Brad Warthen's Blog

Stem cells and the Kulturkampf see-saw

Here's a place for those of you who are so inclined to comment on the Obama administration's new policy on stem cells. That is to say, the latest tilt in the Kulturkampf see-saw. Republicans get in charge, it tilts one way. Democrats get in charge, it tilts the other. And so it continues, even in the "post-partisan" era.

I don't know what to say about it myself because ... I don't know; I guess I haven't thought about it enough or something. The partisans seem REALLY sure of their sides, and personally, I don't know how they can be. But maybe it's something missing in me.

I suppose I was relatively comfortable with the Bush position because, near as I could tell, it was a compromise. But then, if I'm reading correctly, the Obama position is ALSO to some extent a compromise, because some restrictions will remain. And yet it is touted as a total reversal, which perhaps it is. I find it confusing.

It's not something we have a position on as an editorial board, because on these culture war things we are often genuinely conflicted. Many editorial boards are quick to sound off on these things because they are more ideologically homogeneous than we are. For us, it's not so simple, and we generally prefer to use up our political capital with each other struggling over the very difficult issues facing South Carolina, which are tough enough.

Anyway, if you read the editorials of most newspapers on the subject, you might think that there is no controversy at all, that the Obama position is of course the right and true one, and you need to be awfully backward to think otherwise -- nothing short of a triumph of science over the forces of darkness. Some examples:

• The New York Times: "We welcome President Obama’s decision to lift the Bush administration’s restrictions on federal financing for embryonic stem cell research. His move ends a long, bleak period in which the moral objections of religious conservatives were allowed to constrain the progress of a medically important science."
• The Boston Globe: "We applaud President Obama's executive order reversing the ban on federal stem-cell research, and the return of science unhobbled by political or religious considerations." (Actually, that quote is not from the editorial itself, but from the blurb summarizing it online.)
• The Philadelphia Inquirer: "Americans are understandably divided over President Obama's decision to lift restrictions on federal funding of human embryonic stem-cell research. But he took the course that promises the greater medical benefit. In reversing a funding ban imposed by President Bush, Obama yesterday also took a welcome step toward restoring the rightful place of scientific research in guiding public policy."
• St. Louis Post-Dispatch: "Federal funding is no guarantee that embryonic stem cell research will provide hoped-for cures to dreaded diseases like diabetes, let alone guarantee that any cures might come soon. But the executive order that Mr. Obama signed on Monday will clear away bureaucratic and procedural hurdles that have hampered that research. It provides an important new source of funding. Perhaps most important, it signals a new commitment to science ideals, free inquiry and open debate in American public policy."

The relatively "conservative" Chicago Tribune was more muted in its praise and even-handed in its presentation, but nevertheless expressed approval for the Obama move, saying the Bush policy had been too restrictive:

Sensible barriers to federal funding for cloning and the creation of embryos for research purposes remain in place. On Monday, Obama asked lawmakers to provide the support that will put the country at the forefront of vital stem cell research. It's now up to Congress to get behind the scientists. All Obama did was get out of their way.

And The Wall Street Journal? No editorial. But they did run an op-ed piece criticizing the new policy, headlined, "The President Politicizes Stem-Cell Research," with the subhead, "Taxpayers have a right to be left out of it."

That last point is one that one doesn't see emphasized enough, which is that this is not about whether research is allowed, but whether we the taxpayers will pay for it. And that's a legitimate conversation to have.

Another point that I would appreciate being updated on, and that seems to get ignored in the shouting matches, is the idea that the science has made the political argument moot, in terms of moving beyond the need for embryonic cells. That was the point made in this Krauthammer column a while back:

    A decade ago, Thomson was the first to isolate human embryonic stem cells. Last week, he (and Japan's Shinya Yamanaka) announced one of the great scientific breakthroughs since the discovery of DNA: an embryo-free way to produce genetically matched stem cells.
    Even a scientist who cares not a whit about the morality of embryo destruction will adopt this technique because it is so simple and powerful. The embryonic stem cell debate is over.

Was that wishful thinking on Krauthammer's part? Did that turn out to be a dead-end? Maybe some of you who follow the issue more closely than I do can point to something I should read to that effect.

