Greater doom brings greater destinies.
Heraclitus

We shall not cease from exploration
And the end of all exploring
Will be to arrive where we started
And know the place for the first time.
T. S. Elliot

The days are surely coming,
says the Lord,
when I will establish a new covenant…
not like the covenant that I made with their
Ancestors,
for they did not continue in my covenant,
I will put my laws in their minds,
And write them on their hearts,
And I will be their God,
And they shall be my people.
And they shall no teach one another
Or sat to each other, “Know the Lord,”
For they shall all know me,
From the least of them to the greatest,
And I will remember their sins no more.
Hebrews 9.11

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The study, published in the latest edition of the Journal of Environmental Management, found that per capita visits to U.S. national parks have been declining for nearly 20 years - largely as a result of increased time spent watching television and movies, playing video games and surfing the web.

Although the study was conducted in the U.S., and Canadians tend to have stronger ties to the outdoors, I would be surprised if the trends were that different here. Canadians watch less television than do Americans, but we also have some of the highest internet usage rates in the world. We stare at computer screens more than practically anybody else.

And while lower attendance levels in national parks do not necessarily mean people are spending less time outdoors in general, the connection to time glued to electronic media is hard to ignore. In fact, the evidence was strong enough for the researchers to conclude: "We may be seeing evidence of a fundamental shift away from people's appreciation of nature (biophilia, Wilson 1984) to 'videophilia,' which we here define as "the new human tendency to focus on sedentary activities involving electronic media." Such a shift would not bode well for the future of biodiversity conservation."

Indeed. The Internet is a fantastic tool, as is television. Even video games can have educational value as well as be entertaining. But as with anything, there needs to be a balance. When I was a boy, escaping to the air-conditioned comfort of a movie theatre during the heat of the summer was a real treat. But it was an exception, not the norm. Far from spending the majority of my time indoors, I spent most of my waking hours outside - swimming, fishing, hiking or just exploring.

Times certainly change, but when are behaviours change in a way that alienate us from the natural world upon which we depend for our food, our energy, our natural resources - our very lives - that, to me, is cause for concern.

We tend to forget that the world we live in today - the electronic age - barely registers in the timeline of human history. For the vast majority of that history, we were a rural people. We lived in family groups and small villages and followed the natural cycles of days and nights, and the seasons. We didn't buy processed food from the mini-mart, text message people halfway around the world or watch infomercials at three a.m. bathed in the glow of artificial light. Most of the modern electronics we take for granted today have only been around for 50 years or less.

These electronics may make our lives easier, but I sometimes question if they are making our lives better. People tap away on Blackberries and personal computers during meetings. They take cell phone calls during the birth of their children and play video games for days at a time, virtually without a break. They walk down the street, listening to MP3 players, lost in their own world. We seem to be plugged in 24 hours a day, seven days a week. That strikes me as decidedly unbalanced.

So try this; for the rest of the summer, or maybe just a week, or even a day - unplug. Put away all your electronic gizmos and go outside. Lie under a tree. Watch the clouds. Smell the air. Enjoy real life, rather than a virtual version of it.

Most important, take the kids.

Originally published on July 28, 2006.

Dr. David Takayoshi Suzuki is distinguished Canadian geneticist who has attained prominence as a science broadcaster and an environmental activist. He is also a co-founder of the David Suzuki Foundation.

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The problem is that while there might well be short term gains in the long run the house always wins. Whether its craps, blackjack or the slots, the odds always favor the house. If you play long enough you lose.

You would think a novel that indulges itself in somewhat lengthy explanations and critiques of economic theories from Adam Smith and David Ricardo through Karl Marx to econometrics and macro-economics, supplemented by doses of biological and astrophysical data might be dreary going. And while there is no doubt that there will be a good many readers who will find these passages dry and daunting, it is equally true that there will be those that will marvel at the chutzpah of an author who deliberately chooses the dismal science as raw material for his work, and even more importantly admire his skill in shaping it into art. On some level, certainly less epic but less digressive as well, it reminds one of the discourses on whales and whaling in Melville’s Moby Dick, discourses that have brought even that venerable voice his share of detractors. A writer takes a gamble when he loads a work of fiction with this kind of baggage–with some readers he will win, unfortunately, no matter how well he manages the material, with some he will lose.

