fawning over his every word.

There’s more:

You, and the rest of the 50 million people who elected Barack Obama to not one, but two terms, deserve the pain that’s coming.

You asked for it. Now bask in it.

Go. Read the whole thing.


In response to Graybeard’s comment on my post about job prospects in the EMS field:

Yes, fraud is running rampant. In 2002, Medicare reimbursement for ambulances was less than $1 billion. In 2009, it had more than doubled, despite the fact that the amounts paid for each trip had not changed. I can tell you that the linked article’s claim that 80% of interfacility ambulance rides are fraudulent doesn’t surprise me one bit. I think that number is spot on.

The Feds are cracking down on this, but they are not even catching a fraction of the fraud. As the Affordable Care Act is implemented, it will only get worse.

Certification versus licensure

One of the most frequent memes in EMS is that paramedics are certified, while nurses are licensed. The people who say this are misinformed. To understand why, we need to look at what the terms mean.

Certification, as it relates to this case, is the process whereby a person is said to have met a standard by a certifying authority. Certification is the process of publicly attesting that a specified quality or standard has been achieved or exceeded. Usually this standard includes education, experience, and an exam of knowledge, skills, and abilities needed to perform the job. When an individual meets the standard, he or she receives certification from a certifying agency. The credibility and integrity of the certifying agency determines whether the agency’s certification means anything to the public. Certification is usually a voluntary process.

Licensing is an involuntary process, whereby a governmental authority grants permission for an entity to perform a given act. Licensing it always based on the action of a legislative body. Once a licensing law has been passed it becomes illegal for anyone to engage in that occupation unless he or she has a license. The health care professions are typically licensed at the state and/or local level, but not usually at the federal level. The license may or may not require that the person seeking the license meet a standard. Requirements for licensing vary from state to state. For example: Driver’s licenses only require that a standard be met on initial issue, a fishing license has no requirements for a standard, and a Concealed Weapons permit usually requires meeting a standard.

This makes paramedic a license, just as nursing is a license.

The biology of self control, part 2

This is a continuation of the post on the physiological origins of self control and criminals. For the first part, click here.

The next neurotransmitter that is important is Serotonin. Serotonin is not capable of crossing the blood-brain barrier, so the brain must produce all that it needs. Serotonin is produced by converting an amino acid called tryptophan into Serotonin. (Serotonin is also used for other purposes in other parts of the body, but that is not within the scope of this post.)

Serotonin is the chemical that causes us to feel loved, safe, and comfortable. This is why meals high in tryptophan are called comfort foods. This is also how the drug Ecstasy (MDMA) works. That drug causes a massive release of Serotonin from your neurons. Long term use of MDMA actually causes a decrease in Serotonin, though, as the cells that produce it begin to “burn out.” Various other drugs that are centrally acting also work on Serotonin and its receptors, like SSRIs.

When we do what we know that we are supposed to do, the frontal lobe rewards us with a rush of Serotonin. This is the brain’s reward system for good behavior. The Midbrain rewards pleasurable behavior with Dopamine. The balance between the two is the way our behavior is controlled: Midbrain rewards us for pleasure seeking, the Frontal Lobe rewards us for controlling our bad behavior. Most people are fairly balanced between the two, and mostly seek out pleasurable but good behavior.

There are things that can upset this balance:
A mother who exposes her unborn child to alcohol can damage the frontal lobe, and giver birth to a child with impulsive and unsocial behavior. Remember hearing about how the prenatal exposure to alcohol affects the corpus callosum? That’s the membrane between the left brain and the right brain that passes information between the two hemispheres of the brain. The corpus callosum of kids with fetal alcohol syndrome is damaged, and in some cases it is absent. This is very similar to what happens when a “normal” person drinks alcohol. After a few drinks, alcohol shuts down the left side of the frontal lobe, which no longer functions the way it should and this suppresses the frontal lobe, causing the person to act on impulse, disregarding consequences, and seek more reward from the Midbrain. A person will act to do things, even  when they know that it is wrong and will cause them trouble in the end. With long term alcohol and drug use, this condition becomes a permanent dysfunction.

Since much of this is biochemical and not conscious thought, people with frontal lobes that are damaged by congenital defects or drug use have no way of stopping this behavior.

That brings us back to recognizing a person’s potential for becoming a killer. We can look for people who:
 – chronically use alcohol or drugs,
– have displayed a history of not producing enough Serotonin. They are easy to recognize, as they have problems controlling their impulsive behavior (in other words- criminal records). However, this only is a reliable indicator if the criminal KNEW that what he was doing was wrong. After all, the person must know it is the wrong thing to do, if the frontal lobe is to be expected to control the impulse.
– Identifying others who have problems with their impulse control center. This suggests that there may be a test that can be performed that will indicate a person’s proclivity for committing crimes, which may mean that there is a medical solution for some criminals.

You also can see why gun control has little effect. The criminal is a criminal because his brain doesn’t stop him from committing acts that he knows are wrong. He knows it is illegal to rob someone, but he doesn’t care. He knows as a convicted criminal that it is wrong for him to own a gun, but doesn’t care.

On the other side of that, a man convicted of an obscure felony like owning more than 5 sex toys is not a threat to public safety and is unlikely to commit a crime with a firearm, as his impulse control is most probably fully functional.

Killers, biology, and control

There are always people who think that keeping people from owning guns is the answer to preventing murder. These people say that anyone is capable of being a criminal, and therefore guns are too dangerous for anyone but cops and the military. Others say that there is no way to predict who will be a killer, but is this true? Why do people become criminals, addicts, or killers? The answer is in our brains.

The neurological system of human beings is controlled by chemicals called neurotransmitters. The brain manufactures more than 60 different neurotransmitters that are responsible for everything we do from breathing, to pupil contractions, and even our thoughts and emotions. For the purposes of emotion and this discussion, there are three that we are talking about: Dopamine, Serotonin, and Norepinephrine.

Everything that we do that brings us pleasure involves Dopamine. If it makes you happy, Dopamine is the chemical that is responsible. The nervous system uses dopamine as the reward for good behavior. Serotonin is the love and comfort chemical. This neurotransmitter gives us our feelings of belonging, self-confidense, and calm. Norepinephrine is responsible for the “4 F’s” (feeding, fleeing, fighting, and f*cking).

In the human brain, there are components that control our emotions and behaviors without our conscious control. Among these is the midbrain. A small area of the midbrain called the Substantia Nigra makes dopamine, and passes that reward through a structure called the nucleus accumbens, past the frontal lobe, and to the rest of the brain. Since the midbrain is out of our conscious control, there are no ethics or morals involved in this level of control, this is pure instinct. In this way, the midbrain causes us to do whatever brings us pleasure.

We can exhibit a certain amount of control by utilizing the frontal lobe of the brain to interdict some of these impulsive, hedonistic impulses. You see, the frontal lobe of the brain is where our sense of morals, self control,  and duty originate. In children and young adults (up to about age 25) this area of the brain is not yet fully developed, and this is why people in that age group do stupid and irresponsible things.

In addition, various genetic and environmental factors either damage or prevent the development of this part of the brain. Individuals that do not have a fully developed frontal lobe have little self-control, no sense of right and wrong, and no morals. In short, they are out of control criminals.

Part two of this post can be found here.