Anyway, I'll be interested to see what Krauthammer says about it, if he addresses it. He has an interesting perspective for someone wearing the "conservative" stamp. First, to my knowledge he's not anti-abortion. Also, he is a physician by training, and he served on the Bush administration's Council on Bioethics, which HE maintains (and I'm sure some of you will disagree, although I just don't know) was...

... one of the most ideologically balanced bioethics commissions in the history of this country. It consisted of scientists, ethicists, theologians, philosophers, physicians -- and others (James Q. Wilson, Francis Fukuyama and me among them) of a secular bent not committed to one school or the other.

Anyway, that ought to be enough fodder to get y'all started, if you want to discuss this.

Working out is hard to do

Set that headline to the Neil Sedaka tune, which seems appropriate. After trying to get back into working out the last couple of days, I feel about as macho as Neil Sedaka. Not to cast any aspersions, but I haven't exactly been coming on like Ah-nold. I look in the mirror in the locker room, and I see a flabalanche.

How bad is it? It had been so long since I had worked out -- maybe once or twice the middle of last year, I guess -- that it took me at least 10 minutes to remember my locker combination. That has never happened to me before since I first learned to work a combination lock in the seventh grade. I've had this lock for years, and there I was sweating over the fact that I knew there was a 35 in there somewhere, and I had a general idea (within two or three numbers) of what another number was, but I had no idea in what order. And as it turned out, I was somewhat wrong about the 35, as I learned on about my 30th guess.

Anyway, on Monday I did 25 minutes on the elliptical trainer, and one circuit of light weights, then some stretches to close, and was worn out. Then Tuesday, I did 35 minutes on the elliptical, followed by five or six minutes on the rowing machine. And I experienced new vistas of being out of shape. That first day, the last five minutes on the elliptical -- the cool-down, during which I reverse the action just to work different muscles -- was ridiculously hard.

The only good news is that when you're 55, if you go by the charts, it's REALLY easy to reach your target heart rate.

Why do I mention this to you? Because I figure if I mention it to somebody, you'll help hold me accountable. I AM going to work out again today. Y'all hold me to it, please. To paraphrase John Winger in "Stripes," if I don't get into shape, I'll be dead before I'm 30. Or however old I am.

Palmetto Health comes out swinging

Well, you're not going to be surprised to know that Palmetto Health is not a BIT pleased that Providence Hospital and Lexington Medical Center have cut a deal on open-heart and left it out. Palmetto Health issued this statement at 4:37 this afternoon, after the other two parties made their big announcement:

IMMEDIATE RELEASE
Feb. 25, 2009

Statement by Charles D. Beaman, Jr., CEO, Palmetto Health

I have great respect for the dedicated professionals associated with Lexington Medical Center and Providence Hospital. However, I am surprised and very disappointed that the leaders of those hospitals excluded Palmetto Health when they negotiated a private agreement regarding health care delivery for the Midlands of South Carolina.

Palmetto Health is the largest provider of health care in the area.  We have been urging collaboration and cooperation from the beginning.

Frankly, I am at a loss to understand why a private agreement regarding health care delivery would be negotiated and announced that excludes the region’s largest hospital system.  Our goal is to provide the best, most efficient services to the families of central South Carolina.  It is simply not possible to develop a regional health care delivery plan that excludes Palmetto Health.  

Here are just a few of the questions left unresolved by the private agreement negotiated by only two of the region’s hospitals:

• Will Lexington Medical Center agree to support Palmetto Health’s plan to build Parkridge Hospital in the Irmo area?  That plan was approved by state officials in August of 2007.  The community involved is eager to have a hospital in their area.  But progress has been blocked for nearly two years by legal maneuvers.
• Will we have sufficient trauma coverage for our region? If open heart surgery must be provided in a hospital that has one of the busiest ERs in the area, why not consider providing trauma services in that same ER?
• Will we have adequate behavioral health services for our region?  Right now Palmetto Health is the only inpatient provider for unfunded patients.  As the state continues to cut services for inpatients and outpatients, our regional hospitals need to work together.
• Where are the oversight and the spirit of cooperation to provide care for the uninsured and underinsured who are showing up in growing numbers at the region’s only safety-net hospital – Palmetto Health Richland?  Is open heart surgery the only service worth sharing?

At Palmetto Health, we remain willing to cooperate and collaborate with other hospital systems to create a true regional health care delivery plan.  And we urge our colleagues in the health care delivery system to focus on the full range of services needed in these difficult economic times. 