This is all the more unfortunate because Thomas Legendre’s first novel, The Burning, is a rewarding, skillfully controlled piece of work well worth the serious reader’s attention. Its forays into the esoterica of economics and science are integrated functional expressions of both theme and character. Three of the four central figures in the book are academics–two recently ‘doctored’ economists and an astrophysicist. That such people would tend to look at the world in terms of the metaphors and models of their professions is only natural. Logan Smith, the novel’s protagonist, is something of a maverick among economists. Unlike Deck Moore (one has to wonder about Legendre’s choices of character names. There are a Keris and a Dallas still to come. Whatever happened to Bob and Carol, Ted and Alice.) the novel’s putative villain, he isn’t into the professional specialty du jour, econometrics. His concerns are much more humanistic. He is interested in reevaluating economic theories in the light of their effects on society. His doctoral dissertation is a study of Adam Smith attempting to show where the father of laissez faire capitalism went wrong. Not that he is a communist, Marxist theory has its own problems, it is simply that modern economic theory rest on assumptions about resources that ignore certain basic scientific truths that need to be taken into account.

Deck is a pragmatist. He knows which side of the academic bread the butter is spread. He understands the wheeling and dealing necessary to getting ahead even in the hallowed halls of ivy, besides he has goals even beyond the university. Visions of presidential commissions dance in his head. He knows critiques of two hundred and fifty year old theories that have calcified into dogma are not going to get him where he wants to go, no matter how cogent and well reasoned they might be.

The contrast between the two is crystalized by the way they think about economics and illustrates the aesthetically functional way in which Legendre uses this material. Here is Deck: "He had wanted to show that point-of-sales ATM transactions, when isolated from other expenditures, would result in step-shaped consumption functions with a series of zero-slope or nearly horizontal plateaus bridging the traditional upward sloping sections." Moreover when the data begin to betray him, he simply puts the whole theory on the "back burner" to await some new equation. Compare this with Logan talking to a class about the ideas of Jeremy Bentham (It is also worthwhile to note that Logan is a much more committed and effective teacher; for Deck, like many other academics, teaching is something of a necessary evil). "Bentham wanted to reconcile individual freedom with the greater public welfare. He believed that social institutions have a major effect on people’s actions and, as a result, should be modified to ensure that everyone’s pursuit of his or her ‘rational self-interest, as most economists phrase it, was compatible with the long-term goals of society." Their ideas about economics are functions of their personality.

Logan and Deck are set up as opposite poles, not only professional, but in most other ways as well. Deck is a California boy: outgoing, glib, blonde. Logan is a dark Pennsylvanian; sensitive and careful about what he says. Logan is straight forward, Deck manipulative. Deck is casual and emotionally distant in his sexual behavior; Logan cannot help but become emotionally involved. Deck is at home in places like strip clubs; Logan wants no part of them. Deck works on his body in a gym; Logan bikes and works redoing his garden. Deck looks at the world in which he lives to see how he can use it, Logan looks to see how he can change it.

The third of the academics, the astrophysicist, is Keris Aguilar, divorced mother of one, into Yoga and natural therapy; liberated, bright and beautiful in an uncommon way. Not only is she interested in Logan’s ideas, she is fully capable of critiquing and indeed collaborating with him. A perfect mate for an idealistic young economist, you would think. And you would be right, but for the fact that–this is after all a novel, so there has to be a but for the fact that–Logan is married, although needless to say, married to a woman completely wrong for him.

The fourth member of the character quartet is Dallas Cole. She is a blackjack dealer that Logan met on a trip with Deck to Las Vegas to celebrate their ascent to ‘Ph. D.-dom.’ While Deck runs off to a strip club, Logan sits at her table, and since he is a novice, she takes him under her wing as Vegas dealers are wont to do with neophytes. She also takes him home with her at the end of her shift. When the story picks up again, they are married and living in Arizona where Logan is now teaching. Of course it doesn’t take long for them to discover that blackjack dealers and professors of economics might not have all that much in common when the sexual heat begins to cool. It doesn’t take her long to find out that there aren’t too many towns that have the glamor and excitement of Las Vegas. It doesn’t take him long to find out that beautiful blackjack dealers may need more tender loving care than one might have thought on first acquaintance.