In the mean time, our friends in Lexington County can rest assured we will continue to support them in their specialized heart care needs.  Just last week, a patient from Lexington County had his heart blockage removed within 19 minutes of his arrival at Palmetto Health Heart Hospital after being transported there by Lexington County EMS.  We remain ready and able to accommodate patients needing our care.

# # # # #

In those four bulleted items, Chuck Beaman sets out the biggest beefs that Palmetto Health has long held in terms of getting the short end of the stick on Midlands health care -- it treats the most indigent patients, and it maintains the expensive trauma services that the other hospitals don't have to provide because IT does. That's why it was so important to Palmetto Richland to develop it's expanded open-heart program, because it brings in revenue it needs to offset those expenses.

That question, "Is open heart surgery the only service worth sharing?" is about as loaded as a question gets. Lexington has argued all along that it needed open heart because it was getting such a disproportionate share of acute cardiac cases coming into its ER. In that case, the other hospitals have said, why don't you beef up ER -- which would COST money, rather than bringing it in the way open-heart does. Now, Providence isn't saying that, and is getting $15 million, and Palmetto Health is feeling very isolated and neglected.

Note that the release doesn't promise to keep opposing Lexington's CON request on open-heart, but says it will be happy to continue serving those patients at the Richland campus, which one of course reads as meaning the same thing.

Bottom line: Two of the combatants have made peace. But the war's not over.

The war is over -- between Providence and Lexington Medical

Just to briefly mention what I've been up to on this Ash Wednesday, we had a meeting this morning with representatives of Providence Hospital and Lexington Medical Center. They had come to jointly announce a major breakthrough -- they've stopped fighting over whether LexMed should be allowed to do open-heart surgery.

As you know, Lexington has tried everything it could think of in recent years -- regulatory, legal and political -- to get around the fact that DHEC has said (in a shocking, rare instance of DHEC saying "no" to anyone) that they can't do bypasses. Providence and Palmetto Health have been on the opposite side of the table, arguing that a third such program would be duplicative and damage the quality of overall care in the Midlands by reducing the number of procedures they do below the level considered necessary for maintaining proficiency.

We have agreed with Providence and Palmetto Health on this. In fact, we also opposed Palmetto Health expanding its heart program several years back, on the same grounds, but DHEC approved it. We have maintained that yet a third such program would be insupportable.

But now two of these three parties have decided to stop spending millions fighting each other, and after months of negotiations have agreed on the following:

• Providence and Lexington Medical will ask DHEC to "de-certify" one of Providence's four open-heart surgical suites.
• The two will then ask DHEC to certify ONE such unit at Lexington Medical.
• Lexington will drop its challenge to certificates for expansion for Providence Northeast.
• Lexington will pay Providence, in three installments, a total of $15 million to compensate it for the lost revenues from de-certifying a unit.

So what's missing? Well, Palmetto Health. What we have here is a classic 1984 sort of situation: Eastasia and Eurasia have always been at war with Oceania. But now Eurasia and Oceania are friends. Does that mean they are now at war with Eastasia -- I mean, Palmetto Health? Well, no -- at least not at this moment. But Palmetto Health is not a part of the peace agreement, and it's hard to see how the overall battle over this issue is over until it is. We'll see in the coming days.

All of that is not to take away from what a huge breakthrough this is. This has been a very, VERY bitter battle that has distorted local politics as well as spending all that money on lawyers and such. As one who lives right behind Lexington Medical, I can tell you I've caught a lot of heat over this emotional issue, as has the newspaper. It's been tough to get people to look beyond the feelings to the larger issue. (One way I've tried to do that personally has been by pointing out that if I were having a heart attack, I'd have to be transported right past Lexington, only a mile from my house, to Providence -- but that I believe that situation is best for the community overall, in terms of better outcomes for more patients in the Midlands.)

Now, suddenly, it's over? Well, this part of it is. And I find myself torn between on the one hand celebrating the end of a really destructive conflict, and wondering why it's suddenly OK for an experienced open-heart team to be replaced by a startup? Mind you, I'm sure Lexington Medical will do as a good a job as anyone could starting such a program. It's an excellent hospital, and takes tremendous pride in doing everything it does well. Still, all things being equal, would we not be better off with the established team at Providence doing that portion of the region's procedures?

The thing is, politically and financially and in other ways, all things were NOT equal, and continued conflict had its cost. So I can see why Providence has agreed to this even as I have reservations. Lexington Medical is giving ground, too, by the way, aside from giving up money -- it still has objections to the wisdom and advisability of the Providence Northeast expansion. But it's dropping those concerns in the interests of agreement.

By the way, as a brief primer on the importance of money in all these considerations: When Providence started doing open-heart decades ago, it wasn't a money-maker. The Sisters of Charity did it because somebody in South Carolina needed to. Later, open-heart surgery became very lucrative. And while I fully believe that all parties believed they were also doing what was best for their patients, the money has played a big role at each step in these battles. Palmetto Richland, with the largest share of indigent care and an extremely expensive trauma unit, needed to expand into heart surgery to have something that brought in revenues. Lexington didn't want to be left out of that. And Providence, which has struggled financially in recent years after an ill-advised partnership with a for-profit corporation (which the good sisters mortgaged their convent to get out of), could ill afford to give up the revenues.

That's the simplistic, "it's all about money" explanation. There are other factors at work as well. One of them is that the treatment of heart disease is increasingly moving beyond open-heart, often to less invasive therapies. That's one reason why Providence was unwilling to give up part of a pie that was diminishing in overall size. But it also seems to be a reason why it is willing to give it up now -- open-heart isn't the future the way it once was, so Providence sees no point in continuing a wasteful fight over a portion of the diminishing number of such procedures to be done in the future.

Meanwhile, if I heard it right today, Lexington is NOT giving up its objections to a certificate involving the main Providence campus. So all is not sweetness and light, with all conflicts behind us in this community.

But no doubt about it, this is a major step by these two very important local institutions. It's huge. But it's SO huge, and complicated, that much remains to be sorted out.

Reactions to the president's speech?

As I noted, I missed the start of Obama's speech, and at this point I won't feel confident commenting on it in full until I've had a chance to go back and catch up, which I might not do until tomorrow at this rate. I don't have Obama's stamina. It's been a long day, and tomorrow is Ash Wednesday. (That Obama sure knows how to celebrate Mardi Gras, huh? What a workaholic. It's after 10, and he's still going...)

But I thought I'd provide y'all with this space to share YOUR observations, so have at it...

Oh, yeah -- you can read about it here and here and here.

Did Nancy get hold of the bong?

After dropping by to see the twins on my way home tonight and getting a late start on dinner, I didn't tune in to Obama's speech until way into it. And watching, all I could think for a moment was, "What's with that weird stoner smirk on Nancy Pelosi's face?" Did she get ahold of Phelps' bong? I pointed it out to my wife, who said maybe she had a little drink first.

Joe Biden, on the contrary, looks pretty normal. Or as normal as he can look when not talking, which of course is NOT normal for him.

I guess I need to catch up on what has been actually said here... I hope it was good.

Just now, the president promised a cure for cancer.... That certainly got my attention...

Fair warning: I'm back on the hard stuff

Remember the miracle nose-drying drug I told you about yesterday? Well, forget that. I spent the night snuffling, blowing, practically drowning. And this morning I had to hold my breath to eat, because I couldn't breathe through my nose at all.

So nothing had worked. Not the zyrtec, not the allegra, not the Alka-Seltzer Plus, not the diphenhydramine, not the Afrin, not the celebrated ipratropium bromide, even in various combinations.

Those of you who have suffered, really suffered, with hay fever probably know what that means. Yes, I had to Go Nuclear. I called the doctor's office, and they told me to go ahead and take the prednisone that I keep on hand for severe asthma -- but which will work just as well on hay fever, itchy eyes, etc., when you run out of other options. I took 60 mg. (six pills) as soon as I got off the phone, and will take another 40 tonight, and then it will take nine more days to taper off of it. You can't just quit this stuff all of a sudden.

This is the second time in two months, after I'd managed not to resort to it since 2007. Dang.

You ever take this stuff? I don't know what it does to you, but it jacks me up. As an uncle once said when he first took it, "It revs my motor." It stimulates appetite (causing weight gain), interferes with sleep, and has various other effects on the bod that are less than pleasant. Although it's not a hallucinogen, for some reason it puts me in mind of what Wolfe wrote about Owsley Blues: "with a picture of Batman on them, 500 micrograms worth of Superhero inside your skull." Or imagine swallowing little Three Mile Islands and feeling them start to glow inside you...

But I exaggerate. Of course, that's one of the side effects.