Set this quartet into action and you have the formula for the plot of The Burning. While the book does make what seems to be the obvious point about these relationships, it is also concerned with more cosmic issues: unsustainable economic growth, depletion of resources, environmental deterioration, urban sprawl, allocation of wealth, among others. Ultimately it forecasts a dire scenario unless some radical changes are made. There is something very seductive about the American life style. Everyone, all over the world, seems to want it. The problem is that everyone cannot have it. Its very existence is predicated on the fact that there are multitudes that do not have it and never will. It demands to be constantly fed; it demands always something new to consume.

Las Vegas is in some sense the perfect symbol of the American economy and gambling the perfect metaphor. From a limited stock of money (it may be a very large stock, but ultimately it is always limited), the gambler bets some looking for greater gains, much in the same way the capitalist economy uses or ‘bets’ its resources. The problem is that while there might well be short term gains in the long run the house always wins. Whether its craps, blackjack or the slots, the odds always favor the house. If you play long enough you lose. If you play long enough your chips are gone. This is the free market. It will sustain itself s long as the chips hold out, but if you play long enough. . . . That Las Vegas with its flashy neon excess provides a glitzy contrast to the university lecture halls belies the fact that they have a good deal more in common than meets the eye.

Las Vegas, John Maynard Keynes, g-strings and radon-219–What more can a reader ask for?

About the Reviewer: Jack Goodstein is a professor emeritus at California University of Pennsylvania, where he has taught English for more than thirty years. His work has appeared in scholarly journals such as Critique, Theatre Journal and College English and in literary magazines such as The Maine Review, The Small Pond Magazine of Literature and The Jewish Digest. In 1990 at age 51, he tried his hand at acting, and while he has always loved the theatre from the audience, discovered an unexpected addiction to the stage as a performer. Since then he has appeared in more than sixty plays throughout Pittsburgh and Southwestern Pennsylvania. He has also done film and commercial work. This ultimately led to his attempts at writing for the stage. His one act, Pinochle was given a staged reading at the ATHE conference in Toronto in July of 1999 and was published by the University of Charleston Press. In April 2000, his one act, Poker, was produced by the Pulse Ensemble Theatre in Manhattan as part of their OPAL series. Bride of the Father(2000) and Creative Daydreaming (2001) were produced by the Gallery Players of Park Slope in Brooklyn. Other one acts have had readings or been staged at Far Off Broadway and Northern LightsTheatre in Canada, and New York University and the Cafe Sha Sha in New York.

The Burning
by Thomas Legendre
Little, Brown
Hardcover: 368 pages, July 6, 2006, ISBN: 031615380X

Originally published in http://www.compulsivereader.com/html. Reproduced here with permission.

⁽⁰⁾

Michael lives in London and Hamburg, and teaches in Florida. He is the author of four books of poems, a book of criticism, and the translator of many books from the German. Here he kindly answers my questions.

Mark Thwaite: Acrimony was a wonderful collection of poems, much of it about your relationship with your father.Was that book important to you? Do you still write poetry?

Michael Hofmann: I haven’t written so many poetry books – four – that they aren’t all important to me, if that doesn’t sound a little plaintive. But with its two-part organization, and the clutch of poems about my father and growing up and so on, I suppose Acrimony packs the most punch. It seems like a book I might have written on purpose, and not like the others, which contain more or less whatever I managed to write over a certain period. I still feel close to the poems in it – especially in the first, non-father, part – which is a little alarming, after almost twenty years. Somewhere in there is the clue too to why I haven’t written more, and why I’m hardly writing anything now. There doesn’t seem to me much wrong with what I have written, but at the same time I don’t want to write any more of it; I’m looking – or waiting – for some kind of new orientation. I’m not sure to what extent I’ve failed – dried up or gone away – and to what extent I’m doing what I always did and always wanted to do, which is a mix of things. That archaic designation, “man of letters”. Though of course I never imagined I’d be reduced to a poem every other year, or whatever it is! A friendly critic – I’m thinking of Dennis O’Driscoll – told me my poems must have taken a lot of living, and that a hiatus in production was not unexpected, and possibly a good thing. I’d like to find some way of writing that was less exorbitant, less antagonistic, less cannibalistic…

MT: I'm guessing from books like The Faber Berryman and Robert Lowell: Poems Selected by Michael Hofmann and your new The Faber Book of 20th Century German Poems that poetry is still important to you!?