So I thought I'd warn you that posts such as this one, written on my last prednisone experience, could be coming at you.

That's the bad news. The good news is that it freaking works. It always does. Also, it's cheap -- like aspirin. You just hate to have to resort to it.

Did you see the Gossett column?

Just by way of completing a loop...

Remember my column of Jan. 25, in which I wrote, in part:

    While I was writing that column, I heard from my colleague Cindi Scoppe that Manufacturers Alliance chief Lewis Gossett was sending us an op-ed clarifying his position after The State’s Sammy Fretwell had reported that he and S.C. Chamber of Commerce president Otis Rawl were supporting legislative efforts to put DHEC in the governor’s Cabinet.
    Not having received that op-ed (and we still hadn’t received it a week later, when this page was composed), I just wrote around the business leaders, and focused on another Fretwell story that reported that the chairman of the DHEC board, Bo Aughtry, was supportive of the Cabinet idea. “It is worthy of serious consideration because I believe it would take some of the political influence out of decisions that really should not be political,” he had told Sammy.

That ran something like 10 days after I'd heard that we were going to get that "clarifying" op-ed.

Well, it ran on Monday, in case you missed it. Here's a link.

By way of full disclosure, I want to tell you that it didn't take Mr. Gossett quite as long as it looks to get back to us. Cindi (who handles local op-eds these days) says in answer to my asking her today that she received it on Feb. 5. It was the right length for a Monday slot (it was short, and we usually run a short op-ed on Mondays), and she wasn't able to get it edited to her satisfaction in time to run it on Monday, Feb. 9 (content for that page had to be ready on the morning of Feb. 6). So it ran on the following Monday, Feb. 16.

Just so you know.

Anyway, Mr. Gossett had three main points in his piece:

1. First, he wanted to complain that in their stories about DHEC Sammy and John down in the newsroom had reported only part of what he had said on the subject. (Of course, anyone can say that at any time unless we just publish transcripts of interviews, but you get what he means -- that in his opinion, important points were left out.)
2. Then, he wanted to say that while "I generally prefer the Cabinet form of government if any restructuring is necessary," he doesn't think it's necessary in this case.
3. Finally, he wanted to say that DHEC is really as tough on manufacturers as it needs to be.

Actually, you know what? Never mind my summary of what he said (even though summarizing what people say is kinda what I do professionally); he might claim I left out the important parts. Just go read it.

You might also want to read the Bo Aughtry piece ALSO saying his support of restructuring was not accurately represented. And then you might fully understand what I said at the outset of my Jan. 25 column:

JUST IN CASE you were wondering, or knew and had forgotten, this is the way the political culture pushes back against change in South Carolina: Not with a bang, but with an “Aw, never mind.”
    Remember last week’s column, in which I offered, as a rare sign of hope, the gathering consensus that the state Department of Health and Environmental Control should be made more accountable by placing it directly under the elected chief executive? Well, ever since then, there’s been some backtracking.

Keep a clean nose

Here's a little news-you-can-use info.

You remember how sick I was before Christmas? Well, I never really got over it. I had the usual resolution to start working out in the New Year, and still haven't done it once, because I haven't had a day when I didn't feel like total crud, Ferris.

It's morphed. Started out as upset stomach, turned into bronchitis, followed by asthma, followed by recurring bouts of the worst head cold/allergy symptoms I've experienced in many a day. I've done two courses of antibiotics, been on prednisone over a week in between, and in the last few weeks have been taking antihistamines and associated remedies every four hours, including in the middle of the night, and STILL haven't been able to stop my nose from running.

And when I talk runny nose, I'm talking incapacitating. Like you can't do anything but blow. Night before last, my wife was leaving the kitchen and asked me to mash the potatoes she had just cooked. I said I couldn't. Feeling guilty, I TRIED while she was out of the room, but it went like this -- blow nose (and I'm talking fire hose here, not some dainty dabbing), throw away the tissue, wash hands, dry hands, pick up fork, turn to the potatoes, DROP fork, grab tissue, blow just in time, and so on. Had lunch yesterday with Clemson's President James Barker, and it was really embarrassing. I must have gone through half a box of tissues; poor President Barker.

I was taking antihistamines (diphenhydramine, Alka-Seltzer Plus) on top of other antihistamines (zyrtec, or, when I lose faith in that, allegra 180) and still couldn't stop it. The only way I could go to sleep was stop up my nose with cotton balls. Yeah, way more than you wanted to know; I getcha.