MH: Yes, it is. Never in the exclusive way it’s supposed to be important to poets – I’ve always read other things, and held them in higher regard than most poetry – but it’s part of my furniture. Fierce furniture. Those books are projections if you like, or shadows, of the vast time I’ve spent on their authors: Berryman I first wrote about as an undergraduate; Lowell I was supposed to write a PhD on (though I didn’t come close), and I continually re-read; and I’m a sort of autodidact in German poetry. The German anthology is about one-third translated by me, for what that’s worth.

MT: Of late you seem to have been focussing on translation. Is translating the dayjob whilst you concentrate your artistic energy on your own writing or do you see translating itself as a creative endeavour?

MH: I started translating only shortly after my “debut” as poet (1979, in London Magazine) and as reviewer (1980, in the TLS). My first translation from – my native language – German came out in 1985. A novel by Kurt Tucholsky, called Castle Gripsholm, and I did a few odds and ends before that. I expected to translate a novel a year, or every other year, to stay busy, and to make a little money. It’s rather run away with me. I’ve even lost count of how many books I’ve done. I suppose Joseph Roth is the main culprit (I’m working on my tenth book of his, an annotated selection of his letters), but there are others too whom I couldn’t stand not to do: Wolfgang Koeppen (four titles), Wim Wenders (three), my father (three again). I’m translating my second Kafka (the short stories), my second Brecht (Mother Courage). I don’t really know what it is. An expression of my fealty to German? Or to prose? Something Macchiavellian, a practical identification of a type of work that’s always there to do, and that’s endlessly portable? Or something altogether more sinister: a kind of driven self-obliteration? Am I pushing myself forward, or holding myself back? I dislike the process and the work, but I love the results, the finished books. Perhaps poetry, at my rate of output, just doesn’t seem enough to show for a life. “A slim bundle of dead writs,” Ian Hamilton puts it; he forced himself to do these big editing jobs (the Oxford Companion to Twentieth Century Literature, etc.) and these big biographies (Lowell, Salinger, Hollywood writers, etc.). Perhaps my translations are my equivalent, a partial self-industrialisation that leaves my poetry – like his, I would say – home-made? As to whether it’s creative or not, I think it’s not for me to say. It takes every last word out of me, that’s for sure, and I do have the highest hopes and ambitions for it. I don’t fool myself that the translations are “by” me, but they are “my books”, and carry my imprimatur. I like to think there is something in them that sets them apart, that they wouldn’t have been exactly the same if someone else had done them. Or a machine…

MT: You've recently translated Storm of Steel by Ernst Junger, Party in the Blitz by Elias Canetti, The Radetzky March by Joseph Roth and written the introduction to the Penguin Modern Classics The Sheltering Sky by Paul Bowles. A diverse list! Are they all books you have a passion for?

MH: That’s exactly it! It’s a bit of a relief being confronted with something like that, because I think of myself often as being a rather carping and dissatisfied and negative sort of person. But I’m very enthusiastic about those books, however mutually incompatible they and their authors probably are. To take the Junger for an example: Simon Winder at Penguin read the existing English version, from around 1930, and straightaway wanted to bring the book into Penguin Classics. I hadn’t read any Junger, beyond a few nauseating pages from Battle As Inner Experience, a revolting screed he wrote later, in the 1920s; plus I was aware of his German reputation, as a kind of unrepentant red rag to the Left. And not just that, as a German growing up in England in the 1960s, I hadn’t read anything about the War or Wars. Anyway, I thought In Stahlgewittern was great, and also surprisingly unproblematical, very clear and vivid and unconstructed. Really, an undesigning book, but as close as I could ever come to war, the great, defining experience of most human generations. In other words, I’m happy to take things as and where I find them.

MT: You've translated many works by Joseph Roth. Indeed you (and Granta) must be congratulated for making Roth's name known again (to those who read English). What makes Roth so worthy of our - and your - attention.

MH: I think Roth comes into the category of a great, but still under-rated and under-read writer. His reputation is still unsettled, and still inadequate to the man. You can open any book of his and start reading, and find something to repay you for your trouble. As Joseph Brodsky put it to me at a time when I was reading Roth, but hadn’t progressed to translating him: there’s a poem on every page of his. As for it being worth my attention, I don’t put a great premium on that. What else? Partly it’s what P.G. Wodehouse called “the series habit” – which, along with the growing of side whiskers, he claimed to find the besetting danger to the writer… If you’ve done five, you do a sixth. Or do you suddenly turn round and say he’s only worth five books of my time? They say fidelity is its own reward; I suppose a translator’s chances of getting noticed improve if he or she does a lot of books from the same author. Then the shadow or the numen or whatever rubs off still more. (Not that I’ve ever done anything from that kind of calculation! You must understand I don’t see myself as a card-carrying translator.)

MT: Your father Gert Hofmann is someone else you have translated. Is translating your father a more difficult task than your other translating work? Do you think via translating your father you have a greater appreciation of his work?

MH: I think actually it was easier. There was never to me any question, to me, of “not getting it”. Growing up with the man was – in ironic hindsight – a kind of preparation or training for translating him when he was gone. The oddity and the macabreness and the humour of it are all in me anyway. If you like I was able to read it in stereo. The appreciation was there, by the way, before I started translating it. It’s important to me that I agreed to – I wanted to – translate him in his lifetime. In other words, it wasn’t a stroke of belated piety on my part. I was working on The Film Explainer when he died, wholly unexpectedly and far too early, in 1993. Thereafter I determined to translate his two subsequent books as well, Luck and Lichtenberg and the Little Flower Girl. To me they all go together.

MT: What would you say is your father's best work?

MH: I like Luck very much: the last day of a family, the father’s moving out, and taking his son with him, the mother stays behind with the daughter, to take receipt of an awful new man. It might have been our own story, I suppose I believe on some level. And I think The Parable of the Blind, about Breughel’s painting of the same name is very very good. From the point of view of the seven blind men, in the first person plural, a voice that arises from somewhere in the midst of them all.

MT: We are big fans of Thomas Bernhard here at RSB and, so, we were wondering: is his poetry any use!? Do you fancy translating it?

MH: I’ve read very little of Bernhard’s poetry, just the occasional piece in anthologies. But then I don’t think anyone much has. I like his evolution. Six books of poems and then something like “Sod this!” and a novel, and then many more novels and plays. I’ve only seen two of the plays, Elizabeth II and Heldenplatz, and I thought they were both wonderful. I’d love to translate plays of his. You might be interested to learn that I’ve recently handed in a translation of Frost, that first novel.

MT: Handke is another writer we'd love to see you working on. Do you admire his work?

MH: I’m rather mixed on Handke. The longer books seem not only to have, but to be longueurs. A book of journal entries that I reviewed once upon a time, The Weight of the World, My Year in No One’s Bay or whatever it was called. I think he is very different in German, and also very differently perceived: turgid, fussy, paranoid… A much more useful and interesting writer for export, I can see. But on the other hand, I thought A Sorrow Beyond Dreams was terrific, and then there was another little book of short pieces, off-cuts really from one of the long books, called “Thucydides Once More”, which was just lovely. Pieces about Croatia or Slovenia, being in a harbour town, getting your shoes polished, concentrating on the few minutes in the evening between the last swallow and the first bat. Lovely things. I think even as a poet, I ask for a little more novel from a novel than he usually gives. But if you like Handke, then I would refer you to a book I came across and translated by a man called Peter Stephan Jungk (a friend of Handke’s, and now of mine as well): the book is called Tigor or The Snowflake Constant. That should have been a cult novel: an amazingly persuasive account of the strangeness of life.

MT: Do you read any literary websites!? What are your favourites?

MH: I have to disappoint you there. The vehemence and opinionatedness and lack of accountability of the online world worry me. I don’t know who is telling me something (and usually at the top of their voices). I’m sure you’re not like that, I must look you up. I’m very new to all this. (Good luck!)

MT: Who is your favourite writer/book? What is the best thing you have read recently?