But I say all this not to gross you out or cry the blues, but to tell you about the drug that my allergist's office called in yesterday. It was a nasal spray called ipratropium bromide, the generic name (and of course, I got the generic) for something that is marketed as Atrovent.

It worked unbelievably well. No, I still don't feel great; my sinuses still hurt -- but my nose is no longer like a busted fire hydrant. It's dry. I'm able to use my hands for extended periods for something other than reaching for the Puffs.

And I'm sort of shocked that in 55 years of fighting severe allergies, with all the major hay fever bouts I've had, I've never run across this before. Or if I did, I'd forgotten it.

So, in case you have similar problems, I thought I'd let you know about it. Look on this as one of those "ask your doctor about..." ads, except that I'm not getting paid for it. Which shows you what a terrible businessman I am. Maybe I should get an agent.

There's one cool side effect. All of a sudden, I understand "Subterranean Homesick Blues." Maybe that's what I've got. Seems as good a diagnosis as any. Just follow the links:

Johnny's in the basement
Mixing up the medicine
I'm on the pavement
Thinking about the government
The man in the trench coat
Badge out, laid off
Says he's got a bad cough
Wants to get it paid off
Look out kid
It's somethin' you did
God knows when
But you're doin' it again...

Keep a clean nose
Watch the plain clothes
You don't need a weather man
To know which way the wind blows...

Have you seen the PETA billboard?

While I disagree with the dope-legalization folks, I can at least see why they use the Michael Phelps case to promote their cause. A little more unexpected is the very local, specific way that PETA has used it to promote its agenda.

I think I mentioned before that PETA was putting up a billboard locally. Well, they say it's up now, over on the outskirts of Shandon, or Old Shandon, or whatever. I haven't seen it. Have you? That's it above, and below is the release about it:

IN WAKE OF MICHAEL PHELPS BONG INCIDENT, PETA'S NEW ANTI-POT (ROAST) BILLBOARD RISES NEAR USC

Meat Is a Bigger Health Hazard Than Marijuana, Says Group
 

Columbia, S.C. — The infamous photo of Olympic swimmer Michael Phelps as he tokes a bong has now given rise to more than just a few million eyebrows—namely, a brand-new PETA billboard. The billboard—which shows a cow's face next to the tagline "Say 'No!' to Pot … Roast. Don't Be a Meathead. Kick the Habit!"—aims to warn students about a substance that can be even more hazardous to their health than marijuana: meat. Click here to view the billboard, which is located at the intersection of Millwood Avenue and King Street in Columbia.

Bongs and needles aren't the only place drugs are found; meat often is loaded with drugs — including hormones and antibiotics. Consumption of artery-clogging meat and other animal products has been linked to heart disease, obesity, diabetes, and several types of cancer — not to mention other hazards, such as E. coli, salmonella, and listeria. So while smoking marijuana is illegal, eating meat can be deadly.

Not only is eating animal flesh responsible for the horrendous suffering of billions of chickens, fish, cows, and pigs, it also wreaks havoc on the planet. A recent U.N. study found that raising animals for food creates more greenhouse-gas emissions than all the cars, trucks, trains, and planes in the world combined and contributes to water pollution and land degradation.

"While Michael was busy apologizing for smoking pot, millions of Americans should have been apologizing for eating pot roast—to animals, to the planet, and to their own bodies, " says PETA Executive Vice President Tracy Reiman. "We want to remind USC students that while smoking pot might land them in front of the dean, eating meat burgers and chicken nuggets could land them an early date with their maker."

To view the ad, go to PETA's blog. For more information about the benefits of going vegetarian, please visit PETA.org.

            #

You know, for my part I've been eating less beef lately. I've eaten a lot of turkey burger instead, so I don't think PETA's going to be proud of me on that score.

So you can assume I am NOT sharing this with you in order to endorse the PETA agenda. But I do hope that if you pay enough attention to PETA, with its campaigns for the rights of George the Lobster and so forth, you'll turn back to me and see me as reassuringly moderate and sensible...

You know, if these folks stuck to vegetarianism as a health and environmental issue they'd gain more traction -- and they're wise to emphasize those points. It's when it's all driven by a view of animals as having RIGHTS akin to those of people that they lose me.