MH: Probably Malcolm Lowry. I re-read Under the Volcano most years, having first been put on to it by a dead English teacher of mine. (Not dead at the time, you understand.) I think the best living English writer is James Buchan. I wish he would write another novel. I re-read him all the time as well. Especially Heart’s Journey in Winter. The poet who is closest to me, probably has been for the last five years or so, is James Schuyler, one of the New York School, friend of Ashbery’s and O’Hara’s.

MT: What are you working on now? More translations? teaching? your "own" work?

MH: All of the above! I usually teach one semester a year in the States, but sometimes two, as now. Usually creative writing – poetry workshops – but with a fair bit of latitude for reading and discussion. More translating, because if I don’t do it, someone else will, or perhaps worse, no one else will. As I mentioned, the Kafka stories, and a novel by a very good German writer of the Thirties and Forties, Irmgard Keun, about exile, then the Roth letters. Sometimes I give the whole enterprise just another five or ten years, so why bale out any sooner? And poems, well, as and when. I wish.

MT: Anything else you'd like to say?

MH: No, not really! Thanks for your questions, thanks for bearing with me, I’ve enjoyed myself.

-Mark Thwaite (05/10/2005)

Originally Published in ReadySteadyBook.com. Reproduced here with permission.

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A favorite line of editors always refers to the measurements used, which are often given in both metric and Imperial. You are cautioned to use one set of measurements or the other, but never to mix them. The implication is that if you do, disaster will be the result. It's a bit like the exhortation which goes something like "three free-range eggs", as if the dish cannot be produced with any other type of egg.

This is the sort of thing that has inexperienced cooks quickly turning the pages, looking for a recipe with less ingredients or abandoning the idea altogether and heading for the takeaway. I call it 'the tyranny of the recipe'. It's as unnecessary as it is silly.

If you are one of those who ignore a recipe simply because the list of ingredients is too long, or looks too complicated, please keep reading. You don't need to change your cookbook. You just need to change your mindset.

The first thing to remember is that recipes are written by people trying to pass on a method they use to cook something. They are a convention for exchanging information which has developed over many years and which, on the whole, work very well. But that's all they are. You are not dealing with chemical formulas that will blow up in your face if you measurements happen to be a few grams out, or you change one ingredient for another.

In just about any recipe you can not only change ingredients around, alter the amounts used and so on, you can also leave them out altogether. You may not achieve exactly the same dish as the cook who wrote the recipe, but so what? Who's to say that your version won't be just as good, or even better?

Good cooks, and that really means experienced cooks, will read through a recipe, grasp the general idea, and proceed to put it all together using previous knowledge and their own tastebuds. How things taste to you, and even how they look, are far more important than any written instruction and far more liberating.

Try this simple test. Open two different cookbooks at the chicken recipe section and compare the recipes. It will very quickly dawn on you that the recipes in one are simply variations on the listings in the other, the biggest variation being in the flavorings used. So the conclusion must be, if the recipes can be varied in flavors and quantities between cookbooks, you can do exactly the same thing and still come up with some stunning dishes for your friends and family.

Using cookbooks as a source of ideas only is an enormously liberating experience for most people, turning a chore into a pleasure. As a bonus, it often produces far superior results as well. For example, did you know that many of the dishes published in cookbooks have never actually been cooked? They are frequently just rewritten from notebooks and archives. That's because the professionals know that the contents are not critical. It just makes us look more highly skilled if we pretend they are.

Don't be trapped in this way. One of the most influential cookery writers of her day, Elizabeth David, put only the barest of information in her recipes and often didn't bother to mention quantities at all. Beginner cooks might have struggled a little, more through nerves than anything else, but more experienced cooks were quickly at home creating their own versions of classic French recipes.

And that's something to bear in mind when you are cooking for the family. Professionals did not invent cooking, ordinary people did. Many of the classic Italian and French dishes are not the results of swanky restaurant posing, but simple food prepared from fresh ingredients with many regional variations. They have nothing to do with the culinary antics of celebrity chefs.

Take a break from tyranny. Close the cookbook and make something you have cooked before, but change it a little - or a lot if you wish. Add, substitute or take away one ingredient, taste or smell everything before you use it and get used to the idea of cooking with your palate, which really means your nose. You will probably find that you surprise yourself by how much you instinctively know and how much you have learnt. You will also be pleasantly surprised by how much easier life in the kitchen has become.

About the Author
Michael Sheridan is a former head-chef as well as an acknowledged authority and published writer on cooking matters. His website at www.thecoolcook.com contains a wealth of information, hints, tips and recipes for busy home cooks.

Originally published in www.upublish.info.

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The companies take full advantage of this situation. As many patients in India are poor and illiterate, and lack information on health care, they often visit local pharmacists or quacks for medical advice. Pharmacists routinely dispense drugs illegally over the counter. We visited 40 local pharmacy stores for medical advice for a feigned medical ailment, and we found that all 40 pharmacists dispensed drugs, including expensive antibiotics [2].

Pharmaceutical promotional campaigns in India, unlike those in developed countries (where pharmacists have little influence on drug sales), are not only aimed at changing the prescribing habits of physicians but also at pharmacists and quacks. Pharmaceutical companies in India offer various schemes and incentives (including television sets, motorcycles, and the opportunity for higher profit margins) to lure pharmacists into buying more drugs than they would normally need. As a result, the pharmacists make every effort to sell these drugs to patients visiting them for medical advice. They may also associate themselves with quacks or physicians in their efforts to shift their stock of the drugs.

In developed countries, dubious pharmaceutical marketing practices would soon attract the attention of watchdog bodies and social activists, but in India they go undetected. We believe that this situation demands proactive action on the part of the medical profession and also of the government.

The efforts of the pharmaceutical industry to medicalize human life should be resisted. We do not wish India to be in the same position as the countries of the West, where adverse drug reactions are responsible for a significant proportion of hospital admissions and require millions of outpatient visits and corrective measures. In the United States, for example, there are about 100,000 deaths due to medical errors every year, of which about 7,000 are attributed to drug reactions [3].

We believe it is important to assess current awareness about disease mongering among medical and pharmaceutical students, as pharmaceutical promotional campaigns are aimed at both professions. Assessing current awareness could provide a basis for further research, leading to the development of effective measures that will raise awareness levels and motivate students to participate in future campaigns that seek to combat disease mongering.

Most medical and pharmaceutical students in India are not aware of the issue of disease mongering; neither do most of them know that recent audits have shown medical interventions and adverse drug reactions to be major causes of death and disability in the US [4].

Articles have been published warning the profession about disease mongering [5–7], but for the most part these warnings have not been heeded. One is reminded of Aristotle, who so rightly observed that “truth could influence only half a score of men in a century, while falsehood and mystery would drag millions by the nose.”

We prepared a 20-item questionnaire (Text S1) about disease mongering and the influence of the drug industry on clinical practice. The questionnaires were distributed among a random sample of 250 final-year medical and 250 final-year pharmaceutical students. The overall response rate was 406 out of 500 (81.2%), comprising 199 medical and 207 pharmaceutical students. Of the medical students, 30 out of 199 (15%) were able to explain disease mongering with relevant examples. Of the pharmaceutical students, 114 out of 207 (55%) were able to do so, suggesting that awareness of the problem was much greater among these students. Interestingly, however, 87 out of 114 pharmaceutical students believed the government, not the pharmaceutical industry, was responsible for the problem.

All the students, both medical and pharmaceutical, said they had frequently seen drugs dispensed without prescription. They had also often seen patients visit local pharmacists for medical advice. They agreed that both practices were unethical. However, both the medical and the pharmaceutical students were unaware of the incentives offered by drug companies to pharmacists for buying their drugs, which lead to unethical dispensing.

We believe that our small project, despite its inherent limitations, has thrown some light on the situation. Pharmaceutical students, who are exposed to the drug industry to some extent during their studies, have some idea of the magnitude of the problem, while the majority of medical students have no idea that even their textbooks are written with the help of money that comes from drug companies [8]. We need to make a more concerted attempt to educate the student community of all the health-care professions, in order to counter this unfair tendency.

The government should undertake major initiatives to ensure that drugs are only dispensed with a prescription from a licensed physician. Medical associations and medical college administrators should alert their members to cross-check the information provided in drug company literature. Medical students should be warned about disease mongering through the display of posters, and through the organization of essay competitions and interactive plays. Students can play a further role by conducting regional and national surveys of the awareness of the public concerning this serious issue.

Supporting Information
Text S1. 20-Item Questionnaire about Disease Mongering and the Influence of the Drug Industry on Clinical Practice
(25 KB DOC).

Acknowledgments
I would like to acknowledge the support of P. Sulochana, Correspondent, Sai Padmavathi School of Pharmacy, Tirupathi

C. Jairaj Kumar
E-mail: jairaj81in@yahoo.co.in
Abhizith Deoker
Ashwini Kumar
Arunachalam Kumar
Kasturba Medical College Mangalore
Karnataka, India
B. M. Hegde
Manipal Academy of Higher Education
Manipal, Karnataka, India

References
Lal A (2001) Pharmaceutical drug promotion: How it is being practiced in India? J Assoc Physicians India 49: 266–273.

Kumar CJ, Kumar A (2005) Is prescription necessary to buy drugs in India [abstract]? Regional Conference on Medical Ethics; 2005 7–8 March Tirupati, India: Padmavathi School of Nursing. pp 3–5.

Kohn L, Corrigan J, Donaldson M, editors (2000) To err is human: Building a safer health system. Washington (D. C.): National Academy Press. 287 p.
Starfield B (2000) Is US health really best in the world? JAMA 284: 483–485.

Hegde BM (2001) Is academic medicine for sale? J Assoc Physicians India 49: 831–832.

Angell M (1997) Anti-polymer antibodies, silicone breast implants, and fibromyalgia. Lancet 349: 1171–1172.

Smith R (2003) The screening industry. BMJ 326. Available: http://bmj.bmjjournals.com/cgi/content/full/326/7395/0/f. Accessed 8 March 2006.

[Anonymous] (2000) Drug company influence on medical education in USA. Lancet 356: 781–783.

Funding: The authors received no specific funding for this article.
Competing Interests: The authors have declared that no competing interests exist.

Originally published in PLOS Medicine.

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We all know life is uncertain and death inevitable. Yet how many of us are really ready and geared up for any drastic change, especially an unpleasant one? Mostly everyone is an escapist. When confronted with such a question we become evasive or just brush it aside saying we’ll see when the time comes or anything bad happens.

And so when something horrid takes place, life wakes us up from complacency with a jolt and we are crushed emotionally and mentally. We read tragedies or identify with the sadness of a protagonist in a novel or film, not so much to make ourselves ready for our own tragedies, but to feel better about our pleasant condition as compared to theirs.

And we need to simply reiterate the transitory nature of it all. By reminding ourselves everyday about the temporal and fleeting character of life, we not only accept unpleasant changes gracefully but also save ourselves of the after shock. More so, we make our present more fulfilling and gratifying. To ready oneself for any situation in life is true spirituality and the crux of true understanding of life.

Let us be able to take ourselves to that pinnacle.

Still preparing,
Manjit

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2. Blabbermouth
a) Reticent
b) A person who talk too much indiscreetly
c) Related to a whale
d) Indecent talker

3. Buttinsky (slang)
a) Related to butt
b) Related to a fish
c) A meddler
d) Related to human anatomy

4. Conversable
a) Easy and pleasant to talk with
b) Offensive
c) A gaseous drink
d) Pertaining to an entertainment

5. Hearken (literature)
a) Careless
b) Without any sense
c) A type-set
d) To listen

6. Indic
a) Related to India
b) Full of vitality
c) Related to an ancient civilization
d) None of the above

7. Lurch
a) Plant branch
b) An act of sudden sway
c) Betrayal
d) None of the above

8. Nebulose
a) Cloudlike
b) Related to stars or galaxies
c) Hazy
d) Both a & C

9. Pecky (related to timber)
a) Kissable
b) Spotted with fungi
c) Solid
d) Coloration of leaves

10. Wabble
a) Dress heavily
b) To wobble
c) To talk nonsense
d) None of the above

Answers:
1. (d) 2. (b) 3. (c) 4. (a) 5 (d) 6 (a) 7 (b) 8 (d) 9. (b) 10 (b)

Your Score:
8-10 Excellent
5-7 Good
1-4 Need improvement

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